Endoscopic Images by a Single-Shot Multibox Detector for the Identification of Early Cancerous Lesions in the Esophagus: A Pilot Study
by
, , and
Yao-Kuang Wang
1,2,3
,
Hao-Yi Syu
4,
Yi-Hsun Chen
1
,
Chen-Shuan Chung
5,
Yu Sheng Tseng
4,
Shinn-Ying Ho
6,
Chien-Wei Huang
7,8,*,†,
I-Chen Wu
1,3,*,† and
Hsiang-Chen Wang
4,*,†
1
Division of Gastroenterology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, No.100, Tzyou 1st Rd., Sanmin Dist., Kaohsiung City 80756, Taiwan
2
Graduate Institute of Clinical Medicine, College of Medicine, Kaohsiung Medical University, No.100, Tzyou 1st Rd., Sanmin Dist., Kaohsiung City 80756, Taiwan
3
Department of Medicine, Faculty of Medicine, College of Medicine, Kaohsiung Medical University, No.100, Tzyou 1st Rd., Sanmin Dist., Kaohsiung City 80756, Taiwan
4
Department of Mechanical Engineering and Center for Innovative Research on Aging Society (CIRAS), National Chung Cheng University, 168, University Rd., Min Hsiung, Chia Yi 62102, Taiwan
5
Department of Internal Medicine, Far Eastern Memorial Hospital, No.21, Sec. 2, Nanya S. Rd., Banciao Dist., New Taipei City 220, Taiwan
6
Institute of Bioinformatics and Systems Biology, National Chiao Tung University, Hsinchu City 30010, Taiwan
7
Department of Gastroenterology, Kaohsiung Armed Forces General Hospital, 2, Zhongzheng 1st Rd., Lingya District, Kaohsiung City 80284, Taiwan
8
Department of Nursing, Tajen University, 20, Weixin Rd., Yanpu Township, Pingtung County 90741, Taiwan
*
Authors to whom correspondence should be addressed.
†
These authors contributed equally to this work.
Cancers 2021, 13(2), 321; https://doi.org/10.3390/cancers13020321
Submission received: 30 December 2020
/
Revised: 11 January 2021
/
Accepted: 11 January 2021
/
Published: 17 January 2021
(This article belongs to the Special Issue Recent Research on Gastrointestinal Carcinoma)
Simple Summary
Detection of early esophageal cancer is important to improve patient’s survival, but accurate diagnosis of superficial esophageal neoplasms is difficult even for experienced endoscopists. Computer-aided diagnostic system is believed to be an important method to provide accurate and rapid assistance for endoscopists in diagnosing esophageal neoplasms. We developed a single-shot multibox detector using a convolutional neural network for diagnosing esophageal cancer by using endoscopic images and the aim of our study was to assess the ability of our system. Our system showed good diagnostic performance in detecting as well as differentiating esophageal neoplasms and the accuracy can achieve 90%. Differentiating different histological grades of esophageal neoplasm is usually conducted by magnified endoscopy and we confirm that artificial intelligence system has great potential for helping endoscopists in accurately diagnosing superficial esophageal neoplasms without the necessity of magnified endoscopy and experienced endoscopists.
Abstract
Diagnosis of early esophageal neoplasia, including dysplasia and superficial cancer, is a great challenge for endoscopists. Recently, the application of artificial intelligence (AI) using deep learning in the endoscopic field has made significant advancements in diagnosing gastrointestinal cancers. In the present study, we constructed a single-shot multibox detector using a convolutional neural network for diagnosing different histological grades of esophageal neoplasms and evaluated the diagnostic accuracy of this computer-aided system. A total of 936 endoscopic images were used as training images, and these images included 498 white-light imaging (WLI) and 438 narrow-band imaging (NBI) images. The esophageal neoplasms were divided into three classifications: squamous low-grade dysplasia, squamous high-grade dysplasia, and squamous cell carcinoma, based on pathological diagnosis. This AI system analyzed 264 test images in 10 s, and the sensitivity, specificity, and diagnostic accuracy of this system in detecting esophageal neoplasms were 96.2%, 70.4%, and 90.9%, respectively. The accuracy of this AI system in differentiating the histological grade of esophageal neoplasms was 92%. Our system showed better accuracy in diagnosing NBI (95%) than WLI (89%) images. Our results showed the great potential of AI systems in identifying esophageal neoplasms as well as differentiating histological grades.
