51. Artificial Intelligence in Surveillance of Barrett’s Esophagus
- Author
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Anant Madabhushi, Joseph Willis, and Paula Toro
- Subjects
0301 basic medicine ,Adult ,Male ,Cancer Research ,Endoscope ,Adolescent ,Esophageal Neoplasms ,Pilot Projects ,Adenocarcinoma ,Article ,03 medical and health sciences ,Barrett Esophagus ,Young Adult ,0302 clinical medicine ,Artificial Intelligence ,medicine ,Humans ,Prospective Studies ,Esophagus ,Aged ,Aged, 80 and over ,Multispectral data ,business.industry ,Endoscopy ,Middle Aged ,medicine.disease ,Prognosis ,Reflectivity ,digestive system diseases ,United Kingdom ,030104 developmental biology ,medicine.anatomical_structure ,Oncology ,030220 oncology & carcinogenesis ,Barrett's esophagus ,Case-Control Studies ,Population Surveillance ,Female ,Artificial intelligence ,business ,Algorithms ,Follow-Up Studies - Abstract
Early detection of esophageal neoplasia enables curative endoscopic therapy, but the current diagnostic standard of care has low sensitivity because early neoplasia is often inconspicuous with conventional white light endoscopy. Here we hypothesized that spectral endoscopy could enhance contrast for neoplasia in surveillance of patients with Barrett’s esophagus (BE). A custom spectral endoscope was deployed in a pilot clinical study of 20 patients to capture 715 in vivo tissue spectra matched with gold standard diagnosis from histopathology. Spectral endoscopy was sensitive to changes in neovascularization during the progression of disease; both non-dysplastic and neoplastic BE showed higher blood volume relative to healthy squamous tissue (p = 0.001 and 0.02, respectively), and vessel radius appeared larger in neoplasia relative to non-dysplastic BE (p = 0.06). We further developed a deep learning algorithm capable of classifying spectra of neoplasia vs. non-dysplastic BE with high accuracy (84.8% accuracy, 83.7% sensitivity, 85.5% specificity, 78.3% positive predictive value and 89.4% negative predictive value). Exploiting the newly acquired library of labeled spectra to model custom color filter sets identified a potential 12-fold enhancement in contrast between neoplasia and non-dysplastic BE using application-specific color filters compared to standard-of-care white light imaging (perceptible color difference = 32.4, 2.7 respectively). This work demonstrates the potential of endoscopic spectral imaging to extract vascular properties in BE, to classify disease stages using deep learning, and to enable high-contrast endoscopy.
- Published
- 2021