Human-Like Artificial Intelligent System for Predicting Invasion Depth of Esophageal Squamous Cell Carcinoma Using Magnifying Narrow-Band Imaging Endoscopy: A Retrospective Multicenter Study

作者：Lihui Zhang, Renquan Luo, Dehua Tang, Jie Zhang, Yuchen Su, Xin‐Li Mao, Liping Ye, Liwen Yao, Wei Zhou, Jie Zhou, Zihua Lu, Mengjiao Zhang, Y. Xu, Yunchao Deng, Huang Xu, Chunping He, Yong Xiao, Junxiao Wang, Lianlian Wu, Jia Li, Xiaoping Zou, Honggang Yu · 发表于：Clinical and Translational Gastroenterology · 年份：2023 · DOI：10.14309/ctg.0000000000000606 · 被引用次数：17 · 研究领域：Esophageal Cancer Research and Treatment、AI in cancer detection、Lung Cancer Diagnosis and Treatment

INTRODUCTION: Endoscopic evaluation is crucial for predicting the invasion depth of esophagus squamous cell carcinoma (ESCC) and selecting appropriate treatment strategies. Our study aimed to develop and validate an interpretable artificial intelligence-based invasion depth prediction system (AI-IDPS) for ESCC. METHODS: We reviewed the PubMed for eligible studies and collected potential visual feature indices associated with invasion depth. Multicenter data comprising 5,119 narrow-band imaging magnifying endoscopy images from 581 patients with ESCC were collected from 4 hospitals between April 2016 and November 2021. Thirteen models for feature extraction and 1 model for feature fitting were developed for AI-IDPS. The efficiency of AI-IDPS was evaluated on 196 images and 33 consecutively collected videos and compared with a pure deep learning model and performance of endoscopists. A crossover study and a questionnaire survey were conducted to investigate the system's impact on endoscopists' understanding of the AI predictions. RESULTS: AI-IDPS demonstrated the sensitivity, specificity, and accuracy of 85.7%, 86.3%, and 86.2% in image validation and 87.5%, 84%, and 84.9% in consecutively collected videos, respectively, for differentiating SM2-3 lesions. The pure deep learning model showed significantly lower sensitivity, specificity, and accuracy (83.7%, 52.1% and 60.0%, respectively). The endoscopists had significantly improved accuracy (from 79.7% to 84.9% on average, P = 0....