Real-time differentiation of adenomatous and hyperplastic diminutive colorectal polyps.
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Real-time differentiation of adenomatous and hyperplastic diminutive colorectal polyps.
- 2. Introduction ● Can we ignore diminutive distal colon hyperplastic polyps? ○ Vleugels JLA, Hazewinkel Y, Fockens P, Dekker E. Natural history of diminutive and small colorectal polyps: a systematic literature review. Gastrointest Endosc. 2017;85(6):1169-1176.e1. ● Distinguish adenoma (especially sessile serrated adenoma) / hyperplastic polyps is difficult. Short, Matthew W., et al. "Colorectal cancer screening and surveillance." American family physician 91.2 (2015).
- 3. NBI International Colorectal Endoscopic classification Utsumi T, Iwatate M, Sano W, et al. Polyp Detection, Characterization, and Management Using Narrow- Band Imaging with/without Magnification. Clin Endosc. 2015;48(6):491-7.
- 4. WASP classification system Vleugels JL, Ijspeert JE, Dekker E. Serrated lesions of the colon and rectum: the role of advanced endoscopic imaging. Best Pract Res Clin Gastroenterol. 2015;29(4):675-86.
- 5. Methods: obtaining of videos Olympus 190 Series Far focus mode Near focus mode Resected & retrieved NICE Classification
- 6. Methods: convolutional neural network
- 7. Methods: the overall process
- 8. Methods: augmentation and the architecture
- 9. Methods: dataset size ● The training, validation, and final testing sets of endoscopic videos of polyps had no overlaps. ● Training set: 223 polyp videos: 29% NICE type I, 53% type II, 18% normal mucosa ○ Comprising 60080 frames ● Validation set: 40 polyp videos
- 10. Methods: credibility credibility(t)= alpha * credibility(t−1) + (1−alpha) * update(t) update(t): prediction changed alpha: a founded parameter
- 11. Result: the final testing set ● The final test set: 125 consecutively identified diminutive polyps ○ 51 hyperplastic polyps ○ 74 adenomas 158 consecutive diminutive polyps 3: SSP 25: normal or lymphoid tissue 2: faecal material 1: corrupted 2: multiple polyps in one frame 125 polyps for final testing dataset
- 12. Result: the high confidence prediction ● Only 106 polypes was labeled as “high confidence”. ● Accuracy of the model was 94% (95% CI: 86% - 97%) ● Adenoma: sensitivity 98% (95% CI: 92% ~ 100%); negative predictive value: 97% specificity 83%(95% CI 67% ~ 93%); positive predictive value: 90%
- 13. Result: AUC
- 15. Discussion Abu dayyeh BK, Thosani N, Konda V, et al. ASGE Technology Committee systematic review and meta- analysis assessing the ASGE PIVI thresholds for adopting real-time endoscopic assessment of the histology of diminutive colorectal polyps. Gastrointest Endosc. 2015;81(3):502.e1-502.e16.
- 16. Discussion ● Real time recognition: 50 ms ● Previous studies have used magnifying colonoscopes or endocytoscopy, both of which are rarely available in the USA or Europe. ● Limitation ○ The collection of the videos was done by a single operator. ○ The videos was not collected for this (CADx) purpose, therefore, some polyps may be blur or partial presented in the videos. ● This algorithm was not optimised for sessile serrated adenoma.
Editor's Notes
- credibility(t)=alpha * credibility(t−1) + (1−alpha) * update(t) update(t) is an indication of whether the model’s predictions have changed between frames at t−1 and t alpha is a parameter between 0 and 1 that is found by searching over a validation set
- 將同一模型每個閾值 的 (FPR, TPR) 座標都畫在 ROC 空間裡，就成為特定模型的 ROC 曲線。
- 將同一模型每個閾值 的 (FPR, TPR) 座標都畫在 ROC 空間裡，就成為特定模型的 ROC 曲線。