1. Deep learning and automatic differentiation of pancreatic lesions in endoscopic ultrasound - a transatlantic study.
- Author
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Saraiva MM, González-Haba M, Widmer J, Mendes F, Gonda T, Agudo B, Ribeiro T, Costa A, Fazel Y, Lera ME, Horneaux de Moura E, Bestetti A, Afonso J, Martins M, Almeida MJ, Vilas-Boas F, Moutinho-Ribeiro P, Lopes S, Fernandes J, Ferreira J, and Macedo G
- Abstract
Endoscopic ultrasound (EUS) allows characterization and biopsy of pancreatic lesions. Pancreatic cystic neoplasms (PCN) include in mucinous (M-PCN) and non-mucinous lesions (NM-PCN). Pancreatic ductal adenocarcinoma (P-DAC) is the commonest pancreatic solid lesion (PSL), followed by pancreatic neuroendocrine tumor (P-NET). While EUS is preferred for pancreatic lesion evaluation, its diagnostic accuracy is suboptimal. This multicentric study aims to develop a convolutional neural network (CNN) for detecting and distinguishing PCN (namely M-PCN and NM-PCN) and PSL (particularly P-DAC and P-NET). A CNN was developed with 378 EUS exams from 4 international reference centers (Centro Hospitalar Universitário São João, Hospital Universitario Puerta de Hierro Majadahonda, New York University Hospitals, Hospital das Clínicas FMUSP). 126.000 images were obtained - 19.528 M-PCN, 8.175 NM-PCN, 64.286 P-DAC, 29.153 P-NET and 4.858 normal pancreas images. A trinary CNN differentiated normal pancreas tissue from M-PCN and NM-PCN. A binary CNN distinguished P-DAC from P-NET. The total dataset was divided in a training and testing dataset (used for model's evaluation) in a 90/10% ratio. The model was evaluated through its sensitivity, specificity, positive and negative predictive values and accuracy. The CNN had 99.1% accuracy for identifying normal pancreatic tissue, 99.0% and 99.8% for M-PCN and NM-PCN, respectively. P-DAC and P-NET were distinguished with 94.0% accuracy. Our group developed the first worldwide CNN capable of detecting and differentiating the commonest PCN and PSL in EUS images, using exams from 4 centers in two continents, minimizing the impact of the demographic bias. Larger multicentric studies are needed for technology implementation., (Copyright © 2024 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of The American College of Gastroenterology.)
- Published
- 2024
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