Clin Endosc.  2024 Jan;57(1):11-17. 10.5946/ce.2023.173.

Application of artificial intelligence for diagnosis of early gastric cancer based on magnifying endoscopy with narrow-band imaging

• Horiuchi Y
• Hirasawa T
• Fujisaki J

• KMID: 2551185
• DOI: http://doi.org/10.5946/ce.2023.173

Abstract

Although magnifying endoscopy with narrow-band imaging is the standard diagnostic test for gastric cancer, diagnosing gastric cancer using this technology requires considerable skill. Artificial intelligence has superior image recognition, and its usefulness in endoscopic image diagnosis has been reported in many cases. The diagnostic performance (accuracy, sensitivity, and specificity) of artificial intelligence using magnifying endoscopy with narrow band still images and videos for gastric cancer was higher than that of expert endoscopists, suggesting the usefulness of artificial intelligence in diagnosing gastric cancer. Histological diagnosis of gastric cancer using artificial intelligence is also promising. However, previous studies on the use of artificial intelligence to diagnose gastric cancer were small-scale; thus, large-scale studies are necessary to examine whether a high diagnostic performance can be achieved. In addition, the diagnosis of gastric cancer using artificial intelligence has not yet become widespread in clinical practice, and further research is necessary. Therefore, in the future, artificial intelligence must be further developed as an instrument, and its diagnostic performance is expected to improve with the accumulation of numerous cases nationwide.

Keyword

Artificial intelligence; Diagnosis; Endoscopy; Narrow-band imaging; Stomach neoplasms

Figure

• 

  Fig. 1. Endoscopic images used to educate the convolutional neural network. (A) Differentiated-type cancer: irregular vessels (yellow arrows indicate demarcation line). (B) Differentiated-type cancer: irregular vessels and structures (yellow arrows indicate demarcation lines). (C) Undifferentiated-type cancer: irregular vessels and structure. (D) Undifferentiated-type cancer: irregular vessels. (E) Gastritis: atrophy of fundic gland. (F) Gastritis: intestinal metaplasia. Reproduced from Horiuchi et al. Dig Dis Sci 2020;65:1355–1363, with permission.17

• 

  Fig. 2. Magnifying endoscopy with narrow-band imaging findings. (A) Differentiated-type findings defined by the fine network or loop pattern. (B) Undifferentiated-type findings defined by extended intervening parts, wavy microvessels, or a corkscrew pattern. Reproduced Horiuchi et al. Dig Dis Sci 2020;65:591–599, with permission.37

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