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Prospective development and validation of a volumetric laser endomicroscopy computer algorithm for detection of Barrett’s neoplasia - 17/03/21

Doi : 10.1016/j.gie.2020.07.052 
Maarten R. Struyvenberg, MD 1, Albert J. de Groof, MD 1, Roger Fonollà, MSc 2, Fons van der Sommen, PhD 2, Peter H.N. de With, PhD 2, Erik J. Schoon, MD, PhD 3, Bas L.A.M. Weusten, MD, PhD 4, Cadman L. Leggett, MD, PhD 5, Allon Kahn, MD 6, Arvind J. Trindade, MD 7, Eric K. Ganguly, MD 8, Vani J.A. Konda, MD 9, Charles J. Lightdale, MD 10, Douglas K. Pleskow, MD 11, Amrita Sethi, MD 12, Michael S. Smith, MD, MBA 13, Michael B. Wallace, MD, MPH 14, Herbert C. Wolfsen, MD 14, Gary J. Tearney, MD, PhD 15, Sybren L. Meijer, MD, PhD 16, Michael Vieth, MD, PhD 17, Roos E. Pouw, MD, PhD 1, Wouter L. Curvers, MD, PhD 3, Jacques J. Bergman, MD, PhD 1, ⁎
1 Department of Gastroenterology and Hepatology, Amsterdam UMC, location AMC, Amsterdam, the Netherlands 
2 Department of Electrical Engineering, VCA group, Eindhoven University of Technology, Eindhoven, the Netherlands 
3 Department of Gastroenterology and Hepatology, Catharina Hospital, Eindhoven, the Netherlands 
4 Department of Gastroenterology and Hepatology, St. Antonius Hospital, Nieuwegein, the Netherlands 
5 Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota, USA 
6 Division of Gastroenterology and Hepatology, Mayo Clinic, Scottsdale, Arizona, USA 
7 Division of Gastroenterology and Hepatology, Zucker School of Medicine at Hofstra/Northwell. Long Island Jewish Medical Center, New Hyde Park, New York, USA 
8 Department of Gastroenterology and Hepatology, University of Vermont Medical Center, Burlington, Vermont, USA 
9 Department of Gastroenterology and Hepatology, Baylor University Medical Center at Dallas, Dallas, Texas, USA 
10 Division of Gastroenterology and Hepatology, New York-Presbyterian Hospital, New York, New York, USA 
11 Department of Gastroenterology and Hepatology, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA 
12 Department of Gastroenterology and Hepatology, Columbia University Medical Center, New York, New York, USA 
13 Division of Gastroenterology and Hepatology, Mount Sinai West & Mount Sinai St. Luke's Hospitals, New York, New York, USA 
14 Division of Gastroenterology and Hepatology, Mayo Clinic, Jacksonville, Florida, USA 
15 Department of Pathology, Wellman Center for Photomedicine, Massachusetts General Hospital, Boston, Massachusetts, USA 
16 Department of Pathology, Amsterdam UMC, location AMC, Amsterdam, the Netherlands 
17 Institute of Pathology, Bayreuth Clinic, Bayreuth, Germany 

∗Reprint requests: Prof. dr. J.J.G.H.M. Bergman, Department of Gastroenterology and Hepatology, Amsterdam University Medical Center, Meibergdreef 9, 1105 AZ Amsterdam, the Netherlands.Department of Gastroenterology and HepatologyAmsterdam University Medical CenterMeibergdreef 9Amsterdam1105 AZthe Netherlands

Abstract

Background and Aims

Volumetric laser endomicroscopy (VLE) is an advanced imaging modality used to detect Barrett’s esophagus (BE) dysplasia. However, real-time interpretation of VLE scans is complex and time-consuming. Computer-aided detection (CAD) may help in the process of VLE image interpretation. Our aim was to train and validate a CAD algorithm for VLE-based detection of BE neoplasia.

Methods

The multicenter, VLE PREDICT study, prospectively enrolled 47 patients with BE. In total, 229 nondysplastic BE and 89 neoplastic (high-grade dysplasia/esophageal adenocarcinoma) targets were laser marked under VLE guidance and subsequently underwent a biopsy for histologic diagnosis. Deep convolutional neural networks were used to construct a CAD algorithm for differentiation between nondysplastic and neoplastic BE tissue. The CAD algorithm was trained on a set consisting of the first 22 patients (134 nondysplastic BE and 38 neoplastic targets) and validated on a separate test set from patients 23 to 47 (95 nondysplastic BE and 51 neoplastic targets). The performance of the algorithm was benchmarked against the performance of 10 VLE experts.

Results

Using the training set to construct the algorithm resulted in an accuracy of 92%, sensitivity of 95%, and specificity of 92%. When performance was assessed on the test set, accuracy, sensitivity, and specificity were 85%, 91%, and 82%, respectively. The algorithm outperformed all 10 VLE experts, who demonstrated an overall accuracy of 77%, sensitivity of 70%, and specificity of 81%.

Conclusions

We developed, validated, and benchmarked a VLE CAD algorithm for detection of BE neoplasia using prospectively collected and biopsy-correlated VLE targets. The algorithm detected neoplasia with high accuracy and outperformed 10 VLE experts. (The Netherlands National Trials Registry (NTR) number: NTR 6728.)

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Abbreviations : BE, CAD, CI, IQR, NDBE, ROI, VLE


Plan


 DISCLOSURE: Dr Weusten has received research support and speakers fees from Pentax Medical. Dr Leggett has received indirect research support from NinePoint Medical. Dr Kahn received an unrestricted travel grant and research equipment from NinePoint Medical. Dr Trindade has received research support NinePoint Medical and consultant fees from Olympus America and Pentax Medical. Dr Ganguly has received consultant fees from Boston Scientific. Dr Konda has received a research grant from Pentax. Dr Pleskow has received consultant fees from NinePoint Medical, Boston Scientific, Olympus, Fuji, Medtronic, and CSA. Dr Sethi has received consultant fees from Boston Scientific, Olympus, and Fujifilm. Dr Smith has received consultant fees from NinePoint Medical. Dr Wallace has received research grants from NinePoint Medical, Fujifilm, Boston Scientific, Olympus, Medtronic, NinePoint Medical, Cosmo/Aries Pharmaceuticals; consultant fees from Virgo Inc, Cosmo/Aries Pharmaceuticals, Anx Robotica (2019), Covidien, and GI Supply; he holds stock options in Virgo Inc and has consulted on behalf of Mayo Clinic for GI Supply (2018), Endokey, Endostart, Boston Scientific, and Microtek; he has received general payments from Synergy Pharmaceuticals, Boston Scientific, and Cook Medical. Dr Tearney has received consultant fees and royalties from NinePoint Medical and research support from Boston Scientific, iLumen, and CN USA Biotech Holdings. Dr Vieth has received honoraria for lecturing from Falk, Shire, and Olympus. Dr Bergman has received research support from NinePoint Medical and speaker fees from Fujifilm. All other authors disclosed no financial relationships.


© 2021  American Society for Gastrointestinal Endoscopy. Tous droits réservés.
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Vol 93 - N° 4

P. 871-879 - avril 2021 Retour au numéro
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