Artificial intelligence-assisted detection of nasopharyngeal carcinoma on endoscopic images: a national, multicentre, model development and validation study

作者：Yuxuan Shi, Zhen Li, Li Wang, Hong Wang, Xiaofeng Liu, Dantong Gu, Xi Chen, Xueli Liu, Wentao Gong, Xiaowen Jiang, Wenquan Li, Yongdong Lin, Peng Liu, Deyan Luo, Peng Tao, Xuemei Peng, Meimei Tong, Huizhen Zheng, Xuanchen Zhou, Jianrong Wu, Georges El Fakhri, Mingzhang Chang, Jun Liao, Jieen Li, Desheng Wang, Jing Ye, Shenhong Qu, Weihong Jiang, Quan Liu, Xicai Sun, Yefeng Zheng, Hongmeng Yu · 发表于：The Lancet Digital Health · 年份：2025 · DOI：10.1016/j.landig.2025.03.001 · 被引用次数：12 · 研究领域：Head and Neck Cancer Studies、Brain Tumor Detection and Classification、Dysphagia Assessment and Management

BACKGROUND: Nasopharyngeal carcinoma is highly curable when diagnosed early. However, the nasopharynx's obscure anatomical position and the similarity of local imaging manifestations with those of other nasopharyngeal diseases often lead to diagnostic challenges, resulting in delayed or missed diagnoses. Our aim was to develop a deep learning algorithm to enhance an otolaryngologist's diagnostic capabilities by differentiating between nasopharyngeal carcinoma, benign hyperplasia, and normal nasopharynx during endoscopic examination. METHODS: In this national, multicentre, model development and validation study, we developed a Swin Transformer-based Nasopharyngeal Diagnostic (STND) system to identify nasopharyngeal carcinoma, benign hyperplasia, and normal nasopharynx. STND was developed with 27 362 nasopharyngeal endoscopic images (10 693 biopsy-proven nasopharyngeal carcinoma, 7073 biopsy-proven benign hyperplasia, and 9596 normal nasopharynx) sourced from eight prominent nasopharyngeal carcinoma centres (stage 1), and externally validated with 1885 prospectively acquired images from ten comprehensive hospitals with a high incidence of nasopharyngeal carcinoma (stage 2). Furthermore, we did a fully crossed, multireader, multicase study involving four expert otolaryngologists from four regional leading nasopharyngeal carcinoma centres, and 24 general otolaryngologists from 24 geographically diverse primary hospitals. This study included 400 images to evaluate the diagnostic c...