Automated software-assisted diagnosis of esophageal squamous cell neoplasia using high-resolution microendoscopy.
Automated software-assisted diagnosis of esophageal squamous cell neoplasia using high-resolution microendoscopy.
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DOI：
10.1016/j.gie.2020.07.007
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发表时间：
2021-04
影响因子：
7.7
通讯作者：
Anandasabapathy S
中科院分区：
文献类型：
--
作者：
Tan MC;Bhushan S;Quang T;Schwarz R;Patel KH;Yu X;Li Z;Wang G;Zhang F;Wang X;Xu H;Richards-Kortum RR;Anandasabapathy S
高分辨率显微内窥镜（HRME）是一种光学活检技术，可提供食管粘膜的亚细胞成像，但需要专家对这些组织病理学样图像进行解释。我们比较了内镜医师使用自动软件算法检测食管鳞状细胞瘤（ESCN），并评估了内镜医师使用和不使用软件算法输入的准确性。13名内窥镜医师（6名专家，7名新手）接受了培训，并对来自130名接受ESCN筛查/监测的连续患者的218张事后HRME图像进行了测试。自动软件算法将所有图像解释为肿瘤（高度异型增生，ESCN）或非肿瘤。所有内镜医师提供了他们的解释（肿瘤性或非肿瘤性）和置信水平（高或低），不了解和了解突出显示异常细胞核的软件叠加和软件解释。诊断标准为2名病理医师的组织病理学一致性诊断。内镜医师的平均灵敏度较高，（84.3%，标准差[SD] 8.0% vs 76.3%，p=0.004），特异性较低（75.0%，SD 5.2% vs 85.3%，p<0.001），但准确性无显著差异（81.1%，SD 5.2% vs 79.4%，p=0.26）。了解软件算法后，内镜医师的特异性（75.0%-80.1%，p=0.002）显著增加，但灵敏度（84.3%-84.8%，p=0.75）或准确度（81.1%-83.1%，p=0.13）没有增加。特异性的增加是新手（p=0.008），但不是专家（p=0.11）。软件算法对ESCN检测的灵敏度较低，但特异性高于内镜医师。使用计算机辅助诊断，内窥镜医师保持了高灵敏度，同时与最初诊断相比提高了特异性和准确性。人力资源监测和评价自动化解释将有助于在需要这种便携式低成本技术的资源贫乏地区广泛使用。
High-resolution microendoscopy (HRME) is an optical biopsy technology that provides subcellular imaging of esophageal mucosa but requires expert interpretation of these histopathology-like images. We compared endoscopists with an automated software algorithm in esophageal squamous cell neoplasia (ESCN) detection and evaluated the endoscopists’ accuracy with and without input from the software algorithm. Thirteen endoscopists (6 experts, 7 novices) were trained and tested on 218 post-hoc HRME images from 130 consecutive patients undergoing ESCN screening/surveillance. The automated software algorithm interpreted all images as neoplastic (high-grade dysplasia, ESCN) or non-neoplastic. All endoscopists provided their interpretation (neoplastic or non-neoplastic) and confidence level (high or low) without and with knowledge of the software overlay highlighting abnormal nuclei and software interpretation. The criterion standard was histopathology consensus diagnosis by 2 pathologists. The endoscopists had a higher mean sensitivity (84.3%, standard deviation [SD] 8.0% vs 76.3%, p=0.004), lower specificity (75.0%, SD 5.2% vs 85.3%, p<0.001) but no significant difference in accuracy (81.1%, SD 5.2% vs 79.4%, p=0.26) in ESCN detection compared with the automated software algorithm. With knowledge of the software algorithm, the endoscopists significantly increased their specificity (75.0% to 80.1%, p=0.002) but not sensitivity (84.3% to 84.8%, p=0.75) or accuracy (81.1% to 83.1%, p=0.13). The increase in specificity was among novices (p=0.008) but not experts (p=0.11). The software algorithm had lower sensitivity but higher specificity for ESCN detection than endoscopists. Using computer-assisted diagnosis, the endoscopists maintained high sensitivity while increasing their specificity and accuracy compared with their initial diagnosis. Automated HRME interpretation would facilitate widespread usage in resource-poor areas where this portable, low-cost technology is needed.
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影响因子：
7.7
作者：
Quang, Timothy;Schwarz, Richard A.;Richards-Kortum, Rebecca
通讯作者：
Richards-Kortum, Rebecca
影响因子：
12.6
作者：
Louie, Justin S.;Richards-Kortum, Rebecca;Anandasabapathy, Sharmila
通讯作者：
Anandasabapathy, Sharmila
影响因子：
3.3
作者：
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通讯作者：
Helenon, O
影响因子：
3.5
作者：
Ishijima, Ayumu;Schwarz, Richard A.;Richards-Kortum, Rebecca
通讯作者：
Richards-Kortum, Rebecca
影响因子：
9.3
作者：
Lambert, R.;Hainaut, P.
通讯作者：
Hainaut, P.