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Computer-assisted assessment of colonic polyp histopathology using probe-based confocal laser endomicroscopy

DOI:10.1007/s00384-019-03406-y 期刊:International Journal of Colorectal Disease 出版年份:2019 更新时间:2025-09-12 10:27:22
摘要: Introduction Probe-based confocal laser endomicroscopy (pCLE) is a promising modality for classifying polyp histology in vivo, but decision making in real-time is hampered by high-magnification targeting and by the learning curve for image interpretation. The aim of this study is to test the feasibility of a system combining the use of a low-magnification, wider field-of-view pCLE probe and a computer-assisted diagnosis (CAD) algorithm that automatically classifies colonic polyps. Methods This feasibility study utilized images of polyps from 26 patients who underwent colonoscopy with pCLE. The pCLE images were reviewed offline by two expert and five junior endoscopists blinded to index histopathology. A subset of images was used to train classification software based on the consensus of two GI histopathologists. Images were processed to extract image features as inputs to a linear support vector machine classifier. We compared the CAD algorithm’s prediction accuracy against the classification accuracy of the endoscopists. Results We utilized 96 neoplastic and 93 non-neoplastic confocal images from 27 neoplastic and 20 non-neoplastic polyps. The CAD algorithm had sensitivity of 95%, specificity of 94%, and accuracy of 94%. The expert endoscopists had sensitivities of 98% and 95%, specificities of 98% and 96%, and accuracies of 98% and 96%, while the junior endoscopists had, on average, a sensitivity of 60%, specificity of 85%, and accuracy of 73%. Conclusion The CAD algorithm showed comparable performance to offline review by expert endoscopists and improved performance when compared to junior endoscopists and may be useful for assisting clinical decision making in real time.
作者: Pushpak Taunk,Christopher D. Atkinson,David Lichtenstein,Eladio Rodriguez-Diaz,Satish K. Singh
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To test the feasibility of a system combining the use of a low-magnification, wider field-of-view pCLE probe and a computer-assisted diagnosis (CAD) algorithm that automatically classifies colonic polyps.

The CAD algorithm showed comparable performance to offline review by expert endoscopists and improved performance when compared to junior endoscopists and may be useful for assisting clinical decision making in real time.

A data-driven approach would benefit from a larger cohort of patients. Pre-selection of frames used in the study based on the quality of the imaged mucosa could serve to add an optimistic bias to the observed results. The absence of sessile serrated adenomas (SSAs) in the dataset.

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