Abstract：
OBJECTIVE: This study presents a novel computer-aided diagnosis (CADx) designed for optically diagnosing colorectal polyps using white light imaging (WLI).We aimed to evaluate the effectiveness of the CADx and its auxiliary role among endoscopists with different levels of expertise.
METHODS: We collected 2,324 neoplastic and 3,735 nonneoplastic polyp WLI images for model training, and 838 colorectal polyp images from 740 patients for model validation. We compared the diagnostic accuracy of the CADx with that of 15 endoscopists under WLI and narrow band imaging (NBI). The auxiliary benefits of CADx for endoscopists of different experience levels and for identifying different types of colorectal polyps was also evaluated.
RESULTS: The CADx demonstrated an optical diagnostic accuracy of 84.49%, showing considerable superiority over all endoscopists, irrespective of whether WLI or NBI was used (P < 0.001). Assistance from the CADx significantly improved the diagnostic accuracy of the endoscopists from 68.84% to 77.49% (P = 0.001), with the most significant impact observed among novice endoscopists. Notably, novices using CADx-assisted WLI outperform junior and expert endoscopists without such assistance.
CONCLUSIONS: The CADx demonstrated a crucial role in substantially enhancing the precision of optical diagnosis for colorectal polyps under WLI and showed the greatest auxiliary benefits for novice endoscopists.
METHODS: We collected 2,324 neoplastic and 3,735 nonneoplastic polyp WLI images for model training, and 838 colorectal polyp images from 740 patients for model validation. We compared the diagnostic accuracy of the CADx with that of 15 endoscopists under WLI and narrow band imaging (NBI). The auxiliary benefits of CADx for endoscopists of different experience levels and for identifying different types of colorectal polyps was also evaluated.
RESULTS: The CADx demonstrated an optical diagnostic accuracy of 84.49%, showing considerable superiority over all endoscopists, irrespective of whether WLI or NBI was used (P < 0.001). Assistance from the CADx significantly improved the diagnostic accuracy of the endoscopists from 68.84% to 77.49% (P = 0.001), with the most significant impact observed among novice endoscopists. Notably, novices using CADx-assisted WLI outperform junior and expert endoscopists without such assistance.
CONCLUSIONS: The CADx demonstrated a crucial role in substantially enhancing the precision of optical diagnosis for colorectal polyps under WLI and showed the greatest auxiliary benefits for novice endoscopists.
摘要：
目的：本研究提出了一种新颖的计算机辅助诊断（CADx），旨在使用白光成像（WLI）对大肠息肉进行光学诊断。我们旨在评估CADx的有效性及其在具有不同专业知识水平的内窥镜医师中的辅助作用。
方法：我们收集了2,324张肿瘤和3,735张非肿瘤息肉WLI图像进行模型训练，和740名患者的838张结肠直肠息肉图像进行模型验证。我们比较了在WLI和窄带成像（NBI）下CADx与15位内窥镜医师的诊断准确性。还评估了CADx对不同经验水平的内窥镜医师和识别不同类型的结直肠息肉的辅助益处。
结果：CADx的光学诊断准确率为84.49%，在所有内窥镜医师中表现出相当大的优势，无论使用WLI还是NBI（P<0.001）。CADx的辅助将内窥镜医师的诊断准确率从68.84％提高到77.49％（P=0.001），在新手内窥镜医师中观察到的影响最大。值得注意的是,使用CADx辅助WLI的新手在没有这种帮助的情况下优于初级和专家内窥镜医师。
结论：CADx在显著提高WLI下结直肠息肉的光学诊断精度方面发挥了关键作用，并且对新手内镜医师显示出最大的辅助益处。
方法：我们收集了2,324张肿瘤和3,735张非肿瘤息肉WLI图像进行模型训练，和740名患者的838张结肠直肠息肉图像进行模型验证。我们比较了在WLI和窄带成像（NBI）下CADx与15位内窥镜医师的诊断准确性。还评估了CADx对不同经验水平的内窥镜医师和识别不同类型的结直肠息肉的辅助益处。
结果：CADx的光学诊断准确率为84.49%，在所有内窥镜医师中表现出相当大的优势，无论使用WLI还是NBI（P<0.001）。CADx的辅助将内窥镜医师的诊断准确率从68.84％提高到77.49％（P=0.001），在新手内窥镜医师中观察到的影响最大。值得注意的是,使用CADx辅助WLI的新手在没有这种帮助的情况下优于初级和专家内窥镜医师。
结论：CADx在显著提高WLI下结直肠息肉的光学诊断精度方面发挥了关键作用，并且对新手内镜医师显示出最大的辅助益处。
