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Houwen BBSL, Hartendorp F, Giotis I, Hazewinkel Y, Fockens P, Walstra TR, Dekker E, van Boeckel P, Boparai K, Borg FT, Carballal S, Cazemier M, Daca M, van Eijk B, Jansen J, Koussoulas V, Kuipers T, van Lelyveld N, Ordas I, Marsman W, Moreira L, Muños FR, Noach L, Pellisé M, Ramsoekh D, Schröder R, van Soest E, van Noorden JT, Tytgat K, van Oosterwijk P, van Putten P, Vehmeijer A, Vries RD, van der Vlugt M, Voogd F, van der Zanden E. Computer-aided classification of colorectal segments during colonoscopy: a deep learning approach based on images of a magnetic endoscopic positioning device. Scand J Gastroenterol 2022; 58:649-655. [PMID: 36458659 DOI: 10.1080/00365521.2022.2151320] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/03/2022]
Abstract
OBJECTIVE Assessment of the anatomical colorectal segment of polyps during colonoscopy is important for treatment and follow-up strategies, but is largely operator dependent. This feasibility study aimed to assess whether, using images of a magnetic endoscope imaging (MEI) positioning device, a deep learning approach can be useful to objectively divide the colorectum into anatomical segments. METHODS Models based on the VGG-16 based convolutional neural network architecture were developed to classify the colorectum into anatomical segments. These models were pre-trained on ImageNet data and further trained using prospectively collected data of the POLAR study in which endoscopists were using MEI (3930 still images and 90,151 video frames). Five-fold cross validation with multiple runs was used to evaluate the overall diagnostic accuracies of the models for colorectal segment classification (divided into a 5-class and 2-class colorectal segment division). The colorectal segment assignment by endoscopists was used as the reference standard. RESULTS For the 5-class colorectal segment division, the best performing model correctly classified the colorectal segment in 753 of the 1196 polyps, corresponding to an overall accuracy of 63%, sensitivity of 63%, specificity of 89% and kappa of 0.47. For the 2-class colorectal segment division, 1112 of the 1196 polyps were correctly classified, corresponding to an accuracy of 93%, sensitivity of 93%, specificity of 90% and kappa of 0.82. CONCLUSION The diagnostic performance of a deep learning approach for colorectal segment classification based on images of a MEI device is yet suboptimal (clinicaltrials.gov: NCT03822390).
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Affiliation(s)
- Britt B S L Houwen
- Department of Gastroenterology and Hepatology, Amsterdam University Medical Center, Location Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands
| | - Fons Hartendorp
- Department of Computer Science, University of Amsterdam, Amsterdam, the Netherlands
| | - Ioanis Giotis
- ZiuZ Visual Intelligence, Gorredijk, the Netherlands
| | - Yark Hazewinkel
- Department of Gastroenterology and Hepatology, Radboud University Medical Center, Radboud University, Nijmegen, The Netherlands
| | - Paul Fockens
- Department of Gastroenterology and Hepatology, Amsterdam University Medical Center, Location Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands
| | - Taco R Walstra
- Department of Computer Science, University of Amsterdam, Amsterdam, the Netherlands
| | - Evelien Dekker
- Department of Gastroenterology and Hepatology, Amsterdam University Medical Center, Location Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands.,Bergman Clinics Maag & Darm Amsterdam, Amsterdam, The Netherlands
| | | | | | - P. van Boeckel
- Department of Gastroenterology and Hepatology, Sint Antonius Ziekenhuis, Nieuwegein, the Netherlands
| | - K. Boparai
- Department of Gastroenterology and Hepatology, Amstelland Hospital, Amstelveen, the Netherlands
| | - F. ter Borg
- Department of Gastroenterology and Hepatology, Deventer Hospital, Deventer, The Netherlands
| | - S. Carballal
- Department of Gastroenterology and Hepatology, Onze Lieve Vrouwe Gasthuis, Amsterdam, the Netherlands
- Department of Gastroenterology, Hospital Clinic of Barcelona, Barcelona, Spain
| | - M. Cazemier
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Institut d‘Investigacions Biomediques August Pi i Sunyer (IDIBAPS), Universitat de Barcelona, Barcelona, Spain
| | - M. Daca
- Department of Gastroenterology and Hepatology, Onze Lieve Vrouwe Gasthuis, Amsterdam, the Netherlands
- Department of Gastroenterology, Hospital Clinic of Barcelona, Barcelona, Spain
| | - B. van Eijk
- Department of Gastroenterology and Hepatology, Spaarne Ziekenhuis, Hoofddorp, the Netherlands
| | - J.M Jansen
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Institut d‘Investigacions Biomediques August Pi i Sunyer (IDIBAPS), Universitat de Barcelona, Barcelona, Spain
| | - V. Koussoulas
- Department of Gastroenterology and Hepatology, Nij Smellinghe Hospital, Drachten, The Netherlands
| | - T. Kuipers
- Department of Gastroenterology and Hepatology, Amstelland Hospital, Amstelveen, the Netherlands
| | - N. van Lelyveld
- Department of Gastroenterology and Hepatology, Sint Antonius Ziekenhuis, Nieuwegein, the Netherlands
| | - I. Ordas
- Department of Gastroenterology and Hepatology, Onze Lieve Vrouwe Gasthuis, Amsterdam, the Netherlands
- Department of Gastroenterology, Hospital Clinic of Barcelona, Barcelona, Spain
| | - W. Marsman
- Department of Gastroenterology and Hepatology, Nij Smellinghe Hospital, Drachten, The Netherlands
| | - L. Moreira
- Department of Gastroenterology and Hepatology, Onze Lieve Vrouwe Gasthuis, Amsterdam, the Netherlands
- Department of Gastroenterology, Hospital Clinic of Barcelona, Barcelona, Spain
| | - F.J Rando Muños
- Department of Gastroenterology and Hepatology, Nij Smellinghe Hospital, Drachten, The Netherlands
| | - L. Noach
- Department of Gastroenterology and Hepatology, Amstelland Hospital, Amstelveen, the Netherlands
| | - M. Pellisé
- Department of Gastroenterology and Hepatology, Onze Lieve Vrouwe Gasthuis, Amsterdam, the Netherlands
- Department of Gastroenterology, Hospital Clinic of Barcelona, Barcelona, Spain
| | - D. Ramsoekh
- Department of Gastroenterology and Hepatology, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, the Netherlands
- Bergman Clinics Maag & Darm Amsterdam, Amsterdam, The Netherlands
- Department of Gastroenterology and Hepatology, Amstelland Hospital, Amstelveen, the Netherlands
| | - R. Schröder
- Department of Gastroenterology and Hepatology, Nij Smellinghe Hospital, Drachten, The Netherlands
| | - E.J van Soest
- Department of Gastroenterology and Hepatology, Spaarne Ziekenhuis, Hoofddorp, the Netherlands
| | - J. Tenthof van Noorden
- Department of Gastroenterology and Hepatology, Sint Antonius Ziekenhuis, Nieuwegein, the Netherlands
| | - K.M.A.J Tytgat
- Department of Gastroenterology and Hepatology, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, the Netherlands
- Bergman Clinics Maag & Darm Amsterdam, Amsterdam, The Netherlands
| | - P. van Oosterwijk
- Department of Gastroenterology and Hepatology, Deventer Hospital, Deventer, The Netherlands
| | - P. van Putten
- Department of Gastroenterology and Hepatology, Medical Center Leeuwarden, Leeuwarden, The Netherlands
| | - A. Vehmeijer
- Department of Gastroenterology and Hepatology, Spaarne Ziekenhuis, Hoofddorp, the Netherlands
| | - R. de Vries
- Department of Gastroenterology and Hepatology, Deventer Hospital, Deventer, The Netherlands
| | - M. van der Vlugt
- Department of Gastroenterology and Hepatology, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, the Netherlands
- Bergman Clinics Maag & Darm Amsterdam, Amsterdam, The Netherlands
| | - F. Voogd
- Department of Gastroenterology and Hepatology, Medical Center Leeuwarden, Leeuwarden, The Netherlands
| | - E. van der Zanden
- Department of Gastroenterology and Hepatology, Amstelland Hospital, Amstelveen, the Netherlands
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