Triage-driven diagnosis of Barrett's esophagus for early detection of esophageal adenocarcinoma using deep learning.
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Authors
Berman, Adam G
O'Donovan, Maria
Fitzgerald, Rebecca C
Publication Date
2021-05Journal Title
Nat Med
ISSN
1078-8956
Publisher
Springer Science and Business Media LLC
Volume
27
Issue
5
Pages
833-841
Type
Article
This Version
AM
Physical Medium
Print-Electronic
Metadata
Show full item recordCitation
Gehrung, M., Crispin-Ortuzar, M., Berman, A. G., O'Donovan, M., Fitzgerald, R. C., & Markowetz, F. (2021). Triage-driven diagnosis of Barrett's esophagus for early detection of esophageal adenocarcinoma using deep learning.. Nat Med, 27 (5), 833-841. https://doi.org/10.1038/s41591-021-01287-9
Abstract
Deep learning methods have been shown to achieve excellent performance on diagnostic tasks, but how to optimally combine them with expert knowledge and existing clinical decision pathways is still an open challenge. This question is particularly important for the early detection of cancer, where high-volume workflows may benefit from (semi-)automated analysis. Here we present a deep learning framework to analyze samples of the Cytosponge-TFF3 test, a minimally invasive alternative to endoscopy, for detecting Barrett's esophagus, which is the main precursor of esophageal adenocarcinoma. We trained and independently validated the framework on data from two clinical trials, analyzing a combined total of 4,662 pathology slides from 2,331 patients. Our approach exploits decision patterns of gastrointestinal pathologists to define eight triage classes of varying priority for manual expert review. By substituting manual review with automated review in low-priority classes, we can reduce pathologist workload by 57% while matching the diagnostic performance of experienced pathologists.
Keywords
Adenocarcinoma, Barrett Esophagus, Case-Control Studies, Decision Support Systems, Clinical, Deep Learning, Early Detection of Cancer, Esophageal Neoplasms, Esophagus, Humans, Triage
Sponsorship
Cancer Research UK (C14478/A12088)
MRC (unknown)
National Institute for Health Research (IS-BRC-1215-20014)
MRC (MR/W014122/1)
Medical Research Council (MC_UU_12022/2)
Identifiers
External DOI: https://doi.org/10.1038/s41591-021-01287-9
This record's URL: https://www.repository.cam.ac.uk/handle/1810/332971
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