Clinical Research
Copyright ©2008 The WJG Press and Baishideng. All rights reserved.
World J Gastroenterol. Dec 7, 2008; 14(45): 6929-6935
Published online Dec 7, 2008. doi: 10.3748/wjg.14.6929
A feasibility trial of computer-aided diagnosis for enteric lesions in capsule endoscopy
Tao Gan, Jun-Chao Wu, Ni-Ni Rao, Tao Chen, Bing Liu
Tao Gan, Jun-Chao Wu, Digestive Endoscopic Center, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
Ni-Ni Rao, Bing Liu, School of Life Sciences and Technology, University of Electronic Science and Technology of China, Chengdu 610054, Sichuan Province, China
Tao Chen, Chengdu Yinhai Computer Company, Chengdu 610044, Sichuan Province, China
Author contributions: Gan T and Wu JC designed the research, offered the clinical data and scanned the images of the capsule endoscopy; Gan T, Rao NN and Chen T developed the algorithms and software; Gan T, Chen T and Liu B analyzed the data; Gan T and Wu JC wrote the paper.
Supported by A Grant offered by West China Hospital, Sichuan University, No. 2007SZ018
Correspondence to: Jun-Chao Wu, MD, Digestive Endoscopic Center, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China. gantao123@yahoo.com.cn
Telephone: +86-28-85422389 Fax: +86-28-86637179
Received: June 20, 2008
Revised: September 17, 2008
Accepted: September 24, 2008
Published online: December 7, 2008
Abstract

AIM: To investigate and evaluate the feasibility of the computer-aided screening diagnosis for enteric lesions in the capsule endoscopy (CE).

METHODS: After developing a series of algorithms for the screening diagnosis of the enteric lesions in CE based on their characteristic colors and contours, the normal and abnormal images obtained from 289 patients were respectively scanned and diagnosed by the CE readers and by the computer-aided screening for the enteric lesions with the image-processed software (IPS). The enteric lesions shown by the images included esoenteritis, mucosal ulcer and erosion, bleeding, space-occupying lesions, angioectasia, diverticula, parasites, etc. The images for the lesions or the suspected lesions confirmed by the CE readers and the computers were collected, and the effectiveness rate of the screening and the number of the scanned images were evaluated, respectively.

RESULTS: Compared with the diagnostic results obtained by the CE readers, the total effectiveness rate (sensitivity) in the screening of the commonly-encountered enteric lesions by IPS varied from 42.9% to 91.2%, with a median of 74.2%, though the specificity and the accuracy rates were still low, and the images for the rarely-encountered lesions were difficult to differentiate from the normal images. However, the number of the images screened by IPS was 5000 on average, and only 10%-15% of the original images were left behind. As a result, a large number of normal images were excluded, and the reading time decreased from 5 h to 1 h on average.

CONCLUSION: Though the total accuracy and specificity rates by the computer-aided screening for the enteric lesions with IPS are much lower than those by the CE readers, the computer-aided screening diagnosis can exclude a large number of the normal images and confine the enteric lesions to 5000 images on average, which can reduce the workload of the readers in the scanning of the images. This computer-aided screening technique can make a correct diagnosis as efficiently as possible in most of the patients.

Keywords: Enteric lesions; Image processing; Capsule endoscopy; Diagnosis