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Hsu CM, Hsu CC, Hsu ZM, Shih FY, Chang ML, Chen TH. Colorectal Polyp Image Detection and Classification through Grayscale Images and Deep Learning. SENSORS 2021; 21:s21185995. [PMID: 34577209 PMCID: PMC8470682 DOI: 10.3390/s21185995] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Revised: 08/29/2021] [Accepted: 08/30/2021] [Indexed: 01/10/2023]
Abstract
Colonoscopy screening and colonoscopic polypectomy can decrease the incidence and mortality rate of colorectal cancer (CRC). The adenoma detection rate and accuracy of diagnosis of colorectal polyp which vary in different experienced endoscopists have impact on the colonoscopy protection effect of CRC. The work proposed a colorectal polyp image detection and classification system through grayscale images and deep learning. The system collected the data of CVC-Clinic and 1000 colorectal polyp images of Linkou Chang Gung Medical Hospital. The red-green-blue (RGB) images were transformed to 0 to 255 grayscale images. Polyp detection and classification were performed by convolutional neural network (CNN) model. Data for polyp detection was divided into five groups and tested by 5-fold validation. The accuracy of polyp detection was 95.1% for grayscale images which is higher than 94.1% for RGB and narrow-band images. The diagnostic accuracy, precision and recall rates were 82.8%, 82.5% and 95.2% for narrow-band images, respectively. The experimental results show that grayscale images achieve an equivalent or even higher accuracy of polyp detection than RGB images for lightweight computation. It is also found that the accuracy of polyp detection and classification is dramatically decrease when the size of polyp images small than 1600 pixels. It is recommended that clinicians could adjust the distance between the lens and polyps appropriately to enhance the system performance when conducting computer-assisted colorectal polyp analysis.
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Affiliation(s)
- Chen-Ming Hsu
- Department of Gastroenterology and Hepatology, Linkou Chang Gung Memorial Hospital and Chang Gung University College of Medicine, No. 5, Fuxing St., Guishan Dist., Taoyuan City 333, Taiwan; (C.-M.H.); (T.-H.C.)
| | - Chien-Chang Hsu
- Department of Computer Science and Information Engineering, Fu-Jen Catholic University, 510 Chung Cheng Rd., Hsinchuang Dist., New Taipei City 242, Taiwan; (Z.-M.H.); (F.-Y.S.)
- Graduate Institute of Applied Science and Engineering, Fu-Jen Catholic University, 510 Chung Cheng Rd., Hsinchuang Dist., New Taipei City 242, Taiwan;
- Correspondence:
| | - Zhe-Ming Hsu
- Department of Computer Science and Information Engineering, Fu-Jen Catholic University, 510 Chung Cheng Rd., Hsinchuang Dist., New Taipei City 242, Taiwan; (Z.-M.H.); (F.-Y.S.)
| | - Feng-Yu Shih
- Department of Computer Science and Information Engineering, Fu-Jen Catholic University, 510 Chung Cheng Rd., Hsinchuang Dist., New Taipei City 242, Taiwan; (Z.-M.H.); (F.-Y.S.)
| | - Meng-Lin Chang
- Graduate Institute of Applied Science and Engineering, Fu-Jen Catholic University, 510 Chung Cheng Rd., Hsinchuang Dist., New Taipei City 242, Taiwan;
| | - Tsung-Hsing Chen
- Department of Gastroenterology and Hepatology, Linkou Chang Gung Memorial Hospital and Chang Gung University College of Medicine, No. 5, Fuxing St., Guishan Dist., Taoyuan City 333, Taiwan; (C.-M.H.); (T.-H.C.)
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Song LY, Lin Q, Li LB, Cheng X. Clinical exploration of marking targeting biopsy in the intraoperative localization value of colon polypectomy. Pak J Med Sci 2020; 36:100-104. [PMID: 32063940 PMCID: PMC6994903 DOI: 10.12669/pjms.36.2.756] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Objective To evaluate the feasibility and safety of marking targeting biopsy (MTB) in the intraoperative localization value of colon polypectomy. Methods The clinical data from patients with polyp of colon discovered under colonoscopy from January 2014 to January 2016 were retrospectively analyzed. A total of 87 patients conformed to the inclusion criteria, among them, 43 received colonoscopic polypectomy one week after MTB (MTB group), while 44 underwent colonoscopic polypectomy one week after conventional biopsy (conventional group). The time consumption in colonoscopic treatment, polypectomy rate and postoperative complications between two groups were compared. Results The time consumed in operation in the MTB group was 25.5 (±8.6) minutes, while that in conventional group was 42.0 (±20.5) minutes, and the difference was statistically significant (P<0.01). There were a total of 86 polyps in the MTB group, among which 83 were removed, yielding the removal rate of 96.5%. There were altogether 88 polyps in the conventional group, among which 54 were removed, resulting in the removal rate of 61.4%, and the difference was statistically significant (P<0.05). three polyps in the MTB group were detached after MTB, or the wound surface became flat after gross polyp removal, and no polypectomy was required, but the marking targeting solution was clearly visible. two respective polyps in 12 cases in conventional group could not be found in colonoscopic treatment, and 10 of them had respective one polyp that could not be found again. 12 cases in MTB group suffered from abdominal pain after surgery, and no hemorrhage was seen intraoperatively and postoperatively. 10 cases in the conventional group had abdominal pain after surgery, and one case had delayed hemorrhage after surgery. The results between two groups displayed no statistical significance (P>0.05). Conclusions The localization value of MTB in colon polypectomy is definitely feasible, safe and effective, which can greatly shorten the time of endoscopic colon polypectomy, mitigate patient sufferings, and reduce the incidence of false negative rate of polyp. It displays favorable clinical application value and is worthy of being promoted in clinic.
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Affiliation(s)
- Ling Yun Song
- Dr. Ling Yun Song, M.D. Department of Gastroenterology, Yinzhou No 2. Hospital, Ningbo, Zhejiang, China
| | - Qi Lin
- Dr. Qi Lin, M.D, Department of Gastroenterology, Yinzhou No 2. Hospital, Ningbo, Zhejiang, China
| | - Lian Biao Li
- Dr. Lian-Biao Li, M.D, Department of Gastroenterology, Yinzhou No 2. Hospital, Ningbo, Zhejiang, China
| | - Xiu Cheng
- Dr. Xiu Cheng, M.D, Department of Gastroenterology, Yinzhou No 2. Hospital, Ningbo, Zhejiang, China
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Yabuuchi Y, Imai K, Hotta K, Ito S, Kishida Y, Yamaguchi T, Shiomi A, Kinugasa Y, Yoshida M, Tanaka M, Kawata N, Kakushima N, Takizawa K, Ishiwatari H, Matsubayashi H, Ono H. Higher incidence of metachronous advanced neoplasia in patients with synchronous advanced neoplasia and left-sided colorectal resection for colorectal cancer. Gastrointest Endosc 2018; 88:348-359.e1. [PMID: 29574125 DOI: 10.1016/j.gie.2018.03.011] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2017] [Accepted: 03/11/2018] [Indexed: 02/08/2023]
Abstract
BACKGROUND AND AIMS There is an increased risk of developing metachronous colorectal cancer (CRC) in the remnant colorectum after surgical resection of CRC. We evaluated the incidence of metachronous advanced neoplasia (AN) after surgery for CRC according to resection type and synchronous AN. METHODS This cohort study included patients who underwent surgical resection for initial CRC at a tertiary cancer center in Japan between September 2002 and December 2012. The cumulative probability of metachronous AN was calculated using the Kaplan-Meier method and was evaluated by the log-rank test. RESULTS Metachronous AN was detected in 145 of 1731 included patients, and the 5-year cumulative probability of metachronous AN was 13.1%. There was no significant difference in the incidence of metachronous AN in the right-sided colorectal resection versus left-sided colorectal resection (LCR) groups (log-rank test P = .151), whereas the incidence of metachronous AN was significantly higher in patients with synchronous AN (log-rank test P < .001). In subgroup analysis of patients according to resection type and synchronous AN, the LCR group with synchronous AN showed a significantly higher incidence of metachronous AN than the other groups (log-rank test P < .001). CONCLUSIONS We found that synchronous AN, but not resection type, was independently associated with the incidence of metachronous AN in patients who underwent surgical resection of CRC. In addition, subjects with synchronous AN after LCR had a potentially increased risk for metachronous AN. Thus, it may be useful to perform risk stratification according to synchronous AN and resection type.
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Affiliation(s)
- Yohei Yabuuchi
- Division of Endoscopy, Shizuoka Cancer Center, Shizuoka, Japan
| | - Kenichiro Imai
- Division of Endoscopy, Shizuoka Cancer Center, Shizuoka, Japan
| | - Kinichi Hotta
- Division of Endoscopy, Shizuoka Cancer Center, Shizuoka, Japan
| | - Sayo Ito
- Division of Endoscopy, Shizuoka Cancer Center, Shizuoka, Japan
| | | | - Tomohiro Yamaguchi
- Division of Colon and Rectal Surgery, Shizuoka Cancer Center, Shizuoka, Japan
| | - Akio Shiomi
- Division of Colon and Rectal Surgery, Shizuoka Cancer Center, Shizuoka, Japan
| | - Yusuke Kinugasa
- Department of Colorectal Surgery, Tokyo Medical Dental University, Tokyo, Japan
| | - Masao Yoshida
- Division of Endoscopy, Shizuoka Cancer Center, Shizuoka, Japan
| | - Masaki Tanaka
- Division of Endoscopy, Shizuoka Cancer Center, Shizuoka, Japan
| | - Noboru Kawata
- Division of Endoscopy, Shizuoka Cancer Center, Shizuoka, Japan
| | - Naomi Kakushima
- Division of Endoscopy, Shizuoka Cancer Center, Shizuoka, Japan
| | - Kohei Takizawa
- Division of Endoscopy, Shizuoka Cancer Center, Shizuoka, Japan
| | | | | | - Hiroyuki Ono
- Division of Endoscopy, Shizuoka Cancer Center, Shizuoka, Japan
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Zhou L, Zhang H, Sun S, Huang M, Liu J, Xu D, Song M, Sun C, Li H, Zheng D, Fan Y, Liao Y, Wang P, Wu J. Clinical, endoscopic and pathological characteristics of colorectal polyps in elderly patients: Single-center experience. Mol Clin Oncol 2017; 7:81-87. [PMID: 28685081 DOI: 10.3892/mco.2017.1284] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2016] [Accepted: 03/23/2017] [Indexed: 12/16/2022] Open
Abstract
Increasing age is a risk factor for the development of colorectal adenomas and advanced adenomas. However, few studies have been published on the features of colorectal polyps in the elderly. The present study aimed to investigate the clinical, enteroscopic and pathological characteristics of colorectal polyps in Chinese elderly patients in a single center (The Central Hospital of Wuhan, Hubei, China). The endoscopic and pathological reports of colonoscopies performed in our center were retrospectively analyzed. A total of 7,795 consecutive patients referred for colonoscopy were evaluated between January 2013 and December 2014. Of the 297 who met the inclusion criteria, 279 polyps were observed in men and 230 in women. Of all the polyps, 263 were non-adenomatous polyps, 104 were non-advanced adenomas and 142 were advanced adenomas. 336 polyps were left-sided and 173 were right-sided. Polyps ≥10 mm were more likely to exhibit an adenomatous component and advanced features, and these findings continued to hold true when the size cut-off was set at 5 mm. The data shown in the present study have revealed that a significant number of polyps lie proximal to the splenic flexure. Thus, evaluation of the whole bowel is particularly important in elderly patients who are undergoing colonoscopy. In addition, the polyp size was associated with the presence of adenoma, and advanced component, diminutive and small polyps should not be ignored in elderly patients.
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Affiliation(s)
- Lei Zhou
- Department of Gastroenterology and Key Laboratory for Molecular Diagnosis of Hubei, The Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430014, P.R. China
| | - Heng Zhang
- Department of Gastroenterology and Key Laboratory for Molecular Diagnosis of Hubei, The Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430014, P.R. China
| | - Shengbin Sun
- Department of Gastroenterology and Key Laboratory for Molecular Diagnosis of Hubei, The Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430014, P.R. China
| | - Manling Huang
- Department of Gastroenterology and Key Laboratory for Molecular Diagnosis of Hubei, The Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430014, P.R. China
| | - Jing Liu
- Department of Gastroenterology and Key Laboratory for Molecular Diagnosis of Hubei, The Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430014, P.R. China
| | - Dan Xu
- Department of Gastroenterology and Key Laboratory for Molecular Diagnosis of Hubei, The Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430014, P.R. China
| | - Min Song
- Department of Gastroenterology and Key Laboratory for Molecular Diagnosis of Hubei, The Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430014, P.R. China
| | - Chenming Sun
- Department of Gastroenterology and Key Laboratory for Molecular Diagnosis of Hubei, The Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430014, P.R. China
| | - Hui Li
- Department of Gastroenterology and Key Laboratory for Molecular Diagnosis of Hubei, The Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430014, P.R. China
| | - Dan Zheng
- Department of Gastroenterology and Key Laboratory for Molecular Diagnosis of Hubei, The Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430014, P.R. China
| | - Yan Fan
- Department of Gastroenterology and Key Laboratory for Molecular Diagnosis of Hubei, The Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430014, P.R. China
| | - Yusheng Liao
- Department of Gastroenterology and Key Laboratory for Molecular Diagnosis of Hubei, The Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430014, P.R. China
| | - Ping Wang
- Department of Gastroenterology and Key Laboratory for Molecular Diagnosis of Hubei, The Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430014, P.R. China
| | - Jie Wu
- Department of Gastroenterology and Key Laboratory for Molecular Diagnosis of Hubei, The Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430014, P.R. China
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Nando Y, Watari J, Ito C, Hara K, Yamasaki T, Okugawa T, Kondo T, Kono T, Tozawa K, Tomita T, Ohda Y, Oshima T, Fukui H, Matsubara N, Tomita N, Hirota S, Miwa H. Genetic instability, CpG island methylator phenotype, and proliferative activity are distinct differences between diminutive and small tubular adenoma of the colorectum. Hum Pathol 2016; 60:37-45. [PMID: 27746269 DOI: 10.1016/j.humpath.2016.09.022] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2016] [Revised: 09/20/2016] [Accepted: 09/22/2016] [Indexed: 01/06/2023]
Abstract
It is recommended that small (6-10 mm) lesions be treated with endoscopic resection (ER), whereas diminutive (≤5 mm) lesions are not currently an indication for ER according to the Japanese guidelines. The aim of this study was to evaluate the molecular alterations, and therefore treatment indications, in diminutive versus small tubular adenoma (TA). We prospectively analyzed genetic instability, including microsatellite instability and loss of heterozygosity, methylation status, KRAS/BRAF mutations, and Ki-67 staining in 96 TAs without a villous component. Although no microsatellite instability was identified in either diminutive or small TAs, genetic instability was seen in small TAs (9.1%) but not diminutive TAs (P = .04). In addition, the low-level CpG island methylator phenotype (CIMP-L) was more frequently observed in small TAs (31.8%) than in diminutive TAs (P = .01). Thus, genetic instability and CIMP-L were associated with small TAs, and only CIMP-L was an independent predictive marker for small TAs (odds ratio, 3.29; P = .03). Intriguingly, the Ki-67 proliferative index tended to be higher in small TAs than in diminutive TAs (P = .06) and higher in TAs with CIMP-L than in those without CIMP (P = .08). KRAS mutations were seen in codon 12 in 5.2% of TAs, but no BRAF gene mutations were found. As the molecular events and proliferative activity for the progression may increase from diminutive to small TAs, small TAs should be treated with ER, whereas a "predict, resect, and discard" strategy may be acceptable in most diminutive lesions except flat and depressed-type lesions, in keeping with the current strategy in the West.
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Affiliation(s)
- Yoshiki Nando
- Division of Gastroenterology, Department of Internal Medicine, Hyogo College of Medicine, Nishinomiya, Hyogo 663-8501, Japan
| | - Jiro Watari
- Division of Gastroenterology, Department of Internal Medicine, Hyogo College of Medicine, Nishinomiya, Hyogo 663-8501, Japan.
| | - Chiyomi Ito
- Division of Gastroenterology, Department of Internal Medicine, Hyogo College of Medicine, Nishinomiya, Hyogo 663-8501, Japan
| | - Ken Hara
- Division of Gastroenterology, Department of Internal Medicine, Hyogo College of Medicine, Nishinomiya, Hyogo 663-8501, Japan
| | - Takahisa Yamasaki
- Division of Gastroenterology, Department of Internal Medicine, Hyogo College of Medicine, Nishinomiya, Hyogo 663-8501, Japan
| | - Takuya Okugawa
- Division of Gastroenterology, Department of Internal Medicine, Hyogo College of Medicine, Nishinomiya, Hyogo 663-8501, Japan
| | - Takashi Kondo
- Division of Gastroenterology, Department of Internal Medicine, Hyogo College of Medicine, Nishinomiya, Hyogo 663-8501, Japan
| | - Tomoaki Kono
- Division of Gastroenterology, Department of Internal Medicine, Hyogo College of Medicine, Nishinomiya, Hyogo 663-8501, Japan
| | - Katsuyuki Tozawa
- Division of Gastroenterology, Department of Internal Medicine, Hyogo College of Medicine, Nishinomiya, Hyogo 663-8501, Japan
| | - Toshihiko Tomita
- Division of Gastroenterology, Department of Internal Medicine, Hyogo College of Medicine, Nishinomiya, Hyogo 663-8501, Japan
| | - Yoshio Ohda
- Division of Gastroenterology, Department of Internal Medicine, Hyogo College of Medicine, Nishinomiya, Hyogo 663-8501, Japan
| | - Tadayuki Oshima
- Division of Gastroenterology, Department of Internal Medicine, Hyogo College of Medicine, Nishinomiya, Hyogo 663-8501, Japan
| | - Hirokazu Fukui
- Division of Gastroenterology, Department of Internal Medicine, Hyogo College of Medicine, Nishinomiya, Hyogo 663-8501, Japan
| | - Nagahide Matsubara
- Division of Lower Gastrointestinal Surgery, Department of Surgery, Hyogo College of Medicine, Nishinomiya, Hyogo 663-8501, Japan
| | - Naohiro Tomita
- Division of Lower Gastrointestinal Surgery, Department of Surgery, Hyogo College of Medicine, Nishinomiya, Hyogo 663-8501, Japan
| | - Seiichi Hirota
- Department of Surgical Pathology, Hyogo College of Medicine, Nishinomiya, Hyogo 663-8501, Japan
| | - Hiroto Miwa
- Division of Gastroenterology, Department of Internal Medicine, Hyogo College of Medicine, Nishinomiya, Hyogo 663-8501, Japan
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