Endoscopy 2022; 54(08): 771-777
DOI: 10.1055/a-1731-9535
Innovations and brief communications

A deep learning-based system for real-time image reporting during esophagogastroduodenoscopy: a multicenter study

Zehua Dong
1   Department of Gastroenterology, Renmin Hospital of Wuhan University, Wuhan, China (Ringgold ID: RIN117921)
2   Key Laboratory of Hubei Province for Digestive System Disease, Renmin Hospital of Wuhan University, Wuhan, China (Ringgold ID: RIN117921)
3   Hubei Provincial Clinical Research Center for Digestive Disease Minimally Invasive Incision, Renmin Hospital of Wuhan University, Wuhan, China (Ringgold ID: RIN117921)
,
Lianlian Wu
1   Department of Gastroenterology, Renmin Hospital of Wuhan University, Wuhan, China (Ringgold ID: RIN117921)
2   Key Laboratory of Hubei Province for Digestive System Disease, Renmin Hospital of Wuhan University, Wuhan, China (Ringgold ID: RIN117921)
3   Hubei Provincial Clinical Research Center for Digestive Disease Minimally Invasive Incision, Renmin Hospital of Wuhan University, Wuhan, China (Ringgold ID: RIN117921)
,
Ganggang Mu
1   Department of Gastroenterology, Renmin Hospital of Wuhan University, Wuhan, China (Ringgold ID: RIN117921)
2   Key Laboratory of Hubei Province for Digestive System Disease, Renmin Hospital of Wuhan University, Wuhan, China (Ringgold ID: RIN117921)
3   Hubei Provincial Clinical Research Center for Digestive Disease Minimally Invasive Incision, Renmin Hospital of Wuhan University, Wuhan, China (Ringgold ID: RIN117921)
,
Wei Zhou
1   Department of Gastroenterology, Renmin Hospital of Wuhan University, Wuhan, China (Ringgold ID: RIN117921)
2   Key Laboratory of Hubei Province for Digestive System Disease, Renmin Hospital of Wuhan University, Wuhan, China (Ringgold ID: RIN117921)
3   Hubei Provincial Clinical Research Center for Digestive Disease Minimally Invasive Incision, Renmin Hospital of Wuhan University, Wuhan, China (Ringgold ID: RIN117921)
,
Yanxia Li
1   Department of Gastroenterology, Renmin Hospital of Wuhan University, Wuhan, China (Ringgold ID: RIN117921)
2   Key Laboratory of Hubei Province for Digestive System Disease, Renmin Hospital of Wuhan University, Wuhan, China (Ringgold ID: RIN117921)
3   Hubei Provincial Clinical Research Center for Digestive Disease Minimally Invasive Incision, Renmin Hospital of Wuhan University, Wuhan, China (Ringgold ID: RIN117921)
,
Zhaohong Shi
4   Department of Gastroenterology, Wuhan No. 1 Hospital, Wuhan, China (Ringgold ID: RIN593237)
,
Xia Tian
5   Department of Gastroenterology, Wuhan Third Hospital, Wuhan, China
,
Song Liu
4   Department of Gastroenterology, Wuhan No. 1 Hospital, Wuhan, China (Ringgold ID: RIN593237)
,
Qingxi Zhu
5   Department of Gastroenterology, Wuhan Third Hospital, Wuhan, China
,
Renduo Shang
1   Department of Gastroenterology, Renmin Hospital of Wuhan University, Wuhan, China (Ringgold ID: RIN117921)
2   Key Laboratory of Hubei Province for Digestive System Disease, Renmin Hospital of Wuhan University, Wuhan, China (Ringgold ID: RIN117921)
3   Hubei Provincial Clinical Research Center for Digestive Disease Minimally Invasive Incision, Renmin Hospital of Wuhan University, Wuhan, China (Ringgold ID: RIN117921)
,
Mengjiao Zhang
1   Department of Gastroenterology, Renmin Hospital of Wuhan University, Wuhan, China (Ringgold ID: RIN117921)
2   Key Laboratory of Hubei Province for Digestive System Disease, Renmin Hospital of Wuhan University, Wuhan, China (Ringgold ID: RIN117921)
3   Hubei Provincial Clinical Research Center for Digestive Disease Minimally Invasive Incision, Renmin Hospital of Wuhan University, Wuhan, China (Ringgold ID: RIN117921)
,
Lihui Zhang
1   Department of Gastroenterology, Renmin Hospital of Wuhan University, Wuhan, China (Ringgold ID: RIN117921)
2   Key Laboratory of Hubei Province for Digestive System Disease, Renmin Hospital of Wuhan University, Wuhan, China (Ringgold ID: RIN117921)
3   Hubei Provincial Clinical Research Center for Digestive Disease Minimally Invasive Incision, Renmin Hospital of Wuhan University, Wuhan, China (Ringgold ID: RIN117921)
,
Ming Xu
1   Department of Gastroenterology, Renmin Hospital of Wuhan University, Wuhan, China (Ringgold ID: RIN117921)
2   Key Laboratory of Hubei Province for Digestive System Disease, Renmin Hospital of Wuhan University, Wuhan, China (Ringgold ID: RIN117921)
3   Hubei Provincial Clinical Research Center for Digestive Disease Minimally Invasive Incision, Renmin Hospital of Wuhan University, Wuhan, China (Ringgold ID: RIN117921)
,
Yijie Zhu
1   Department of Gastroenterology, Renmin Hospital of Wuhan University, Wuhan, China (Ringgold ID: RIN117921)
2   Key Laboratory of Hubei Province for Digestive System Disease, Renmin Hospital of Wuhan University, Wuhan, China (Ringgold ID: RIN117921)
3   Hubei Provincial Clinical Research Center for Digestive Disease Minimally Invasive Incision, Renmin Hospital of Wuhan University, Wuhan, China (Ringgold ID: RIN117921)
,
Xiao Tao
1   Department of Gastroenterology, Renmin Hospital of Wuhan University, Wuhan, China (Ringgold ID: RIN117921)
2   Key Laboratory of Hubei Province for Digestive System Disease, Renmin Hospital of Wuhan University, Wuhan, China (Ringgold ID: RIN117921)
3   Hubei Provincial Clinical Research Center for Digestive Disease Minimally Invasive Incision, Renmin Hospital of Wuhan University, Wuhan, China (Ringgold ID: RIN117921)
,
Tingting Chen
1   Department of Gastroenterology, Renmin Hospital of Wuhan University, Wuhan, China (Ringgold ID: RIN117921)
2   Key Laboratory of Hubei Province for Digestive System Disease, Renmin Hospital of Wuhan University, Wuhan, China (Ringgold ID: RIN117921)
3   Hubei Provincial Clinical Research Center for Digestive Disease Minimally Invasive Incision, Renmin Hospital of Wuhan University, Wuhan, China (Ringgold ID: RIN117921)
,
Xun Li
1   Department of Gastroenterology, Renmin Hospital of Wuhan University, Wuhan, China (Ringgold ID: RIN117921)
2   Key Laboratory of Hubei Province for Digestive System Disease, Renmin Hospital of Wuhan University, Wuhan, China (Ringgold ID: RIN117921)
3   Hubei Provincial Clinical Research Center for Digestive Disease Minimally Invasive Incision, Renmin Hospital of Wuhan University, Wuhan, China (Ringgold ID: RIN117921)
,
Chenxia Zhang
1   Department of Gastroenterology, Renmin Hospital of Wuhan University, Wuhan, China (Ringgold ID: RIN117921)
2   Key Laboratory of Hubei Province for Digestive System Disease, Renmin Hospital of Wuhan University, Wuhan, China (Ringgold ID: RIN117921)
3   Hubei Provincial Clinical Research Center for Digestive Disease Minimally Invasive Incision, Renmin Hospital of Wuhan University, Wuhan, China (Ringgold ID: RIN117921)
,
Xinqi He
1   Department of Gastroenterology, Renmin Hospital of Wuhan University, Wuhan, China (Ringgold ID: RIN117921)
2   Key Laboratory of Hubei Province for Digestive System Disease, Renmin Hospital of Wuhan University, Wuhan, China (Ringgold ID: RIN117921)
3   Hubei Provincial Clinical Research Center for Digestive Disease Minimally Invasive Incision, Renmin Hospital of Wuhan University, Wuhan, China (Ringgold ID: RIN117921)
,
Jing Wang
1   Department of Gastroenterology, Renmin Hospital of Wuhan University, Wuhan, China (Ringgold ID: RIN117921)
2   Key Laboratory of Hubei Province for Digestive System Disease, Renmin Hospital of Wuhan University, Wuhan, China (Ringgold ID: RIN117921)
3   Hubei Provincial Clinical Research Center for Digestive Disease Minimally Invasive Incision, Renmin Hospital of Wuhan University, Wuhan, China (Ringgold ID: RIN117921)
,
Renquan Luo
1   Department of Gastroenterology, Renmin Hospital of Wuhan University, Wuhan, China (Ringgold ID: RIN117921)
2   Key Laboratory of Hubei Province for Digestive System Disease, Renmin Hospital of Wuhan University, Wuhan, China (Ringgold ID: RIN117921)
3   Hubei Provincial Clinical Research Center for Digestive Disease Minimally Invasive Incision, Renmin Hospital of Wuhan University, Wuhan, China (Ringgold ID: RIN117921)
,
Hongliu Du
1   Department of Gastroenterology, Renmin Hospital of Wuhan University, Wuhan, China (Ringgold ID: RIN117921)
2   Key Laboratory of Hubei Province for Digestive System Disease, Renmin Hospital of Wuhan University, Wuhan, China (Ringgold ID: RIN117921)
3   Hubei Provincial Clinical Research Center for Digestive Disease Minimally Invasive Incision, Renmin Hospital of Wuhan University, Wuhan, China (Ringgold ID: RIN117921)
,
Yutong Bai
1   Department of Gastroenterology, Renmin Hospital of Wuhan University, Wuhan, China (Ringgold ID: RIN117921)
2   Key Laboratory of Hubei Province for Digestive System Disease, Renmin Hospital of Wuhan University, Wuhan, China (Ringgold ID: RIN117921)
3   Hubei Provincial Clinical Research Center for Digestive Disease Minimally Invasive Incision, Renmin Hospital of Wuhan University, Wuhan, China (Ringgold ID: RIN117921)
,
Liping Ye
6   Department of Gastroenterology, Taizhou Hospital of Zhejiang Province, Zhejiang, China (Ringgold ID: RIN56709)
,
Honggang Yu
1   Department of Gastroenterology, Renmin Hospital of Wuhan University, Wuhan, China (Ringgold ID: RIN117921)
2   Key Laboratory of Hubei Province for Digestive System Disease, Renmin Hospital of Wuhan University, Wuhan, China (Ringgold ID: RIN117921)
3   Hubei Provincial Clinical Research Center for Digestive Disease Minimally Invasive Incision, Renmin Hospital of Wuhan University, Wuhan, China (Ringgold ID: RIN117921)
› Author Affiliations
Supported by: Hubei Province Major Science and Technology Innovation Project 2018-916-000-008
Supported by: Hubei Provincial Clinical Research Center for Digestive Disease Minimally Invasive Incision 2018BCC337

TRIAL REGISTRATION: Registration number (trial ID): ChiCTR2100046695, Trial registry: Chinese Clinical Trial Registry (http://www.chictr.org/), Type of Study: Prospective, observational


Abstract

Background and study aims Endoscopic reports are essential for the diagnosis and follow-up of gastrointestinal diseases. This study aimed to construct an intelligent system for automatic photo documentation during esophagogastroduodenoscopy (EGD) and test its utility in clinical practice.

Patients and methods Seven convolutional neural networks trained and tested using 210,198 images were integrated to construct the endoscopic automatic image reporting system (EAIRS). We tested its performance through man-machine comparison at three levels: internal, external, and prospective test. Between May 2021 and June 2021, patients undergoing EGD at Renmin Hospital of Wuhan University were recruited. The primary outcomes were accuracy for capturing anatomical landmarks, completeness for capturing anatomical landmarks, and detected lesions.

Results The EAIRS outperformed endoscopists in retrospective internal and external test. A total of 161 consecutive patients were enrolled in the prospective test. The EAIRS achieved an accuracy of 95.2% in capturing anatomical landmarks in the prospective test. It also achieved higher completeness on capturing anatomical landmarks compared with endoscopists: (93.1% vs. 88.8%), and was comparable to endoscopists on capturing detected lesions: (99.0% vs. 98.0%).

Conclusions The EAIRS can generate qualified image reports and could be a powerful tool for generating endoscopic reports in clinical practice.

Supporting information



Publication History

Received: 20 July 2021

Accepted after revision: 03 December 2021

Article published online:
10 March 2022

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