Comparative study on artificial intelligence systems for detecting early esophageal squamous cell carcinoma between narrow-band and white-light imaging

Table 1 Patient and lesion characteristics in the validation image set

Patient characteristics, n = 112	Value
Median age, yr (range)	59 (19-86)
Sex, male/female	67/45
Lesion characteristics, n = 42
Median size, mm (range)	23 (9-42)
Location, Ce/Ut/Mt/Lt/Ae	0/3/24/15/0
Pathological diagnosis
LGIN/HGIN	6/18
Cancer, M/SM1	15/3

Ae: Abdominal esophagus; Ce: Cervical esophagus; HGIN: High-grade intraepithelial neoplasia; LGIN: Low-grade intraepithelial neoplasia; Lt: Lower thoracic esophagus; M: Mucosal; Mt: Middle thoracic esophagus; SM1: Submucosal; Ut: Upper thoracic esophagus.

Table 2 Diagnostic performance of computer-assisted detection systems vs endoscopists

	CAD systems		Endoscopists
	CAD-NBI	CAD-WLI	All, n = 20	Experienced, n = 4	Mid-level, n = 8	Junior, n = 8
Sensitivity, % (95%CI)	91.0	98.5	73.9 (68.1-79.7)	94.7 (85.0-100)	73.9 (71.9-75.8)	63.5 (59.7-67.3)
Specificity, % (95%CI)	96.7	83.1	87.7 (84.9-90.5)	92.8 (81.2-100)	83.4 (81.1-85.7)	89.4 (85.0-93.8)
Accuracy, % (95%CI)	94.3	89.5	81.9 (78.9-84.8)	93.6 (89.1-98.1)	79.4 (78.3-80.5)	78.5 (76.6-80.4)
PPV, % (95%CI)	95.3	80.8	81.7 (78.0-85.5)	91.4 (78.0-100)	76.5 (74.2-78.8)	82.2 (76.1-88.2)
NPV, % (95%CI)	93.6	98.7	82.7 (79.2-86.3)	96.4 (90.1-100)	81.5 (80.5-82.4)	77.2 (75.8-78.6)

CAD: Computer-assisted detection; CI: Confidence interval; NBI: Narrow-band imaging; NPV: Negative predictive value; PPV: Positive predictive value; WLI: White-light imaging.

Table 3 Comparison of the improvement of endoscopists under computer-assisted detection-white-light imaging and computer-assisted detection-narrow-band imaging

	2nd phase CAD-WLI assistance	3rd phase CAD-NBI assistance	P value
Sensitivity, % (95%CI)
All, n = 20	86.4 (83.1-89.6)	83.1 (79.6-86.6)	0.162
Experienced, n = 4	96.8 (94.4-99.2)	95.7 (91.8-99.5)	0.454
Mid-level, n = 8	84.5 (80.0-89.0)	82.6 (79.4-85.9)	0.435
Junior, n = 8	83.0 (79.3-86.6)	77.3 (74.9-79.7)	0.008
Specificity, % (95%CI)
All, n = 20	88.7 (86.5-90.8)	94.4 (93.0-95.8)	0.000
Experienced, n = 4	94.5 (87.9-100)	97.2 (93.6-100)	0.310
Mid-level, n = 8	85.9 (84.3-87.4)	92.6 (90.7-94.5)	0.000
Junior, n = 8	88.6 (85.1-92.1)	94.9 (92.5-97.2)	0.003
Accuracy, % (95%CI)
All, n = 20	87.7 (85.5-89.9)	89.7 (87.8-91.5)	0.156
Experienced, n = 4	95.5 (92.4-98.6)	96.5 (93.6-99.4)	0.469
Mid-level, n = 8	85.3 (83.1-87.5)	88.4 (87.1-89.7)	0.012
Junior, n = 8	86.2 (84.2-88.3)	87.5 (86.0-89.0)	0.261
PPV, % (95%CI)
All, n = 20	84.9 (82.2-87.5)	91.6 (89.7-93.6)	0.000
Experienced, n = 4	93.0 (85.1-100)	96.1 (91.4-100)	0.325
Mid-level, n = 8	81.3 (79.4-83.2)	89.2 (86.7-91.7)	0.000
Junior, n = 8	84.4 (80.5-88.2)	91.8 (88.4-95.2)	0.004
NPV, % (95%CI)
All, n = 20	90.1 (87.9-92.3)	88.7 (86.5-90.9)	0.361
Experienced, n = 4	97.7 (96.0-99.3)	96.9 (94.2-99.6)	0.465
Mid-level, n = 8	88.5 (85.6-91.4)	88.1 (86.2-89.9)	0.755
Junior, n = 8	87.8 (85.6-90.1)	85.2 (83.9-86.5)	0.031

CAD: Computer-assisted detection; CI: Confidence interval; NBI: Narrow-band imaging; NPV: Negative predictive value; PPV: Positive predictive value; WLI: Whit-light imaging.

Table 4 Diagnostic performance of endoscopists in screening of esophagus squamous cell carcinoma after referring to the results from computer-assisted detection-white-light imaging and computer-assisted detection-narrow-band imaging

	Sensitivity, % (95%CI)	Specificity, % (95%CI)	Accuracy, % (95%CI)	PPV, % (95%CI)	NPV, % (95%CI)
All, n = 20	92.4 (90.3-94.5)	96.7 (95.7-97.7)	94.9 (93.6-96.1)	95.3 (93.9-96.7)	94.7 (93.2-96.1)
Experienced, n = 4	98.5 (96.3-100)	99.1 (97.5-100)	98.8 (98.2-99.4)	98.7 (96.7-100)	98.9 (97.4-100)
Mid-level, n = 8	93.2 (91.3-95.1)	96.0 (94.5-97.6)	94.8 (93.7-95.9)	94.5 (92.5-96.6)	95.2 (93.8-96.5)
Junior, n = 8	88.5 (86.2-90.8)	96.1 (94.3-97.9)	92.9 (91.2-94.6)	94.3 (91.8-96.8)	92.0 (90.5-93.6)

CI: Confidence interval; NPV: Negative predictive value; PPV: Positive predictive value.