人工智能实时预测大肠直肠息肉组织学由一般内镜医生
Douglas K Rex1, Indira Bhavsar-Burke1, Daniel Buckles2
1Indiana University School of Medicine, Indianapolis, Indiana (D.K.R., I.B., M.F., A.G., T.J., S.K., T.N., I.O., N.R., S.S., A.S., R.S.).
Annals of internal medicine
|May 20, 2024
概括
针对小结直肠多的计算机辅助诊断 (CADx) 没有提高敏感性,但在实时多诊断中略有提高了特异性. 虽然CADx辅助诊断显示了微小的特异性改善,但它仍然不适合常规临床使用.
科学领域:
- 胃肠病学 胃肠病学
- 医疗成像医学成像
- 人工智能在医学中的应用
背景情况:
- 小结直肠多的实时组织学特征预测可以通过避免切除和病理评估来降低成本.
- 以前的计算机辅助诊断 (CADx) 研究显示了高准确性,但没有超过专家内镜师.
研究的目的:
- 在现实环境中评估一般内镜师在CADx辅助前后预测聚组织学方面的诊断性能.
- 评估CADx对小结直肠多瘤光学诊断的灵敏度和特异性的影响.
主要方法:
- 这是一项前性多中心研究,涉及49名美国6个中心的全科医生.
- 实时CADx在1252名患者的常规结肠镜检查中使用,分析了2695个尺寸为5毫米或更小的息肉.
- 主要终点是CADx无辅助与CADx辅助组织学预测的灵敏度和特异性.
主要成果:
- 在无辅助和CADx辅助组之间没有观察到敏感度的显著差异 (90.7%和90.8%).
- 在CADx辅助组 (64.7%) 的特异性高于无辅助组 (59.5%).
- 在CADx的帮助下,可以在没有病理评估的情况下丢弃的息肉比例 (88.2%对86.1%) 和留在现场的息肉比例 (49.5%对47.9%) 增加了.
结论:
- CADx辅助并没有提高小结直肠多体的光学诊断的灵敏度.
- 虽然特异性在CADx辅助下略有增加,但它仍然不足以广泛临床应用.
- 该研究强调了减少不必要程序的潜在好处,但指出诊断准确性的局限性.
相关概念视频
01:26Imaging Studies III: Gastrointestinal Motility Studies and Virtual Colonoscopy
77
This lesson explores three gastrointestinal imaging techniques: radionuclide testing, colonic transit studies, and virtual colonoscopy.
Radionuclide Testing
Radionuclide testing is a sophisticated medical technique for assessing gastrointestinal motility. It focuses on gastric emptying and colonic transit time. Radioactive markers track the movement of food through the digestive system, providing insights into gastrointestinal disorders.
In gastric emptying studies, a meal's liquid and...
Radionuclide Testing
Radionuclide testing is a sophisticated medical technique for assessing gastrointestinal motility. It focuses on gastric emptying and colonic transit time. Radioactive markers track the movement of food through the digestive system, providing insights into gastrointestinal disorders.
In gastric emptying studies, a meal's liquid and...
77
01:25Endoscopic Procedures II: Colonoscopy
82
The colon, or large intestine, is the final segment of the digestive system. Its primary functions include absorbing water and vitamins produced by gut bacteria and transforming waste from liquid to solid to form stool. In adults, the large intestine is approximately 5 feet long and consists of four main sections:
82
01:28Endoscopic Procedures III: Video Capsule Endoscopy
128
Capsule endoscopy, or wireless or video capsule endoscopy, is a diagnostic procedure for examining the entire gastrointestinal tract. Patients swallow a capsule about the size of a vitamin tablet. The capsule is equipped with a transmitter, a battery, an LED light source, and a color video camera to capture images throughout the gastrointestinal tract. This procedure is particularly useful for diagnosing conditions such as Crohn's disease, ulcerative colitis, tumors, polyps, ulcers,...
128