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Ogawa R, Nishikawa J, Hideura E, Goto A, Koto Y, Ito S, Unno M, Yamaoka Y, Kawasato R, Hashimoto S, Okamoto T, Ogihara H, Hamamoto Y, Sakaida I. Objective Assessment of the Utility of Chromoendoscopy with a Support Vector Machine. J Gastrointest Cancer 2020; 50:386-391. [PMID: 29504086 PMCID: PMC6675770 DOI: 10.1007/s12029-018-0083-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
Purpose The utility of chromoendoscopy for early gastric cancer (GC) was determined by machine learning using data of color differences. Methods Eighteen histopathologically confirmed early GC lesions were examined. We prepared images from white light endoscopy (WL), indigo carmine (Indigo), and acetic acid-indigo carmine chromoendoscopy (AIM). A border between cancerous and non-cancerous areas on endoscopic images was established from post-treatment pathological findings, and 2000 pixels with equivalent luminance values were randomly extracted from each image of cancerous and non-cancerous areas. Each pixel was represented as a three-dimensional vector with RGB values and defined as a sample. We evaluated the Mahalanobis distance using RGB values, indicative of color differences between cancerous and non-cancerous areas. We then conducted diagnosis test using a support vector machine (SVM) for each image. SVM was trained using the 100 training samples per class and determined which area each of 1900 test samples per class came from. Results The means of the Mahalanobis distances for WL, Indigo, and AIM were 1.52, 1.32, and 2.53, respectively and there were no significant differences in the three modalities. Diagnosability per endoscopy technique was assessed using the F1 measure. The means of F1 measures for WL, Indigo, and AIM were 0.636, 0.618, and 0.687, respectively. AIM images were better than WL and Indigo images for the diagnosis of GC. Conclusion Objective assessment by SVM found AIM to be suitable for diagnosis of early GC based on color differences.
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Affiliation(s)
- Ryo Ogawa
- Department of Gastroenterology and Hepatology, Yamaguchi University Graduate School of Medicine, 1-1-1 Minamikogushi, Ube, Japan
| | - Jun Nishikawa
- Department of Laboratory Science, Yamaguchi University Graduate School of Medicine, 1-1-1 Minamikogushi, Ube, Japan.
| | - Eizaburo Hideura
- Department of Gastroenterology and Hepatology, Yamaguchi University Graduate School of Medicine, 1-1-1 Minamikogushi, Ube, Japan
| | - Atsushi Goto
- Department of Gastroenterology and Hepatology, Yamaguchi University Graduate School of Medicine, 1-1-1 Minamikogushi, Ube, Japan
| | - Yurika Koto
- Department of Gastroenterology and Hepatology, Yamaguchi University Graduate School of Medicine, 1-1-1 Minamikogushi, Ube, Japan
| | - Shunsuke Ito
- Department of Gastroenterology and Hepatology, Yamaguchi University Graduate School of Medicine, 1-1-1 Minamikogushi, Ube, Japan
| | - Madoka Unno
- Department of Gastroenterology and Hepatology, Yamaguchi University Graduate School of Medicine, 1-1-1 Minamikogushi, Ube, Japan
| | - Yuko Yamaoka
- Department of Gastroenterology and Hepatology, Yamaguchi University Graduate School of Medicine, 1-1-1 Minamikogushi, Ube, Japan
| | - Ryo Kawasato
- Department of Gastroenterology and Hepatology, Yamaguchi University Graduate School of Medicine, 1-1-1 Minamikogushi, Ube, Japan
| | - Shinichi Hashimoto
- Department of Gastroenterology and Hepatology, Yamaguchi University Graduate School of Medicine, 1-1-1 Minamikogushi, Ube, Japan
| | - Takeshi Okamoto
- Department of Gastroenterology and Hepatology, Yamaguchi University Graduate School of Medicine, 1-1-1 Minamikogushi, Ube, Japan
| | - Hiroyuki Ogihara
- Department of Biomolecular Engineering Applied Molecular Bioscience, Yamaguchi University Graduate School of Medicine, 2-16-1 Tokiwadai, Ube, Japan
| | - Yoshihiko Hamamoto
- Division of Electrical, Electronic and Information Engineering, Yamaguchi University Graduate School of Sciences and Technology for Innovation, 2-16-1 Tokiwadai, Ube, Japan
| | - Isao Sakaida
- Department of Gastroenterology and Hepatology, Yamaguchi University Graduate School of Medicine, 1-1-1 Minamikogushi, Ube, Japan
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Behary J, Keegan M, Craig PI. The interobserver agreement of optical features used to differentiate benign from neoplastic biliary lesions assessed at balloon-assisted cholangioscopy. J Gastroenterol Hepatol 2019; 34:595-602. [PMID: 30499127 DOI: 10.1111/jgh.14556] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2018] [Revised: 11/12/2018] [Accepted: 11/17/2018] [Indexed: 12/20/2022]
Abstract
BACKGROUND AND AIM Balloon-assisted cholangioscopy allows mucosal assessment of the biliary tree with pediatric endoscopes. No validated optical criteria exist to differentiate benign from neoplastic biliary lesions. We aimed to identify, validate, and revalidate optical features differentiating benign from neoplastic biliary lesions. Furthermore, we aimed to determine whether cholangioscopic appearance allows endoscopists to accurately differentiate benign from neoplastic biliary lesions. METHODS Baseline: from 44 de-identified balloon-assisted cholangioscopy videos, a blinded investigator analyzed potential optical features distinguishing benign from neoplastic biliary lesions. VALIDATION during the initial "teaching phase," 20 endoscopists viewed video clips of 11 optical features identified in the baseline study. At the subsequent "test phase," 20 further video clips were assessed by the endoscopists blinded to clinical details and questionnaires completed for the presence or absence of optical features, favored diagnosis and diagnostic confidence. Revalidation: The six identified optical features from the validation study with at least moderate agreement were revalidated the same way 12 months later assessing 20 new lesions. RESULTS Baseline: 11 optical features were found to differentiate benign from neoplastic biliary lesions. Validation and revalidation: six optical features demonstrated at least moderate interobserver agreement (irregular margin, dark mucosa, adherent mucous, papillary projections, tubular, or branched/disorganized surface structures). Endoscopists correctly diagnosed lesions as benign in 89% and neoplastic in 83%. When highly confident, endoscopists correctly diagnosed 96% of benign and 87% neoplastic lesions. CONCLUSIONS Six features were validated and revalidated to differentiate benign from neoplastic biliary lesions. When highly confident with a diagnosis, endoscopists usually differentiate benign from neoplastic biliary lesions.
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Affiliation(s)
- Jason Behary
- Department of Gastroenterology and Hepatology, St George Hospital and the University of NSW, Sydney, New South Wales, Australia
| | - Mathew Keegan
- Department of Gastroenterology and Hepatology, St George Hospital and the University of NSW, Sydney, New South Wales, Australia
| | - Philip I Craig
- Department of Gastroenterology and Hepatology, St George Hospital and the University of NSW, Sydney, New South Wales, Australia
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Omura H, Yoshida N, Hayashi T, Miwa K, Takatori H, Tsuji H, Inamura K, Shirota Y, Aoyagi H, Masunaga T, Katayanagi K, Kurumaya H, Kaneko S, Doyama H. Interobserver agreement in detection of "white globe appearance" and the ability of educational lectures to improve the diagnosis of gastric lesions. Gastric Cancer 2017; 20:620-628. [PMID: 27915451 DOI: 10.1007/s10120-016-0676-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2016] [Accepted: 11/20/2016] [Indexed: 02/07/2023]
Abstract
BACKGROUND White globe appearance (WGA) refers to a small white lesion of globular shape underneath cancerous gastric epithelium that can be clearly visualized by magnifying endoscopy with narrowband imaging (M-NBI). WGA has been reported to be a novel endoscopic marker that is highly specific in differentiating early gastric cancer (GC) from low-grade adenoma, and has a significantly higher prevalence in early GCs than in noncancerous lesions. However, interobserver agreement in detecting WGA and whether training intervention can improve diagnostic accuracy are unknown. METHODS Twenty sets of M-NBI images were examined by 16 endoscopists. The endoscopists attended a lecture about WGA, and examined the images again after the lecture. Interobserver agreement in detecting WGA in the second examination and increases in the proportion of correct diagnoses and the degree of confidence of diagnoses of cancerous lesions were evaluated. RESULTS The kappa value for interobserver agreement in detecting WGA in the second examination was 0.735. The proportion of correct diagnoses was significantly higher in the second examination compared with the first examination when WGA was present (95.5% vs 55.4%; P < 0.001), but not when WGA was absent (61.6% vs 52.7%; P = 0.190). The proportion of correct diagnoses with a high degree of confidence was significantly higher in the second examination, both with WGA (91.1% vs 29.5%; P < 0.001) and without WGA (36.6% vs 20.5%; P = 0.031). CONCLUSIONS The detection of WGA by endoscopists was highly reproducible. A brief educational lecture about WGA increased the proportion of correct diagnoses and the degree of confidence of diagnoses of GC with WGA.
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Affiliation(s)
- Hitoshi Omura
- Department of Gastroenterology, Ishikawa Prefectural Central Hospital, 2-1 Kuratsukihigashi, Kanazawa, Ishikawa, 920-8530, Japan.,Department of Gastroenterology, Kanazawa University Hospital, Kanazawa, Ishikawa, Japan
| | - Naohiro Yoshida
- Department of Gastroenterology, Ishikawa Prefectural Central Hospital, 2-1 Kuratsukihigashi, Kanazawa, Ishikawa, 920-8530, Japan
| | - Tomoyuki Hayashi
- Department of Gastroenterology, Kanazawa Medical Center, Kanazawa, Ishikawa, Japan
| | - Kazuhiro Miwa
- Department of Gastroenterology, Japan Community Health care Organization Kanazawa Hospital, Kanazawa, Ishikawa, Japan
| | - Hajime Takatori
- Department of Gastroenterology, Kanazawa University Hospital, Kanazawa, Ishikawa, Japan
| | - Hirokazu Tsuji
- Department of Gastroenterology, Kanazawa Municipal Hospital, Kanazawa, Ishikawa, Japan
| | - Katsuhisa Inamura
- Department of Gastroenterology, Tonami General Hospital, Tonami, Toyama, Japan
| | - Yukihiro Shirota
- Department of Gastroenterology, Saiseikai Kanazawa Hospital, Kanazawa, Ishikawa, Japan
| | - Hiroyuki Aoyagi
- Department of Gastroenterology, Fukui Prefectural Hospital, Fukui, Fukui, Japan
| | - Takaharu Masunaga
- Department of Gastroenterology, Hokuriku Hospital, Kanazawa, Ishikawa, Japan
| | - Kazuyoshi Katayanagi
- Department of Diagnostic Pathology, Ishikawa Prefectural Central Hospital, Kanazawa, Ishikawa, Japan
| | - Hiroshi Kurumaya
- Department of Diagnostic Pathology, Ishikawa Prefectural Central Hospital, Kanazawa, Ishikawa, Japan
| | - Shuichi Kaneko
- Department of Gastroenterology, Kanazawa University Hospital, Kanazawa, Ishikawa, Japan
| | - Hisashi Doyama
- Department of Gastroenterology, Ishikawa Prefectural Central Hospital, 2-1 Kuratsukihigashi, Kanazawa, Ishikawa, 920-8530, Japan.
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Sun C, Han X, Li X, Zhang Y, Du X. Diagnostic Performance of Narrow Band Imaging for Laryngeal Cancer: A Systematic Review and Meta-analysis. Otolaryngol Head Neck Surg 2017; 156:589-597. [PMID: 28168890 DOI: 10.1177/0194599816685701] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Objective To evaluate the performance of narrow band imaging (NBI) for the diagnosis of laryngeal cancer and to compare the diagnostic value of NBI with that of white light endoscopy. Data Sources PubMed, Embase, Cochrane Library, and CNKI databases. Review Methods Data analyses were performed with Meta-DiSc. The updated Quality Assessment of Diagnostic Accuracy Studies–2 tool was used to assess study quality and potential bias. Publication bias was assessed with the Deeks’s asymmetry test. The protocol used in this article has been published on PROSPERO and is in accordance with the PRISMA checklist. The registry number for this study is CRD42015025866. Results Six studies including 716 lesions were included in this meta-analysis. The pooled sensitivity, specificity, and diagnostic odds ratio for the NBI diagnosis of laryngeal cancer were 0.94 (95% confidence interval [95% CI]: 0.91-0.96), 0.89 (95% CI: 0.85-0.92), and 142.12 (95% CI: 46.42-435.15), respectively, and the area under receiver operating characteristics curve was 0.97. Among the 6 studies, 3 evaluated the diagnostic value of white light endoscopy, with a sensitivity of 0.81 (95% CI: 0.76-0.86), a specificity of 0.92 (95% CI: 0.88-0.95), and a diagnostic odds ratio of 33.82 (95% CI: 14.76-77.49). The evaluation of heterogeneity, calculated per the diagnostic odds ratio, gave an I2 of 66%. No marked publication bias ( P = .84) was detected in this meta-analysis. Conclusion The sensitivity of NBI is superior to white light endoscopy, and the potential value of NBI needs to be validated in future studies.
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Affiliation(s)
- Changling Sun
- Department of Otolaryngology–Head and Neck Surgery, Affiliated Hospital of Jiangnan University, The Fourth People’s Hospital of Wuxi City, Wuxi, China
| | - Xue Han
- Medical College of Jiangnan University, Wuxi, China
| | - Xiaoying Li
- Medical College of Jiangnan University, Wuxi, China
| | - Yayun Zhang
- Medical College of Jiangnan University, Wuxi, China
| | - Xiaodong Du
- Department of Otolaryngology–Head and Neck Surgery, Affiliated Hospital of Jiangnan University, The Fourth People’s Hospital of Wuxi City, Wuxi, China
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Hu YY, Lian QW, Lin ZH, Zhong J, Xue M, Wang LJ. Diagnostic performance of magnifying narrow-band imaging for early gastric cancer: A meta-analysis. World J Gastroenterol 2015; 21:7884-7894. [PMID: 26167089 PMCID: PMC4491976 DOI: 10.3748/wjg.v21.i25.7884] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2014] [Revised: 03/01/2015] [Accepted: 04/17/2015] [Indexed: 02/06/2023] Open
Abstract
AIM: To investigate the performance of magnifying endoscopy with narrow-band imaging (ME-NBI) in the diagnosis of early gastric cancer (EGC).
METHODS: Systematic literature searches were conducted until February 2014 in PubMed, EMBASE, Web of Science, Ovid, Scopus and the Cochrane Library databases by two independent reviewers. Meta-analysis was performed to calculate the pooled sensitivity, specificity and diagnostic odds ratio and to construct a summary receiver operating characteristic (ROC) curve. Subgroup analyses were performed based on the morphology type of lesions, diagnostic standard, the size of lesions, type of assessment, country and sample size to explore possible sources of heterogeneity. A Deeks’ asymmetry test was used to evaluate the publication bias.
RESULTS: Fourteen studies enrolling 2171 patients were included. The pooled sensitivity, specificity and diagnostic odds ratio for ME-NBI diagnosis of EGC were 0.86 (95%CI: 0.83-0.89), 0.96 (95%CI: 0.95-0.97) and 102.75 (95%CI: 48.14-219.32), respectively, with the area under ROC curve being 0.9623. Among the 14 studies, six also evaluated the diagnostic value of conventional white-light imaging, with a sensitivity of 0.57 (95%CI: 0.50-0.64) and a specificity of 0.79 (95%CI: 0.76-0.81). When using “VS” (vessel plus surface) ME-NBI diagnostic systems in gastric lesions of depressed macroscopic type, the pooled sensitivity and specificity were 0.64 (95%CI: 0.52-0.75) and 0.96 (95%CI: 0.95-0.98). For the lesions with a diameter less than 10 mm, the sensitivity and specificity were 0.74 (95%CI: 0.65-0.82) and 0.98 (95%CI: 0.97-0.98).
CONCLUSION: ME-NBI is a promising endoscopic tool in the diagnosis of early gastric cancer and might be helpful in further target biopsy.
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Lv X, Wang C, Xie Y, Yan Z. Diagnostic efficacy of magnifying endoscopy with narrow-band imaging for gastric neoplasms: a meta-analysis. PLoS One 2015; 10:e0123832. [PMID: 25856544 PMCID: PMC4391823 DOI: 10.1371/journal.pone.0123832] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2014] [Accepted: 02/21/2015] [Indexed: 02/05/2023] Open
Abstract
Background Magnifying endoscopy with narrow-band imaging (ME-NBI) is a novel, image-enhanced endoscopic technique for differentiating gastrointestinal neoplasms and potentially enabling pathological diagnosis. Objectives The aim of this analysis was to assess the diagnostic performance of ME-NBI for gastric neoplasms. Methods We performed a systematic search of the PubMed, EMbase, Web of Science, and Cochrane Library databases for relevant studies. Meta-DiSc (version 1.4) and STATA (version 11.0) software were used for the data analysis. Random effects models were used to assess diagnostic efficacy. Heterogeneity was tested by the Q statistic and I2 statistic. Meta-regression was used to analyze the sources of heterogeneity. Results A total of 10 studies, with 2151 lesions, were included. The pooled characteristics of these studies were as follows: sensitivity 0.85 (95% confidence interval [CI]: 0.81–0.89), specificity 0.96 (95% confidence interval [CI]: 0.95–0.97), and area under the curve (AUC) 0.9647. In the subgroup analysis, which compared the diagnostic efficacy of ME-NBI and white light imaging (WLI), the pooled sensitivity and specificity of ME-NBI were 0.87 (95% CI: 0.80–0.92) and 0.93 (95% CI: 0.90–0.95), respectively, and the area under the curve (AUC) was 0.9556. In contrast, the pooled sensitivity and specificity of WLI were 0.61 (95% CI: 0.53–0.69) and 0.65 (95% CI: 0.60–0.69), respectively, and the area under the curve (AUC) was 0.6772. Conclusions ME-NBI presents a high diagnostic value for gastric neoplasms and has a high specificity.
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Affiliation(s)
- Xiuhe Lv
- Department of Gastroenterology, West China Hospital of Sichuan University, Chengdu, Sichuan, China
| | - Chunhui Wang
- Department of Gastroenterology, West China Hospital of Sichuan University, Chengdu, Sichuan, China
| | - Yan Xie
- Department of Gastroenterology, West China Hospital of Sichuan University, Chengdu, Sichuan, China
| | - Zhaoping Yan
- Department of Gastroenterology, West China Hospital of Sichuan University, Chengdu, Sichuan, China
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