Artificial intelligence for the detection of esophageal and esophagogastric junctional adenocarcinoma

Hiroyoshi Iwagami, Ryu Ishihara, Kazuharu Aoyama, Hiromu Fukuda, Yusaku Shimamoto, Mitsuhiro Kono, Hiroko Nakahira, Noriko Matsuura, Satoki Shichijo, Takashi Kanesaka, Hiromitsu Kanzaki, Tatsuya Ishii, Yasuki Nakatani, Tomohiro Tada

Research output: Contribution to journalArticle

Abstract

Background and Aim: Conventional endoscopy for the early detection of esophageal and esophagogastric junctional adenocarcinoma (E/J cancer) is limited because early lesions are asymptomatic, and the associated changes in the mucosa are subtle. There are no reports on artificial intelligence (AI) diagnosis for E/J cancer from Asian countries. Therefore, we aimed to develop a computerized image analysis system using deep learning for the detection of E/J cancers. Methods: A total of 1172 images from 166 pathologically proven superficial E/J cancer cases and 2271 images of normal mucosa in esophagogastric junctional from 219 cases were used as the training image data. A total of 232 images from 36 cancer cases and 43 non-cancerous cases were used as the validation test data. The same validation test data were diagnosed by 15 board-certified specialists (experts). Results: The sensitivity, specificity, and accuracy of the AI system were 94%, 42%, and 66%, respectively, and that of the experts were 88%, 43%, and 63%, respectively. The sensitivity of the AI system was favorable, while its specificity for non-cancerous lesions was similar to that of the experts. Interobserver agreement among the experts for detecting superficial E/J was fair (Fleiss' kappa = 0.26, z = 20.4, P < 0.001). Conclusions: Our AI system achieved high sensitivity and acceptable specificity for the detection of E/J cancers and may be a good supporting tool for the screening of E/J cancers.

Original languageEnglish
JournalJournal of Gastroenterology and Hepatology (Australia)
DOIs
Publication statusAccepted/In press - 2020
Externally publishedYes

Keywords

  • AI
  • EGJ
  • adenocarcinoma
  • artificial intelligence
  • detection
  • esophageal

ASJC Scopus subject areas

  • Hepatology
  • Gastroenterology

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  • Cite this

    Iwagami, H., Ishihara, R., Aoyama, K., Fukuda, H., Shimamoto, Y., Kono, M., Nakahira, H., Matsuura, N., Shichijo, S., Kanesaka, T., Kanzaki, H., Ishii, T., Nakatani, Y., & Tada, T. (Accepted/In press). Artificial intelligence for the detection of esophageal and esophagogastric junctional adenocarcinoma. Journal of Gastroenterology and Hepatology (Australia). https://doi.org/10.1111/jgh.15136