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CC BY 4.0 · Endoscopy
DOI: 10.1055/a-2537-3510
Original article

The development and ex vivo evaluation of a computer-aided quality control system for Barrett’s esophagus endoscopy

Martijn R. Jong
1   Department of Gastroenterology and Hepatology, Amsterdam Gastroenterology, Endocrinology and Metabolism, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
,
Tim J. M. Jaspers
2   Department of Electrical Engineering, Eindhoven University of Technology, Eindhoven, the Netherlands
,
Rixta A. H. van Eijck van Heslinga
1   Department of Gastroenterology and Hepatology, Amsterdam Gastroenterology, Endocrinology and Metabolism, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
,
Jelmer B. Jukema
1   Department of Gastroenterology and Hepatology, Amsterdam Gastroenterology, Endocrinology and Metabolism, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
,
Carolus H. J. Kusters
2   Department of Electrical Engineering, Eindhoven University of Technology, Eindhoven, the Netherlands
,
Tim G. W. Boers
2   Department of Electrical Engineering, Eindhoven University of Technology, Eindhoven, the Netherlands
,
Roos E. Pouw
1   Department of Gastroenterology and Hepatology, Amsterdam Gastroenterology, Endocrinology and Metabolism, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
,
Lucas C. Duits
1   Department of Gastroenterology and Hepatology, Amsterdam Gastroenterology, Endocrinology and Metabolism, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
,
Peter H. N. de With
2   Department of Electrical Engineering, Eindhoven University of Technology, Eindhoven, the Netherlands
,
Fons van der Sommen
2   Department of Electrical Engineering, Eindhoven University of Technology, Eindhoven, the Netherlands
,
Albert Jeroen de Groof
1   Department of Gastroenterology and Hepatology, Amsterdam Gastroenterology, Endocrinology and Metabolism, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
,
Jacques J. G. H. M. Bergman 
1   Department of Gastroenterology and Hepatology, Amsterdam Gastroenterology, Endocrinology and Metabolism, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
,
on behalf of the BONS-AI Consortium › Author Affiliations
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Abstract

Background Timely detection of neoplasia in Barrett’s esophagus (BE) remains challenging. While computer-aided detection (CADe) systems have been developed to assist endoscopists, their effectiveness depends heavily on the quality of the endoscopic procedure. This study introduces a novel computer-aided quality (CAQ) system for BE, evaluating its stand-alone performance and integration with a CADe system.

Method The CAQ system was developed using 7,463 images from 359 BE patients. It assesses objective quality parameters (e. g., blurriness, illumination) and subjective parameters (mucosal cleanliness, esophageal expansion) and can exclude low-quality images when integrated with a CADe system.

To evaluate CAQ stand-alone performance, the Endoscopic Image Quality test set, consisting of 647 images from 51 BE patients across 8 hospitals, was labeled for objective and subjective quality. To assess the benefit of the CAQ system as a preprocessing filter of a CADe system, the Barrett CADe test set was developed. It consisted of 956 video frames from 62 neoplastic patients and 557 frames from 35 non-dysplastic patients, in 12 Barrett referral centers.

Results As stand-alone tool, the CAQ system achieved Cohen’s Kappa scores of 0.73, 0.91, and 0.89 for objective quality, mucosal cleanliness, and esophageal expansion, comparable to inter-annotator scores of 0.73, 0.93, and 0.83. As preprocessing filter, the CAQ system improved CADe sensitivity from 82 % to 90 % and AUC from 87 % to 91 %, while maintaining specificity at 75 %.

Conclusion This study presents the first CAQ system for automated quality control in BE. The system effectively distinguishes poorly from well-visualized mucosa and enhances neoplasia detection when integrated with CADe.

* All members and collaborators of the Barrett’s Oesophagus Imaging for Artificial Intelligence (BONS-AI) Consortium are listed in the Supplementary materials.


Supplementary Material



Publication History

Received: 29 November 2024

Accepted after revision: 10 February 2025

Accepted Manuscript online:
11 February 2025

Article published online:
06 March 2025

© 2025. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

© Georg Thieme Verlag KG
Stuttgart · New York

 

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