The use of a real-time computer-aided detection system for visible lesions in the Barrett's esophagus during live endoscopic procedures, a pilot study

Kiki N Fockens; Jelmer B Jukema; Martijn R Jong; Tim Boers; Joost A van der Putten; Carolus H J Kusters; Roos E Pouw; Lucas C Duits; Fons van der Sommen; Peter H de With; A Jeroen de Groof; Jacques J Bergman; BONS-AI consortium

doi:10.1016/j.gie.2024.04.011

The use of a real-time computer-aided detection system for visible lesions in the Barrett's esophagus during live endoscopic procedures, a pilot study

Gastrointest Endosc. 2024 Apr 9:S0016-5107(24)00228-1. doi: 10.1016/j.gie.2024.04.011. Online ahead of print.

Affiliations

¹ Department of gastroenterology and hepatology, Amsterdam Gastroenterology, Endocrinology and Metabolism, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands.
² Department of electrical engineering, Eindhoven University of Technology, Eindhoven, the Netherlands.

PMID: 38604297
DOI: 10.1016/j.gie.2024.04.011

Abstract

Background and aims: In this pilot study we evaluated performance of a recently developed computer-aided detection (CADe) system for Barrett's neoplasia during live endoscopic procedures.

Methods: 15 patients with and 15 without a visible lesion were included in this study. A CAD assisted workflow was employed that included: a slow pullback video recording of the entire Barrett's segment with live CADe assistance, followed by CADe assisted level-based video recordings every 2cm of the Barrett's segment. Outcomes were per patient and per level diagnostic accuracy of the CAD assisted workflow, where the primary outcome was per patient in-vivo CADe sensitivity.

Results: In the per patient analyses, the CADe system detected all visible lesions (sensitivity 100%). Per patient CADe specificity was 53%. Per-level sensitivity and specificity of the CADe assisted workflow were 100% and 73%, respectively.

Conclusion: In this pilot study, the CADe system detected all potentially neoplastic lesions in Barrett's esophagus comparable to an expert endoscopist. Continued refinement of the system may improve specificity. External validation in larger multicenter studies is planned.