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Multi-Instance Learning for Vocal Fold Leukoplakia Diagnosis Using White Light and Narrow-Band Imaging: A Multicenter Study.
- Source :
-
The Laryngoscope [Laryngoscope] 2024 Oct; Vol. 134 (10), pp. 4321-4328. Date of Electronic Publication: 2024 May 27. - Publication Year :
- 2024
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Abstract
- Objectives: Vocal fold leukoplakia (VFL) is a precancerous lesion of laryngeal cancer, and its endoscopic diagnosis poses challenges. We aim to develop an artificial intelligence (AI) model using white light imaging (WLI) and narrow-band imaging (NBI) to distinguish benign from malignant VFL.<br />Methods: A total of 7057 images from 426 patients were used for model development and internal validation. Additionally, 1617 images from two other hospitals were used for model external validation. Modeling learning based on WLI and NBI modalities was conducted using deep learning combined with a multi-instance learning approach (MIL). Furthermore, 50 prospectively collected videos were used to evaluate real-time model performance. A human-machine comparison involving 100 patients and 12 laryngologists assessed the real-world effectiveness of the model.<br />Results: The model achieved the highest area under the receiver operating characteristic curve (AUC) values of 0.868 and 0.884 in the internal and external validation sets, respectively. AUC in the video validation set was 0.825 (95% CI: 0.704-0.946). In the human-machine comparison, AI significantly improved AUC and accuracy for all laryngologists (pā<ā0.05). With the assistance of AI, the diagnostic abilities and consistency of all laryngologists improved.<br />Conclusions: Our multicenter study developed an effective AI model using MIL and fusion of WLI and NBI images for VFL diagnosis, particularly aiding junior laryngologists. However, further optimization and validation are necessary to fully assess its potential impact in clinical settings.<br />Level of Evidence: 3 Laryngoscope, 134:4321-4328, 2024.<br /> (© 2024 The American Laryngological, Rhinological and Otological Society, Inc.)
- Subjects :
- Humans
Male
Female
Middle Aged
Laryngeal Neoplasms diagnostic imaging
Laryngeal Neoplasms diagnosis
Aged
Laryngoscopy methods
ROC Curve
Precancerous Conditions diagnostic imaging
Precancerous Conditions diagnosis
Precancerous Conditions pathology
Artificial Intelligence
Deep Learning
Video Recording
Adult
Prospective Studies
Diagnosis, Differential
Light
Narrow Band Imaging methods
Vocal Cords diagnostic imaging
Vocal Cords pathology
Leukoplakia diagnostic imaging
Leukoplakia diagnosis
Leukoplakia pathology
Subjects
Details
- Language :
- English
- ISSN :
- 1531-4995
- Volume :
- 134
- Issue :
- 10
- Database :
- MEDLINE
- Journal :
- The Laryngoscope
- Publication Type :
- Academic Journal
- Accession number :
- 38801129
- Full Text :
- https://doi.org/10.1002/lary.31537