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Xu ZH, Fan DG, Huang JQ, Wang JW, Wang Y, Li YZ. Computer-Aided Diagnosis of Laryngeal Cancer Based on Deep Learning with Laryngoscopic Images. Diagnostics (Basel) 2023; 13:3669. [PMID: 38132254 PMCID: PMC10743023 DOI: 10.3390/diagnostics13243669] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2023] [Revised: 12/11/2023] [Accepted: 12/12/2023] [Indexed: 12/23/2023] Open
Abstract
Laryngeal cancer poses a significant global health burden, with late-stage diagnoses contributing to reduced survival rates. This study explores the application of deep convolutional neural networks (DCNNs), specifically the Densenet201 architecture, in the computer-aided diagnosis of laryngeal cancer using laryngoscopic images. Our dataset comprised images from two medical centers, including benign and malignant cases, and was divided into training, internal validation, and external validation groups. We compared the performance of Densenet201 with other commonly used DCNN models and clinical assessments by experienced clinicians. Densenet201 exhibited outstanding performance, with an accuracy of 98.5% in the training cohort, 92.0% in the internal validation cohort, and 86.3% in the external validation cohort. The area under the curve (AUC) values consistently exceeded 92%, signifying robust discriminatory ability. Remarkably, Densenet201 achieved high sensitivity (98.9%) and specificity (98.2%) in the training cohort, ensuring accurate detection of both positive and negative cases. In contrast, other DCNN models displayed varying degrees of performance degradation in the external validation cohort, indicating the superiority of Densenet201. Moreover, Densenet201's performance was comparable to that of an experienced clinician (Clinician A) and outperformed another clinician (Clinician B), particularly in the external validation cohort. Statistical analysis, including the DeLong test, confirmed the significance of these performance differences. Our study demonstrates that Densenet201 is a highly accurate and reliable tool for the computer-aided diagnosis of laryngeal cancer based on laryngoscopic images. The findings underscore the potential of deep learning as a complementary tool for clinicians and the importance of incorporating advanced technology in improving diagnostic accuracy and patient care in laryngeal cancer diagnosis. Future work will involve expanding the dataset and further optimizing the deep learning model.
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Affiliation(s)
- Zhi-Hui Xu
- Department of Otolaryngology, The Second Affiliated Hospital, Fujian Medical University, 950 Donghai Street, Fengze District, Quanzhou 362000, China; (Z.-H.X.)
| | - Da-Ge Fan
- Department of Pathology, The Second Affiliated Hospital, Fujian Medical University, 950 Donghai Street, Fengze District, Quanzhou 362000, China;
| | - Jian-Qiang Huang
- Department of Otolaryngology, The Second Affiliated Hospital, Fujian Medical University, 950 Donghai Street, Fengze District, Quanzhou 362000, China; (Z.-H.X.)
| | - Jia-Wei Wang
- Department of Emergency, The Second Affiliated Hospital, Fujian Medical University, 950 Donghai Street, Fengze District, Quanzhou 362000, China;
| | - Yi Wang
- CT/MRI Department, The Second Affiliated Hospital, Fujian Medical University, 950 Donghai Street, Fengze District, Quanzhou 362000, China
| | - Yuan-Zhe Li
- CT/MRI Department, The Second Affiliated Hospital, Fujian Medical University, 950 Donghai Street, Fengze District, Quanzhou 362000, China
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Yan P, Li S, Zhou Z, Liu Q, Wu J, Ren Q, Chen Q, Chen Z, Chen Z, Chen S, Scholp A, Jiang JJ, Kang J, Ge P. Automated detection of glottic laryngeal carcinoma in laryngoscopic images from a multicentre database using a convolutional neural network. Clin Otolaryngol 2023; 48:436-441. [PMID: 36624555 DOI: 10.1111/coa.14029] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2021] [Revised: 11/22/2022] [Accepted: 12/31/2022] [Indexed: 01/11/2023]
Abstract
OBJECTIVE Little is known about the efficacy of using artificial intelligence (AI) to identify laryngeal carcinoma from images of vocal lesions taken in different hospitals with multiple laryngoscope systems. This multicentre study aimed to establish an AI system and provide a reliable auxiliary tool to screen for laryngeal carcinoma. STUDY DESIGN Multicentre case-control study. SETTING Six tertiary care centres. PARTICIPANTS Laryngoscopy images were collected from 2179 patients with vocal fold lesions. OUTCOME MEASURES An automatic detection system of laryngeal carcinoma was established and used to distinguish malignant and benign vocal lesions in 2179 laryngoscopy images acquired from 6 hospitals with 5 types of laryngoscopy systems. Pathological examination was the gold standard for identifying malignant and benign vocal lesions. RESULTS Out of 89 cases in the malignant group, the classifier was able to correctly identify laryngeal carcinoma in 66 patients (74.16%, sensitivity). Out of 640 cases in the benign group, the classifier was able to accurately assess the laryngeal lesion in 503 cases (78.59%, specificity). Furthermore, the region-based convolutional neural network (R-CNN) classifier achieved an overall accuracy of 78.05%, with a 95.63% negative predictive value and a 32.51% positive predictive value for the testing data set. CONCLUSION This automatic diagnostic system has the potential to assist clinical laryngeal carcinoma diagnosis which may improve and standardise the diagnostic capacity of laryngologists using different laryngoscopes.
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Affiliation(s)
- Peikai Yan
- Department of Otolaryngology & Head Neck Surgery, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, China.,School of Medicine, South China University of Technology, Guangzhou, China
| | - Shaohua Li
- Department of Otorhinolaryngology Head and Neck Surgery, Zhongshan Hospital of Traditional Chinese Medicine, Affiliated to Guangzhou University of Chinese Medicine, Guangdong, Zhongshan, Guangdong, China
| | - Zhou Zhou
- Department of Otolaryngology, Shenzhen People's Hospital (The Second Clinical Medical College, Jinan University; The First Affiliated Hospital, Southern University of Science and Technology), Shenzhen, China
| | - Qian Liu
- Department of Otolaryngology, Shenzhen People's Hospital (The Second Clinical Medical College, Jinan University; The First Affiliated Hospital, Southern University of Science and Technology), Shenzhen, China
| | - Jiahui Wu
- Department of Otolaryngology & Head Neck Surgery, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, China
| | - Qingyi Ren
- Department of Otolaryngology & Head Neck Surgery, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, China
| | - Qiuhuan Chen
- Department of Otolaryngology, Zhaoqing Gaoyao People's Hospital, Zhaoqing, China
| | - Zhipeng Chen
- Department of Otolaryngology, The Second People's Hospital of Longgang District, Shenzhen, China
| | - Ze Chen
- Department of Otolaryngology, Gaozhou People's Hospital, Gaozhou, China
| | - Shaohua Chen
- Department of Otolaryngology & Head Neck Surgery, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, China
| | - Austin Scholp
- Department of Biomedical Engineering, University of Iowa, Iowa City, Iowa, USA.,Division of Otolaryngology-Head and Neck Surgery, Department of Surgery, School of Medicine and Public Health (A.S.), University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - Jack J Jiang
- Division of Otolaryngology-Head and Neck Surgery, Department of Surgery, School of Medicine and Public Health (A.S.), University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - Jing Kang
- Department of Otolaryngology & Head Neck Surgery, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, China.,School of Medicine, South China University of Technology, Guangzhou, China
| | - Pingjiang Ge
- School of Medicine, South China University of Technology, Guangzhou, China
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Kim DH, Kim Y, Kim SW, Hwang SH. Use of narrowband imaging for the diagnosis and screening of laryngeal cancer: A systematic review and meta-analysis. Head Neck 2020; 42:2635-2643. [PMID: 32364313 DOI: 10.1002/hed.26186] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2020] [Revised: 03/01/2020] [Accepted: 04/03/2020] [Indexed: 12/11/2022] Open
Abstract
We evaluated the diagnostic accuracy of narrowband imaging (NBI) in terms of detecting laryngeal cancer compared to that of white light endoscopy (WLE). Two reviewers individually searched the six databases for studies published between the first record date and December 31, 2019. We recorded the numbers of true positives, true negatives, false positives, and false negatives. Quality Assessment of Diagnostic Accuracy Studies ver. 2 software was used to assess the studies. The extent of the inter-rater agreement was also measured. The diagnostic odds ratio (OR) associated with NBI was 87.463 (95% confidence interval [CI]: 46.968, 160.873). The area under the summary receiver operating characteristic curve was 0.954. NBI was more diagnostically accurate than WLE, which was associated with a diagnostic OR of 13.750. NBI affords high diagnostic accuracy, thus supporting a role for NBI in the diagnostic work-up of laryngeal cancer.
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Affiliation(s)
- Do Hyun Kim
- Department of Otolaryngology-Head and Neck Surgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Yeonji Kim
- Department of Otolaryngology-Head and Neck Surgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Sung Won Kim
- Department of Otolaryngology-Head and Neck Surgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Se Hwan Hwang
- Department of Otolaryngology-Head and Neck Surgery, Bucheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
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Xiong H, Lin P, Yu JG, Ye J, Xiao L, Tao Y, Jiang Z, Lin W, Liu M, Xu J, Hu W, Lu Y, Liu H, Li Y, Zheng Y, Yang H. Computer-aided diagnosis of laryngeal cancer via deep learning based on laryngoscopic images. EBioMedicine 2019; 48:92-99. [PMID: 31594753 PMCID: PMC6838439 DOI: 10.1016/j.ebiom.2019.08.075] [Citation(s) in RCA: 51] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2019] [Revised: 08/20/2019] [Accepted: 08/30/2019] [Indexed: 01/10/2023] Open
Abstract
OBJECTIVE To develop a deep convolutional neural network (DCNN) that can automatically detect laryngeal cancer (LCA) in laryngoscopic images. METHODS A DCNN-based diagnostic system was constructed and trained using 13,721 laryngoscopic images of LCA, precancerous laryngeal lesions (PRELCA), benign laryngeal tumors (BLT) and normal tissues (NORM) from 2 tertiary hospitals in China, including 2293 from 206 LCA subjects, 1807 from 203 PRELCA subjects, 6448 from 774 BLT subjects and 3191 from 633 NORM subjects. An independent test set of 1176 laryngoscopic images from other 3 tertiary hospitals in China, including 132 from 44 LCA subjects, 129 from 43 PRELCA subjects, 504 from 168 BLT subjects and 411 from 137 NORM subjects, was applied to the constructed DCNN to evaluate its performance against experienced endoscopists. RESULTS The DCCN achieved a sensitivity of 0.731, a specificity of 0.922, an AUC of 0.922, and the overall accuracy of 0.867 for detecting LCA and PRELCA among all lesions and normal tissues. When compared to human experts in an independent test set, the DCCN' s performance on detection of LCA and PRELCA achieved a sensitivity of 0.720, a specificity of 0.948, an AUC of 0.953, and the overall accuracy of 0.897, which was comparable to that of an experienced human expert with 10-20 years of work experience. Moreover, the overall accuracy of DCNN for detection of LCA was 0.773, which was also comparable to that of an experienced human expert with 10-20 years of work experience and exceeded the experts with less than 10 years of work experience. CONCLUSIONS The DCNN has high sensitivity and specificity for automated detection of LCA and PRELCA from BLT and NORM in laryngoscopic images. This novel and effective approach facilitates earlier diagnosis of early LCA, resulting in improved clinical outcomes and reducing the burden of endoscopists.
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Affiliation(s)
- Hao Xiong
- Department of Otolaryngology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, China; Institute of Hearing and Speech-Language Science, Sun Yat-sen University, China
| | - Peiliang Lin
- Department of Otolaryngology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, China; Institute of Hearing and Speech-Language Science, Sun Yat-sen University, China
| | - Jin-Gang Yu
- School of Automation Science and Engineering, South China University of Technology, China
| | - Jin Ye
- Department of Otolaryngology, the Third Affiliated Hospital, Sun Yat-sen University, China
| | - Lichao Xiao
- School of Automation Science and Engineering, South China University of Technology, China
| | - Yuan Tao
- Department of Otolaryngology, Peking University Shenzhen Hospital, China
| | - Zebin Jiang
- Department of Otolaryngology, Puning People's Hospital, China
| | - Wei Lin
- Department of Otolaryngology, Taizhou First People's Hospital, China
| | - Mingyue Liu
- Department of Otolaryngology, the Third Affiliated Hospital, Sun Yat-sen University, China
| | - Jingjing Xu
- Department of Hearing and Speech-Language Science, Xinhua College, Sun Yat-sen University, China
| | - Wenjie Hu
- Department of Hearing and Speech-Language Science, Xinhua College, Sun Yat-sen University, China
| | - Yuewen Lu
- Department of Hearing and Speech-Language Science, Xinhua College, Sun Yat-sen University, China
| | - Huaifeng Liu
- Department of Hearing and Speech-Language Science, Xinhua College, Sun Yat-sen University, China
| | - Yuanqing Li
- School of Automation Science and Engineering, South China University of Technology, China.
| | - Yiqing Zheng
- Department of Otolaryngology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, China; Institute of Hearing and Speech-Language Science, Sun Yat-sen University, China; Department of Hearing and Speech-Language Science, Xinhua College, Sun Yat-sen University, China.
| | - Haidi Yang
- Department of Otolaryngology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, China; Institute of Hearing and Speech-Language Science, Sun Yat-sen University, China; Department of Hearing and Speech-Language Science, Xinhua College, Sun Yat-sen University, China.
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Raposo A, García-Purriños F, Albaladejo C, García-Solano ME, Lajara J. Pseudoepitheliomatous Hyperplasia of the Larynx Requiring Total Laryngectomy. AMERICAN JOURNAL OF CASE REPORTS 2018; 19:634-637. [PMID: 29858491 PMCID: PMC6016562 DOI: 10.12659/ajcr.909201] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Patient: Male, 57 Final Diagnosis: Pseudoepitheliomatous hyperplasia Symptoms: Dysphonia Medication: — Clinical Procedure: Progressive speudoepitheliomaous hyperplasia spreaded Specialty: Oncology
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Affiliation(s)
- Alberto Raposo
- Department of Otorhinolaryngology, Hospital Universitario Los Arcos del Mar Menor (HULAMM), San Javier, Murcia, Spain
| | - Francisco García-Purriños
- Department of Otorhinolaryngology, Hospital Universitario Los Arcos del Mar Menor (HULAMM), San Javier, Murcia, Spain
| | - Celia Albaladejo
- Department of Internal Medicine, Hospital Universitario Santa Lucia (HUSL), Cartagena, Murcia, Spain
| | - Maria E García-Solano
- Department of Anatomic Pathology, Hospital Universitario Los Arcos del Mar Menor (HULAMM), San Javier, Murcia, Spain
| | - Jerónimo Lajara
- Faculty of Health Sciences, Catholic University San Antonio (UCAM), Guadalupe, Murcia, Spain
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Shoffel-Havakuk H, Lahav Y, Meidan B, Haimovich Y, Warman M, Hain M, Hamzany Y, Brodsky A, Landau-Zemer T, Halperin D. Does narrow band imaging improve preoperative detection of glottic malignancy? A matched comparison study. Laryngoscope 2016; 127:894-899. [DOI: 10.1002/lary.26263] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2016] [Revised: 07/13/2016] [Accepted: 08/01/2016] [Indexed: 12/21/2022]
Affiliation(s)
- Hagit Shoffel-Havakuk
- Department of Otolaryngology-Head and Neck Surgery; Kaplan Medical Center; Rehovot Israel
- Hadassah Medical School; Hebrew University; Jerusalem Israel
| | - Yonatan Lahav
- Department of Otolaryngology-Head and Neck Surgery; Kaplan Medical Center; Rehovot Israel
- Hadassah Medical School; Hebrew University; Jerusalem Israel
| | - Barak Meidan
- Hadassah Medical School; Hebrew University; Jerusalem Israel
| | - Yaara Haimovich
- Department of Otolaryngology-Head and Neck Surgery; Kaplan Medical Center; Rehovot Israel
| | - Meir Warman
- Department of Otolaryngology-Head and Neck Surgery; Kaplan Medical Center; Rehovot Israel
- Hadassah Medical School; Hebrew University; Jerusalem Israel
| | - Moshe Hain
- Schneider Children's Medical Center; Petah Tikva Israel
- Sackler Faculty of Medicine; Tel Aviv University; Tel Aviv Israel
| | - Yaniv Hamzany
- Sackler Faculty of Medicine; Tel Aviv University; Tel Aviv Israel
- Department of Otolaryngology-Head and Neck Surgery; Rabin Medical Center; Petah Tikva Israel
| | - Alexander Brodsky
- Department of Otolaryngology-Head and Neck Surgery; Bnai Zion Medical Center; Haifa Israel
- Rappaport Faculty of Medicine; Technion-Israel Institute of Technology; Haifa Israel
| | - Tali Landau-Zemer
- Hadassah Medical School; Hebrew University; Jerusalem Israel
- Department of Otolaryngology, Head and Neck Surgery; Hadassah Medical Center; Jerusalem Israel
| | - Doron Halperin
- Department of Otolaryngology-Head and Neck Surgery; Kaplan Medical Center; Rehovot Israel
- Hadassah Medical School; Hebrew University; Jerusalem Israel
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