Skip to main content
Erschienen in: Esophagus 3/2020

24.01.2020 | Original Article

Application of artificial intelligence using convolutional neural networks in determining the invasion depth of esophageal squamous cell carcinoma

verfasst von: Yoshitaka Tokai, Toshiyuki Yoshio, Kazuharu Aoyama, Yoshimasa Horie, Shoichi Yoshimizu, Yusuke Horiuchi, Akiyoshi Ishiyama, Tomohiro Tsuchida, Toshiaki Hirasawa, Yuko Sakakibara, Takuya Yamada, Shinjiro Yamaguchi, Junko Fujisaki, Tomohiro Tada

Erschienen in: Esophagus | Ausgabe 3/2020

Einloggen, um Zugang zu erhalten

Abstract

Objectives

In Japan, endoscopic resection (ER) is often used to treat esophageal squamous cell carcinoma (ESCC) when invasion depths are diagnosed as EP-SM1, whereas ESCC cases deeper than SM2 are treated by surgical operation or chemoradiotherapy. Therefore, it is crucial to determine the invasion depth of ESCC via preoperative endoscopic examination. Recently, rapid progress in the utilization of artificial intelligence (AI) with deep learning in medical fields has been achieved. In this study, we demonstrate the diagnostic ability of AI to measure ESCC invasion depth.

Methods

We retrospectively collected 1751 training images of ESCC at the Cancer Institute Hospital, Japan. We developed an AI-diagnostic system of convolutional neural networks using deep learning techniques with these images. Subsequently, 291 test images were prepared and reviewed by the AI-diagnostic system and 13 board-certified endoscopists to evaluate the diagnostic accuracy.

Results

The AI-diagnostic system detected 95.5% (279/291) of the ESCC in test images in 10 s, analyzed the 279 images and correctly estimated the invasion depth of ESCC with a sensitivity of 84.1% and accuracy of 80.9% in 6 s. The accuracy score of this system exceeded those of 12 out of 13 board-certified endoscopists, and its area under the curve (AUC) was greater than the AUCs of all endoscopists.

Conclusions

The AI-diagnostic system demonstrated a higher diagnostic accuracy for ESCC invasion depth than those of endoscopists and, therefore, can be potentially used in ESCC diagnostics.
Literatur
1.
Zurück zum Zitat Kamangar F, Dores GM, Anderson WF. Patterns of cancer incidence, mortality, and prevalence across five continents: defining priorities to reduce cancer disparities in different geographic regions of the world. J Clin Oncol. 2006;24:2137–50.CrossRef Kamangar F, Dores GM, Anderson WF. Patterns of cancer incidence, mortality, and prevalence across five continents: defining priorities to reduce cancer disparities in different geographic regions of the world. J Clin Oncol. 2006;24:2137–50.CrossRef
2.
Zurück zum Zitat Wei WQ, Chen ZF, He YT, et al. Long-term follow-up of a community assignment, one-time endoscopic screening study of esophageal cancer in China. J Clin Oncol. 2015;33:1951–7.CrossRef Wei WQ, Chen ZF, He YT, et al. Long-term follow-up of a community assignment, one-time endoscopic screening study of esophageal cancer in China. J Clin Oncol. 2015;33:1951–7.CrossRef
3.
Zurück zum Zitat Natsugoe S, Baba M, Yoshinaka H, et al. Mucosal squamous cell carcinoma of the esophagus: a clinicopathologic study of 30 cases. Oncology. 1998;55:235–41.CrossRef Natsugoe S, Baba M, Yoshinaka H, et al. Mucosal squamous cell carcinoma of the esophagus: a clinicopathologic study of 30 cases. Oncology. 1998;55:235–41.CrossRef
4.
Zurück zum Zitat Tajima Y, Nakanishi Y, Tachimori Y, et al. Significance of involvement by squamous cell carcinoma of the ducts of esophageal submucosal glands. Analysis of 201 surgically resected superficial squamous cell carcinomas. Cancer. 2000;89:248–54.CrossRef Tajima Y, Nakanishi Y, Tachimori Y, et al. Significance of involvement by squamous cell carcinoma of the ducts of esophageal submucosal glands. Analysis of 201 surgically resected superficial squamous cell carcinomas. Cancer. 2000;89:248–54.CrossRef
5.
Zurück zum Zitat Bollschweiler E, Baldus SE, Schröder W, et al. High rate of lymph-node metastasis in submucosal esophageal squamous-cell carcinomas and adenocarcinomas. Endoscopy. 2006;38:149–56.CrossRef Bollschweiler E, Baldus SE, Schröder W, et al. High rate of lymph-node metastasis in submucosal esophageal squamous-cell carcinomas and adenocarcinomas. Endoscopy. 2006;38:149–56.CrossRef
6.
Zurück zum Zitat Higuchi K, Koizumi W, Tanabe S, et al. Current management of esophageal squamous-cell carcinoma in Japan and other countries. Gastrointest Cancer Res. 2009;3:153–61.PubMedPubMedCentral Higuchi K, Koizumi W, Tanabe S, et al. Current management of esophageal squamous-cell carcinoma in Japan and other countries. Gastrointest Cancer Res. 2009;3:153–61.PubMedPubMedCentral
7.
Zurück zum Zitat Kuwano H, Nishimura Y, Oyama T, et al. Guidelines for diagnosis and treatment of carcinoma of the esophagus April 2012 edited by the Japan Esophageal Society. Esophagus. 2015;12:1–30.CrossRef Kuwano H, Nishimura Y, Oyama T, et al. Guidelines for diagnosis and treatment of carcinoma of the esophagus April 2012 edited by the Japan Esophageal Society. Esophagus. 2015;12:1–30.CrossRef
8.
Zurück zum Zitat Horie Y, Yoshio T, Aoyama K, et al. Diagnostic outcomes of esophageal cancer by artificial intelligence using convolutional neural networks. Gastrointest Endosc. 2019;89:25–322.CrossRef Horie Y, Yoshio T, Aoyama K, et al. Diagnostic outcomes of esophageal cancer by artificial intelligence using convolutional neural networks. Gastrointest Endosc. 2019;89:25–322.CrossRef
9.
Zurück zum Zitat Kanda Y. Investigation of the freely available easy-to-use software ‘EZR’ for medical statistics. Bone Marrow Transpl. 2013;48:452–8.CrossRef Kanda Y. Investigation of the freely available easy-to-use software ‘EZR’ for medical statistics. Bone Marrow Transpl. 2013;48:452–8.CrossRef
10.
Zurück zum Zitat Makuuchi H, Shimada H, Mizutani K, et al. Endoscopic criteria for invasive depth of superficial esophageal cancer. Dig Endosc. 1997;9:110–5.CrossRef Makuuchi H, Shimada H, Mizutani K, et al. Endoscopic criteria for invasive depth of superficial esophageal cancer. Dig Endosc. 1997;9:110–5.CrossRef
11.
Zurück zum Zitat Chino O, Makuuchi H, Shimada H, et al. Diagnosis of the invasion depth of superficial esophageal carcinoma. Gastroenterol Endosc. 2015;57:1243–53 (in Japanese with English abstract). Chino O, Makuuchi H, Shimada H, et al. Diagnosis of the invasion depth of superficial esophageal carcinoma. Gastroenterol Endosc. 2015;57:1243–53 (in Japanese with English abstract).
12.
Zurück zum Zitat Ebi M, Shimura T, Yamada T, et al. Multicenter, prospective trial of white-light imaging alone versus white-light imaging followed by magnifying endoscopy with narrow-band imaging for the real-time imaging and diagnosis of invasion depth in superficial esophageal squamous cell carcinoma. Gastrointest Endosc. 2015;81:1355–61.CrossRef Ebi M, Shimura T, Yamada T, et al. Multicenter, prospective trial of white-light imaging alone versus white-light imaging followed by magnifying endoscopy with narrow-band imaging for the real-time imaging and diagnosis of invasion depth in superficial esophageal squamous cell carcinoma. Gastrointest Endosc. 2015;81:1355–61.CrossRef
13.
Zurück zum Zitat Thosani N, Singh H, Kapadia A, et al. Diagnostic accuracy of EUS in differentiating mucosal versus submucosal invasion of superficial esophageal cancers: a systematic review and meta-analysis. Gastrointest Endosc. 2012;75:24253. Thosani N, Singh H, Kapadia A, et al. Diagnostic accuracy of EUS in differentiating mucosal versus submucosal invasion of superficial esophageal cancers: a systematic review and meta-analysis. Gastrointest Endosc. 2012;75:24253.
14.
Zurück zum Zitat Shimizu Y, Kato M, Yamamoto J, et al. EMR combined with chemoradiotherapy: a novel treatment for superficial esophageal squamous-cell carcinoma. Gastrointest Endosc. 2004;59:199–204.CrossRef Shimizu Y, Kato M, Yamamoto J, et al. EMR combined with chemoradiotherapy: a novel treatment for superficial esophageal squamous-cell carcinoma. Gastrointest Endosc. 2004;59:199–204.CrossRef
15.
Zurück zum Zitat Saeki H, Watanabe M, Mine S, et al. Esophagectomy for superficial esophageal cancer after non-curative endoscopic resection. J Gastroenterol. 2015;50:406–13.CrossRef Saeki H, Watanabe M, Mine S, et al. Esophagectomy for superficial esophageal cancer after non-curative endoscopic resection. J Gastroenterol. 2015;50:406–13.CrossRef
16.
Zurück zum Zitat Nakagawa K, Ishihara R, Aoyama K, et al. Classification for invasion depth of esophageal squamous cell carcinoma using a deep neural network compared with experienced endoscopists. Gastrointest Endosc 2019 (Epub ahead of print). Nakagawa K, Ishihara R, Aoyama K, et al. Classification for invasion depth of esophageal squamous cell carcinoma using a deep neural network compared with experienced endoscopists. Gastrointest Endosc 2019 (Epub ahead of print).
Metadaten
Titel
Application of artificial intelligence using convolutional neural networks in determining the invasion depth of esophageal squamous cell carcinoma
verfasst von
Yoshitaka Tokai
Toshiyuki Yoshio
Kazuharu Aoyama
Yoshimasa Horie
Shoichi Yoshimizu
Yusuke Horiuchi
Akiyoshi Ishiyama
Tomohiro Tsuchida
Toshiaki Hirasawa
Yuko Sakakibara
Takuya Yamada
Shinjiro Yamaguchi
Junko Fujisaki
Tomohiro Tada
Publikationsdatum
24.01.2020
Verlag
Springer Singapore
Erschienen in
Esophagus / Ausgabe 3/2020
Print ISSN: 1612-9059
Elektronische ISSN: 1612-9067
DOI
https://doi.org/10.1007/s10388-020-00716-x

Weitere Artikel der Ausgabe 3/2020

Esophagus 3/2020 Zur Ausgabe

Leitlinien kompakt für die Innere Medizin

Mit medbee Pocketcards sicher entscheiden.

Seit 2022 gehört die medbee GmbH zum Springer Medizin Verlag

Update Innere Medizin

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.