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Published in: Digestive Diseases and Sciences 5/2020

01-05-2020 | Endoscopy | Original Article

Convolutional Neural Network for Differentiating Gastric Cancer from Gastritis Using Magnified Endoscopy with Narrow Band Imaging

Authors: Yusuke Horiuchi, Kazuharu Aoyama, Yoshitaka Tokai, Toshiaki Hirasawa, Shoichi Yoshimizu, Akiyoshi Ishiyama, Toshiyuki Yoshio, Tomohiro Tsuchida, Junko Fujisaki, Tomohiro Tada

Published in: Digestive Diseases and Sciences | Issue 5/2020

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Abstract

Background

Early detection of early gastric cancer (EGC) allows for less invasive cancer treatment. However, differentiating EGC from gastritis remains challenging. Although magnifying endoscopy with narrow band imaging (ME-NBI) is useful for differentiating EGC from gastritis, this skill takes substantial effort. Since the development of the ability to convolve the image while maintaining the characteristics of the input image (convolution neural network: CNN), allowing the classification of the input image (CNN system), the image recognition ability of CNN has dramatically improved.

Aims

To explore the diagnostic ability of the CNN system with ME-NBI for differentiating between EGC and gastritis.

Methods

A 22-layer CNN system was pre-trained using 1492 EGC and 1078 gastritis images from ME-NBI. A separate test data set (151 EGC and 107 gastritis images based on ME-NBI) was used to evaluate the diagnostic ability [accuracy, sensitivity, positive predictive value (PPV), and negative predictive value (NPV)] of the CNN system.

Results

The accuracy of the CNN system with ME-NBI images was 85.3%, with 220 of the 258 images being correctly diagnosed. The method’s sensitivity, specificity, PPV, and NPV were 95.4%, 71.0%, 82.3%, and 91.7%, respectively. Seven of the 151 EGC images were recognized as gastritis, whereas 31 of the 107 gastritis images were recognized as EGC. The overall test speed was 51.83 images/s (0.02 s/image).

Conclusions

The CNN system with ME-NBI can differentiate between EGC and gastritis in a short time with high sensitivity and NPV. Thus, the CNN system may complement current clinical practice of diagnosis with ME-NBI.
Literature
1.
go back to reference Ono H, Kondo H, Gotoda T, et al. Endoscopic mucosal resection for treatment of early gastric cancer. Gut. 2001;48:225–229.CrossRef Ono H, Kondo H, Gotoda T, et al. Endoscopic mucosal resection for treatment of early gastric cancer. Gut. 2001;48:225–229.CrossRef
2.
go back to reference Gotoda T, Kondo H, Ono H, et al. A new endoscopic mucosal resection procedure using an insulation-tipped diathermic knife for rectal flat lesions: report of two cases. Gastrointest Endosc. 1999;50:560–563.CrossRef Gotoda T, Kondo H, Ono H, et al. A new endoscopic mucosal resection procedure using an insulation-tipped diathermic knife for rectal flat lesions: report of two cases. Gastrointest Endosc. 1999;50:560–563.CrossRef
3.
go back to reference Ohkuwa M, Hosokawa K, Boku N, Ohtu A, Tajiri H, Yoshida S. New endoscopic treatment for intramucosal gastric tumors using an insulated-tip diathermic knife. Endoscopy. 2001;33:221–226.CrossRef Ohkuwa M, Hosokawa K, Boku N, Ohtu A, Tajiri H, Yoshida S. New endoscopic treatment for intramucosal gastric tumors using an insulated-tip diathermic knife. Endoscopy. 2001;33:221–226.CrossRef
4.
go back to reference Yamamoto H, Kawata H, Sunada K, et al. Success rate of curative endoscopic mucosal resection with circumferential mucosal incision assisted by submucosal injection of sodium hyaluronate. Gastrointest Endosc. 2002;56:507–512.CrossRef Yamamoto H, Kawata H, Sunada K, et al. Success rate of curative endoscopic mucosal resection with circumferential mucosal incision assisted by submucosal injection of sodium hyaluronate. Gastrointest Endosc. 2002;56:507–512.CrossRef
5.
go back to reference Japanese Gastric Cancer Association. Japanese gastric cancer treatment guidelines 2014 (ver. 4). Gastric Cancer. 2017;20:1–19.CrossRef Japanese Gastric Cancer Association. Japanese gastric cancer treatment guidelines 2014 (ver. 4). Gastric Cancer. 2017;20:1–19.CrossRef
6.
go back to reference Ezoe Y, Muto M, Uedo N, et al. Magnifying narrowband imaging is more accurate than conventional white-light imaging in diagnosis of gastric mucosal cancer. Gastroenterology. 2011;141:2017–2025.CrossRef Ezoe Y, Muto M, Uedo N, et al. Magnifying narrowband imaging is more accurate than conventional white-light imaging in diagnosis of gastric mucosal cancer. Gastroenterology. 2011;141:2017–2025.CrossRef
7.
go back to reference Horiuchi Y, Fujisaki J, Yamamoto N, et al. Accuracy of diagnostic demarcation of undifferentiated-type early gastric cancers for magnifying endoscopy with narrow-band imaging: endoscopic submucosal dissection cases. Gastric Cancer. 2016;19:515–523.CrossRef Horiuchi Y, Fujisaki J, Yamamoto N, et al. Accuracy of diagnostic demarcation of undifferentiated-type early gastric cancers for magnifying endoscopy with narrow-band imaging: endoscopic submucosal dissection cases. Gastric Cancer. 2016;19:515–523.CrossRef
8.
go back to reference Horiuchi Y, Fujisaki J, Yamamoto N, et al. Accuracy of demarcation of undifferentiated-type early gastric cancer for magnifying endoscopy with narrow band imaging: surgical cases. Surg Endosc. 2017;31:1906–1913.CrossRef Horiuchi Y, Fujisaki J, Yamamoto N, et al. Accuracy of demarcation of undifferentiated-type early gastric cancer for magnifying endoscopy with narrow band imaging: surgical cases. Surg Endosc. 2017;31:1906–1913.CrossRef
9.
go back to reference Nakanishi H, Doyama H, Ishikawa H, et al. Evaluation of an e-learning system for diagnosis of gastric lesions using magnifying narrow-band imaging: a multicenter randomized controlled study. Endoscopy. 2017;49:957–967.CrossRef Nakanishi H, Doyama H, Ishikawa H, et al. Evaluation of an e-learning system for diagnosis of gastric lesions using magnifying narrow-band imaging: a multicenter randomized controlled study. Endoscopy. 2017;49:957–967.CrossRef
10.
go back to reference Kumagai Y, Takubo K, Kawada K, et al. Diagnosis using deep-learning artificial intelligence based on the endocytoscopic observation of the esophagus. Esophagus. 2019;16:180–187.CrossRef Kumagai Y, Takubo K, Kawada K, et al. Diagnosis using deep-learning artificial intelligence based on the endocytoscopic observation of the esophagus. Esophagus. 2019;16:180–187.CrossRef
11.
go back to reference Ozawa T, Ishihara S, Fujishiro M, et al. Novel computer-assisted diagnosis system for endoscopic disease activity in patients with ulcerative colitis. Gastrointest Endosc. 2018;89:416–421.CrossRef Ozawa T, Ishihara S, Fujishiro M, et al. Novel computer-assisted diagnosis system for endoscopic disease activity in patients with ulcerative colitis. Gastrointest Endosc. 2018;89:416–421.CrossRef
12.
go back to reference Horie Y, Yoshio T, Aoyama K, et al. Diagnostic outcomes of esophageal cancer by artificial intelligence using convolutional neural networks. Gastrointest Endosc. 2019;89:25–32.CrossRef Horie Y, Yoshio T, Aoyama K, et al. Diagnostic outcomes of esophageal cancer by artificial intelligence using convolutional neural networks. Gastrointest Endosc. 2019;89:25–32.CrossRef
13.
go back to reference Ishioka M, Hirasawa T, Tada T. Detecting gastric cancer from video images using convolutional neural networks. Dig Endosc.. 2019;31:e34–e35.CrossRef Ishioka M, Hirasawa T, Tada T. Detecting gastric cancer from video images using convolutional neural networks. Dig Endosc.. 2019;31:e34–e35.CrossRef
14.
go back to reference Takiyama H, Ozawa T, Ishihara S, et al. Automatic anatomical classification of esophagogastroduodenoscopy images using deep convolutional neural networks. Sci Rep. 2018;8:7497.CrossRef Takiyama H, Ozawa T, Ishihara S, et al. Automatic anatomical classification of esophagogastroduodenoscopy images using deep convolutional neural networks. Sci Rep. 2018;8:7497.CrossRef
15.
go back to reference Shichijo S, Nomura S, Aoyama K, et al. Application of convolutional neural networks in the diagnosis of helicobacter pylori infection based on endoscopic images. EBioMedicine. 2017;25:106–111.CrossRef Shichijo S, Nomura S, Aoyama K, et al. Application of convolutional neural networks in the diagnosis of helicobacter pylori infection based on endoscopic images. EBioMedicine. 2017;25:106–111.CrossRef
16.
go back to reference Hirasawa T, Aoyama K, Tanimoto T, et al. Application of artificial intelligence using a convolutional neural network for detecting gastric cancer in endoscopic images. Gastric Cancer. 2018;21:653–660.CrossRef Hirasawa T, Aoyama K, Tanimoto T, et al. Application of artificial intelligence using a convolutional neural network for detecting gastric cancer in endoscopic images. Gastric Cancer. 2018;21:653–660.CrossRef
19.
go back to reference Deng J, Dong W, Socher R, Li L, Li K, Fei-Fei L. Imagenet: a large-scale hierarchical image database. In: IEEE Conference on Computer Vision and Pattern Recognition. 2009:248–255. Deng J, Dong W, Socher R, Li L, Li K, Fei-Fei L. Imagenet: a large-scale hierarchical image database. In: IEEE Conference on Computer Vision and Pattern Recognition. 2009:248–255.
20.
go back to reference Jia Y, Shelhamer E, Donahue J, et al. Caffe: Convolutional Architecture for Fast Feature Embedding. arXiv preprint arXiv:1408.5093, 2014. Jia Y, Shelhamer E, Donahue J, et al. Caffe: Convolutional Architecture for Fast Feature Embedding. arXiv preprint arXiv:​1408.​5093, 2014.
22.
go back to reference Kimura K, Takemoto T. An endoscopic recognition of the atrophic border and its significance in chronic gastritis. Endoscopy. 1969;1:87–97.CrossRef Kimura K, Takemoto T. An endoscopic recognition of the atrophic border and its significance in chronic gastritis. Endoscopy. 1969;1:87–97.CrossRef
23.
go back to reference Muto M, Yao K, Kaise M, et al. Magnifying endoscopy simple diagnostic algorithm for early gastric cancer (MESDA-G). Dig Endosc. 2016;28:379–393.CrossRef Muto M, Yao K, Kaise M, et al. Magnifying endoscopy simple diagnostic algorithm for early gastric cancer (MESDA-G). Dig Endosc. 2016;28:379–393.CrossRef
24.
25.
go back to reference Handelman GS, Kok HK, Chandra RV, et al. Peering into the black box of artificial intelligence: evaluation metrics of machine learning methods. AJR Am J Roentgenol. 2019;212:38–43.CrossRef Handelman GS, Kok HK, Chandra RV, et al. Peering into the black box of artificial intelligence: evaluation metrics of machine learning methods. AJR Am J Roentgenol. 2019;212:38–43.CrossRef
Metadata
Title
Convolutional Neural Network for Differentiating Gastric Cancer from Gastritis Using Magnified Endoscopy with Narrow Band Imaging
Authors
Yusuke Horiuchi
Kazuharu Aoyama
Yoshitaka Tokai
Toshiaki Hirasawa
Shoichi Yoshimizu
Akiyoshi Ishiyama
Toshiyuki Yoshio
Tomohiro Tsuchida
Junko Fujisaki
Tomohiro Tada
Publication date
01-05-2020
Publisher
Springer US
Published in
Digestive Diseases and Sciences / Issue 5/2020
Print ISSN: 0163-2116
Electronic ISSN: 1573-2568
DOI
https://doi.org/10.1007/s10620-019-05862-6

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