Efficient artificial intelligence-based assessment of the gastroesophageal valve with Hill classification through active learning.

Journal: Scientific reports
PMID:

Abstract

Standardized assessment of the gastroesophageal valve during endoscopy, attainable via the Hill classification, is important for clinical assessment and therapeutic decision making. The Hill classification is associated with the presence of hiatal hernia (HH), a common endoscopic finding connected to gastro-esophageal reflux disease. A novel efficient medical artificial intelligence (AI) training pipeline using active learning (AL) is designed. We identified 21,970 gastroscopic images as training data and used our AL to train a model for predicting the Hill classification and detecting HH. Performance of the AL and traditionally trained models were evaluated on an external expert-annotated image collection. The AL model achieved accuracy of 76%. A traditionally trained model with 125% more training data achieved 77% accuracy. Furthermore, the AL model achieved higher precision than the traditional one for rare classes, with 0.54 versus 0.39 (p < 0.05) for grade 3 and 0.72 versus 0.61 (p < 0.05) for grade 4. In detecting HH, the AL model achieved 94% accuracy, 0.72 precision and 0.74 recall. Our AL pipeline is more efficient than traditional methods in training AI for endoscopy.

Authors

  • Ioannis Kafetzis
    Interventional and Experimental Endoscopy (InExEn), Internal Medicine II, University Hospital Würzburg, Würzburg, Germany.
  • Karl-Hermann Fuchs
    Interventional and Experimental Endoscopy (InExEn), Department of Internal Medicine 2, University Hospital Würzburg, Oberdürrbacherstr. 6, 97080, Würzburg, Germany.
  • Philipp Sodmann
    Institute of Bioinformatics, University Medicine Greifswald, Greifswald, Germany. DZHK (German Center for Cardiological Research), partner site Greifswald, Greifswald, Germany.
  • Joel Troya
    Department of Internal Medicine II, Interventional and Experimental Endoscopy (InExEn), University Hospital Wuerzburg, Würzburg, Germany.
  • Wolfram Zoller
    Clinic for General Internal Medicine, Gastroenterology, Hepatology and Infectiology, Pneumology, Klinikum Stuttgart-Katharinenhospital, Kriegsbergstr. 60, 70174, Stuttgart, Germany.
  • Alexander Meining
    Department of Gastroenterology, University of Würzburg, Würzburg, Germany.
  • Alexander Hann
    Department of Internal Medicine II, Interventional and Experimental Endoscopy (InExEn), University Hospital Wuerzburg, Würzburg, Germany.