中国科学院分子影像重点实验室知识库

Background and Aims: Narrow-band imaging with magnifying endoscopy (ME-NBI) has shown advantages in the diagnosis of early gastric cancer (EGC). However, proficiency in diagnostic algorithms requires substantial expertise and experience. In this study, we aimed to develop a computer-aided diagnostic model for EGM (EGCM) to analyze and assist in the diagnosis of EGC under ME-NBI. Methods: A total of 1777 ME-NBI images from 295 cases were collected from 3 centers. These cases were randomly divided into a training cohort (n Z 170), an internal test cohort (ITC, n Z 73), and an external test cohort (ETC, n Z 52). EGCM based on VGG-19 architecture (Visual Geometry Group [VGG], Oxford University, Oxford, UK) with a single fully connected 2-classification layer was developed through fine-tuning and validated on all cohorts. Furthermore, we compared the model with 8 endoscopists with varying experience. Primary comparison measures included accuracy, area under the receiver operating characteristic curve (AUC), sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV). Results: EGCM acquired AUCs of.808 in the ITC and.813 in the ETC. Moreover, EGCM achieved similar predictive performance as the senior endoscopists (accuracy:.770 vs.755, P = .355; sensitivity:.792 vs.767, P = .183; specificity:.745 vs.742, P = .931) but better than the junior endoscopists (accuracy:.770 vs.728, P<.05). After referring to the results of EGCM, the average diagnostic ability of the endoscopists was significantly improved in terms of accuracy, sensitivity, PPV, and NPV (P<.05). Conclusions: EGCM exhibited comparable performance with senior endoscopists in the diagnosis of EGC and showed the potential value in aiding and improving the diagnosis of EGC by endoscopists.