透過您的圖書館登入
IP:3.145.66.67
  • 學位論文

應用深度學習於腸胃道內視鏡對解剖部位分類及自動品質評估

Deep Learning Based Gastrointestinal Endoscopic Anatomy Classification and Automatic Quality Assessment

指導教授 : 李百祺
若您是本文的作者,可授權文章由華藝線上圖書館中協助推廣。

摘要


消化道內視鏡檢查過程中的照片記錄是檢查品質的指標之一,但是該指標在內視鏡檢查中心難以自動測量和審核,而新興的人工智慧技術可能可幫忙解決此問題。首先,我們將利用深度學習(Deep Learning, DL)依據歐洲胃腸內鏡學會指引對上消化道內視鏡影像進行分成八個特定解剖位置,然後再評估是否記錄了所有解剖位置的影像,以照片記錄率的完整性作為內視鏡檢查的自動化品質評估指標。同時,上消化道影像分類和品質指標系統也將擴展到下消化道內視鏡檢查。然而,一個好的 DL 模型需要大量的訓練數據來進行模型開發,為了減少醫師標記時間,我們開發了一種加速數據準備,在此提出的方法中,先使用較小的已標記數據集來訓練基礎模型,然後由基礎模型對另一個較大的尚未標記數據集進行分類,醫生將可以快速查看和修改由基礎模型分類的結果,隨後可以使用校正過的數據集重新訓練增強模型以提高性能,完成的基礎模型和增強模型的準確率分別達到 96.29% 和 96.64%。在開發了好的分類模型後,我們將利用 12 位內視鏡醫師進行的 472 次內視鏡檢查進行品質評估指標實驗,可發現腺瘤檢出率較高的內視鏡醫師從咽部到十二指腸(60.0% vs 38.7%,p<0.0001)和從食道到十二指腸(83.0% vs 65.7%,p<0.0001)有較高的完整檢查率。而在下消化道內視鏡檢查品質指標實驗中共分析了 761 個真實世界的報告和大腸鏡檢查影像,電子報告盲腸檢出率為 99.34%,而所提品質指標系統的盲腸檢出率為 98.95%;使用電子報告和品質指標系統評估息肉切除率的一致率為0.87;使用品質指標系統計算的檢查時間與醫生輸入的檢查時間存在良好的相關性(r = 0.959,p < 0.0001)。由上述實驗結果可得知本研究建立的內視鏡影像品質自動評估系統應可提升內視鏡檢查品質並為病患提供更好的照顧。

並列摘要


Photodocumentation is one endoscopy quality performance indicator; however, manually auditing this indicator is challenging in clinical practice. Artificial intelligence technology may help to solve this problem. In this study, the upper gastrointestinal (GI)endoscopy images are classified into eight specific anatomical landmarks according to the society of Gastrointestinal Endoscopy (ESGE) guideline by the proposed deep learning (DL) system. Then, this classification model can be used to assess whether all images of anatomical locations are documented and the completeness of the photodocumentation rate could be used as the quality indicator. Also, the upper GI classification and quality indicator system could be extended to the lower GI endoscopy. However, a good DL model requires a large amount of training data for model development. In order to reduce the labeling time, we develop an accelerated data preparation approach. In this proposed approach, a smaller labeled data set is first used to train the base model, and then another larger unlabeled data set is classified by the base model. The base model and enhanced model achieve total accuracy of 96.29% and 96.64%, respectively. After developing a good classification model, we can use this DL system to assess whether all images of anatomical locations are documented. The photodocumentation completeness rate could be usedas the quality indicator for the endoscopist performance. A total of 472 upper GI endoscopies performed by 12 endoscopists are enrolled. The higher adenoma detection endoscopists have a higher complete examination rate (83.0% vs. 65.7%). For the proposed lower GI quality indicator system, 761 real-world examinations are analyzed. The accuracy of the proposed algorithm for the cecal intubation rate is 98.95% and the polypectomy agreement rate of the electronic reports and the DL algorithm is 0.87. A good correlation of DL withdrawal time between and that entered by the physician is found (r = 0.959). From the above experiments, the proposed DL endoscopy quality indicator system could help to improve the ndoscopy procedure's performance and provide better patient care.

參考文獻


References
[1] H. Luo et al., "Real-time artificial intelligence for detection of upper gastrointestinal cancer by endoscopy: a multicentre, case-control, diagnostic study," Lancet Oncol, vol. 20, no. 12, pp. 1645-1654, Dec 2019, doi: 10.1016/S1470-2045(19)30637-0.
[2] T. Aoki et al., "Automatic detection of erosions and ulcerations in wireless capsule endoscopy images based on a deep convolutional neural network," Gastrointest Endosc, vol. 89, no. 2, pp. 357-363 e2, Feb 2019, doi: 10.1016/j.gie.2018.10.027.
[3] S. Attardo et al., "Artificial intelligence technologies for the detection of colorectal lesions: The future is now," World J Gastroenterol, vol. 26, no. 37, pp. 5606-5616, Oct 7 2020, doi: 10.3748/wjg.v26.i37.5606.
[4] A. R. Pimenta-Melo, M. Monteiro-Soares, D. Libanio, and M. Dinis-Ribeiro, "Missing rate for gastric cancer during upper gastrointestinal endoscopy: a systematic review and meta-analysis," Eur J Gastroenterol Hepatol, vol. 28, no. 9, pp. 1041-9, Sep 2016, doi: 10.1097/MEG.0000000000000657.

延伸閱讀