Automated In Vivo High-Resolution Imaging to Detect Human Papillomavirus-Associated Anal Precancer in Persons Living With HIV.
Automated In Vivo High-Resolution Imaging to Detect Human Papillomavirus-Associated Anal Precancer in Persons Living With HIV.
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DOI：
10.14309/ctg.0000000000000558
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发表时间：
2023-02-01
影响因子：
3.6
通讯作者：
中科院分区：
文献类型：
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作者：
在美国，肛门癌筛查计划的有效性受到缺乏训练有素的专业人员精通高分辨率肛门镜检查（HRA）和高患者失访率的限制。简化肛门上皮内瘤变2级或更严重（AIN 2+）的检测可以从根本上提高肛门癌预防的可及性和效率。提供即时诊断的新型光学成像可以大大改善现有的HRA和基于组织学的诊断。这项工作旨在证明高分辨率显微内窥镜（HRME）结合新型机器学习算法用于肛门癌前病变的自动体内诊断的潜力。HRME是一种光纤荧光显微镜，用于捕获肛门鳞状上皮细胞核的实时图像。使用0.01%wt/vol的原黄素（一种局部造影剂）实现核染色。通过多任务深度学习网络（MTN）分析HRME图像，该网络计算每个HRME图像的AIN 2+概率。这项研究收集了77名艾滋病毒感染者的数据。对于AIN 2+的检测，MTN达到0.84的受试者工作曲线下面积。在AIN 2+概率截止值为0.212时，MTN的性能与专家HRA印象相当，当使用组织病理学作为金标准时，灵敏度为0.92（P = 0.68），特异性为0.60（P = 0.48）。当与HRA结合使用时，该系统可以通过实现实时诊断来促进更具选择性的活检并促进当天的AIN 2+治疗选择。
In the United States, the effectiveness of anal cancer screening programs has been limited by a lack of trained professionals proficient in high-resolution anoscopy (HRA) and a high patient lost-to-follow-up rate between diagnosis and treatment. Simplifying anal intraepithelial neoplasia grade 2 or more severe (AIN 2+) detection could radically improve the access and efficiency of anal cancer prevention. Novel optical imaging providing point-of-care diagnoses could substantially improve existing HRA and histology-based diagnosis. This work aims to demonstrate the potential of high-resolution microendoscopy (HRME) coupled with a novel machine learning algorithm for the automated, in vivo diagnosis of anal precancer. The HRME, a fiber-optic fluorescence microscope, was used to capture real-time images of anal squamous epithelial nuclei. Nuclear staining is achieved using 0.01% wt/vol proflavine, a topical contrast agent. HRME images were analyzed by a multitask deep learning network (MTN) that computed the probability of AIN 2+ for each HRME image. The study accrued data from 77 people living with HIV. The MTN achieved an area under the receiver operating curve of 0.84 for detection of AIN 2+. At the AIN 2+ probability cutoff of 0.212, the MTN achieved comparable performance to expert HRA impression with a sensitivity of 0.92 (P = 0.68) and specificity of 0.60 (P = 0.48) when using histopathology as the gold standard. When used in combination with HRA, this system could facilitate more selective biopsies and promote same-day AIN2+ treatment options by enabling real-time diagnosis.
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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：
6.4
作者：
de Martel C;Plummer M;Vignat J;Franceschi S
通讯作者：
Franceschi S
影响因子：
25
作者：
Dworkin, Jordan D.;Linn, Kristin A.;Bassett, Danielle S.
通讯作者：
Bassett, Danielle S.
DOI：
10.1016/j.compmedimag.2022.102052
发表时间：
2022-04
期刊：
Computerized medical imaging and graphics : the official journal of the Computerized Medical Imaging Society
影响因子：
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作者：
通讯作者：
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亵渎半硫酸盐作为护理点细胞学的荧光造影剂。
影响因子：
3.7
作者：
Prieto SP;Powless AJ;Boice JW;Sharma SG;Muldoon TJ
通讯作者：
Muldoon TJ