Development of artificial intelligence system for quality control of photo documentation in esophagogastroduodenoscopy

Abstract

Background

Esophagogastroduodenoscopy (EGD) is generally a safe procedure, but adverse events often occur. This highlights the necessity of the quality control of EGD. Complete visualization and photo documentation of upper gastrointestinal (UGI) tracts are important measures in quality control of EGD. To evaluate these measures in large scale, we developed an AI-driven quality control system for EGD through convolutional neural networks (CNNs) using archived endoscopic images.

Methods

We retrospectively collected and labeled images from 250 EGD procedures, a total of 2599 images from eight locations of the UGI tract, using the European Society of Gastrointestinal Endoscopy (ESGE) photo documentation methods. The label confirmed by five experts was considered the gold standard. We developed a CNN model for multi-class classification of EGD images to one of the eight locations and binary classification of each EGD procedure based on its completeness.

Results

Our CNN model successfully classified the EGD images into one of the eight regions of UGI tracts with 97.58% accuracy, 97.42% sensitivity, 99.66% specificity, 97.50% positive predictive value (PPV), and 99.66% negative predictive value (NPV). Our model classified the completeness of EGD with 89.20% accuracy, 89.20% sensitivity, 100.00% specificity, 100.00% PPV, and 64.94% NPV. We analyzed the credibility of our model using a probability heatmap.

Conclusions

We constructed a CNN model that could be used in the quality control of photo documentation in EGD. Our model needs further validation with a large dataset, and we expect our model to help both endoscopists and patients by improving the quality of EGD procedures.

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Acknowledgements

This work was supported by National IT Industry Promotion Agency (A0105-20-1007) and Basic Science Research Program through the National Research Foundation of Korea (NRF) funded by the Ministry of Education (2018R1D1A1B07048202).

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Correspondence to Hyuk Soon Choi or Jaegul Choo.

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Disclosures

Seong Ji Choi, Mohammad Azam Khan, Hyuk Soon Choi, Jaegul Choo, Jae Min Lee, Soonwook Kwon, Bora Keum, and Hoon Jai Chun have no conflicts of interest or financial ties to disclose.

Ethical approval

This study was conducted in accordance with the Helsinki Declaration, and the Ethics Committee of Korea University Anam Hospital approved this study (2019AN0253).

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Choi, S.J., Khan, M.A., Choi, H.S. et al. Development of artificial intelligence system for quality control of photo documentation in esophagogastroduodenoscopy. Surg Endosc (2021). https://doi.org/10.1007/s00464-020-08236-6

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Keywords

  • Endoscopy
  • Esophagogastroduodenoscopy
  • Artificial intelligence
  • Deep learning
  • Quality control