A tablet-interfaced high-resolution microendoscope with automated image interpretation for real-time evaluation of esophageal squamous cell neoplasia
A tablet-interfaced high-resolution microendoscope with automated image interpretation for real-time evaluation of esophageal squamous cell neoplasia
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DOI：
10.1016/j.gie.2016.03.1472
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发表时间：
2016-11-01
影响因子：
7.7
通讯作者：
Richards-Kortum, Rebecca
中科院分区：
文献类型：
--
作者：
Quang, Timothy;Schwarz, Richard A.;Richards-Kortum, Rebecca
背景和目标：近年来，高分辨率显微内镜（HRME）显示出改善食管鳞状细胞瘤筛查的潜力。通过减小系统的尺寸和成本以及结合实时、客观反馈的能力，可以实现在临床环境中，特别是在低资源环境中进一步提高其效用。本文介绍了一种平板电脑接口的HRME与全自动化，实时图像analysis.Methods：平板电脑接口的HRME的性能进行了评估，通过采集图像从口腔粘膜在一个正常的志愿者。开发了一种自动化实时分析算法，并使用来自先前在中国进行筛选或监测内窥镜检查的177例患者的体内研究的训练、测试和验证图像进行了评价。然后在平板电脑HRME中实施该算法，该平板电脑HRME用于获取和分析3例患者的食管组织图像。图像显示旁边的概率，成像区域是neoplastic.Results：平板电脑接口的HRME表现出可比的成像性能以较低的成本相比，第一代笔记本电脑接口的HRME系统。在事后定量分析中，该算法确定肿瘤的敏感性和特异性分别为95%和91%，在验证集相比，84%和95%，实现在原始study.Conclusions：基于平板电脑的HRME是一种低成本的工具，提供定量诊断信息的内窥镜在真实的时间。这对于解释HRME图像的经验较少的操作员来说，在资源较少的环境中尤其有益。
Background and Aims: In recent years high-resolution microendoscopy (HRME) has shown potential to improve screening for esophageal squamous cell neoplasia. Furthering its utility in a clinical setting, especially in lower-resource settings, could be accomplished by reducing the size and cost of the system as well as incorporating the ability of real-time, objective feedback. This article describes a tablet-interfaced HRME with fully automated, real-time image analysis.Methods: The performance of the tablet-interfaced HRME was assessed by acquiring images from the oral mucosa in a normal volunteer. An automated, real-time analysis algorithm was developed and evaluated using training, test, and validation images from a previous in vivo study of 177 patients referred for screening or surveillance endoscopy in China. The algorithm was then implemented in a tablet HRME that was used to obtain and analyze images from esophageal tissue in 3 patients. Images were displayed alongside the probability that the imaged region was neoplastic.Results: The tablet-interfaced HRME demonstrated comparable imaging performance at a lower cost compared with first-generation laptop-interfaced HRME systems. In a post-hoc quantitative analysis, the algorithm identified neoplasia with a sensitivity and specificity of 95% and 91%, respectively, in the validation set compared with 84% and 95% achieved in the original study.Conclusions: The tablet-based HRME is a low-cost tool that provides quantitative diagnostic information to the endoscopist in real time. This could be especially beneficial in lower-resource settings for operators with less experience interpreting HRME images.