胃と腸56巻4号

2021年04月発行

今月の主題 消化管疾患AI診断の現状 主題

食道疾患におけるAI診断—当院における食道AI内視鏡診断システムの開発と今後の展望

著者： 脇幸太郎¹ 石原立¹ 庄司絢香¹ 井上貴裕¹ 松枝克典¹ 三宅宗彰¹ 福田弘武¹ 七條智聖¹ 前川聡¹ 金坂卓¹ 竹内洋司¹ 東野晃治¹ 上堂文也¹ 道田知樹¹ 加藤勇介² 多田智裕²

所属機関： ¹大阪国際がんセンター消化管内科 ²株式会社AIメディカルサービス

ページ範囲：P.411 - P.422

要旨●当科ではAIメディカルサービス社と協力し，食道を含むさまざまなAI内視鏡診断システムを開発してきた．特に食道扁平上皮癌においては拾い上げ，癌・非癌の鑑別，および癌であれば深達度診断といった実臨床における診断プロセスのすべての段階に対応するAIを開発し，動画による検証で内視鏡専門医に匹敵，または凌駕する成績を報告してきた．今後は実際の臨床の場での検証を含め，世界初の食道におけるAI内視鏡診断システムの製品化に向けて開発を進めていく方針である．

参考文献

1）Nakagawa K, Ishihara R, Aoyama K, et al. Classification for invasion depth of esophageal squamous cell carcinoma using a deep neural network compared with experienced endoscopists. Gastrointest Endosc　90：407-414, 2019

2）Ohmori M, Ishihara R, Aoyama K, et al. Endoscopic detection and differentiation of esophageal lesions using a deep neural network. Gastrointest Endosc　91：301-309, 2020

3）Fukuda H, Ishihara R, Kato Y, et al. Comparison of performances of artificial intelligence versus expert endoscopists for real-time assisted diagnosis of esophageal squamous cell carcinoma（with video）. Gastrointest Endosc　92：848-855, 2020

4）Shimamoto Y, Ishihara R, Kato Y, et al. Real-time assessment of video images for esophageal squamous cell carcinoma invasion depth using artificial intelligence. J Gastroenterol　55：1037-1045, 2020

5）Iwagami H, Ishihara R, Aoyama K, et al. Artificial intelligence for the detection of esophageal and esophagogastric junctional adenocarcinoma. J Gastroenterol Hepatol　36：131-136, 2021

6）Bray F, Ferlay J, Soerjomataram I, et al. Global cancer statistics 2018：GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin　68：394-424, 2018

7）Rustgi AK, El-Serag HB. Esophageal carcinoma. N Engl J Med　371：2499-2509, 2014

8）Kodama M, Kakegawa T. Treatment of superficial cancer of the esophagus：a summary of responses to a questionnaire on superficial cancer of the esophagus in Japan. Surgery　123：432-439, 1998

9）Shimizu Y, Tsukagoshi H, Fujita M, et al. Long-term outcome after endoscopic mucosal resection in patients with esophageal squamous cell carcinoma invading the muscularis mucosae or deeper. Gastrointest Endosc　56：387-390, 2002

10）Katada C, Muto M, Momma K, et al. Clinical outcome after endoscopic mucosal resection for esophageal squamous cell carcinoma invading the muscularis mucosae—a multicenter retrospective cohort study. Endoscopy　39：779-783, 2007

11）Yamamoto S, Ishihara R, Motoori M, et al. Comparison between definitive chemoradiotherapy and esophagectomy in patients with clinical stage I esophageal squamous cell carcinoma. Am J Gastroenterol　106：1048-1054, 2011

12）Yamashina T, Ishihara R, Nagai K, et al. Long-term outcome and metastatic risk after endoscopic resection of superficial esophageal squamous cell carcinoma. Am J Gastroenterol　108：544-551, 2013

13）Muto M, Minashi K, Yano T, et al. Early detection of superficial squamous cell carcinoma in the head and neck region and esophagus by narrow band imaging：a multicenter randomized controlled trial. J Clin Oncol　28：1566-1572, 2010

14）Ishihara R, Takeuchi Y, Chatani R, et al. Prospective evaluation of narrow-band imaging endoscopy for screening of esophageal squamous mucosal high-grade neoplasia in experienced and less experienced endoscopists. Dis Esophagus　23：480-486, 2010

15）日本食道学会（編）．食道癌診療ガイドライン2017年版．金原出版，2017

16）石原立，有馬美和子，飯塚敏郎，他．食道癌に対するESD/EMRガイドライン．Gastroenterol Endosc　62：221-271, 2020

17）Ishihara R, Matsuura N, Hanaoka N, et al. Endoscopic imaging modalities for diagnosing invasion depth of superficial esophageal squamous cell carcinoma：a systematic review and meta-analysis. BMC Gastroenterol　17：24, 2017

18）天野祐二，安積貴年，坪井優，他．本邦におけるBarrett食道癌の疫学—現況と展望．日消誌　112：219-231, 2015

19）Matsuno K, Ishihara R, Ohmori M, et al. Time trends in the incidence of esophageal adenocarcinoma, gastric adenocarcinoma, and superficial esophagogastric junction adenocarcinoma. J Gastroenterol　54：784-791, 2019

20）Amano Y, Kinoshita Y. Barrett esophagus：perspectives on its diagnosis and management in Asian populations. Gastroenterol Hepatol（N Y）　4：45-53, 2008

21）Hasegawa S, Yoshikawa T, Cho H, et al. Is adenocarcinoma of the esophagogastric junction different between Japan and western countries? The incidence and clinicopathological features at a Japanese high-volume cancer center. World J Surg　33：95-103, 2009

22）Ebigbo A, Mendel R, Probst A, et al. Real-time use of artificial intelligence in the evaluation of cancer in Barrett's oesophagus. Gut　69：615-616, 2020

23）Ebigbo A, Mendel R, Probst A, et al. Computer-aided diagnosis using deep learning in the evaluation of early oesophageal adenocarcinoma. Gut　68：1143-1145, 2019

24）Ghatwary N, Zolgharni M, Ye X. Early esophageal adenocarcinoma detection using deep learning methods. Int J Comput Assist Radiol Surg　14：611-621, 2019

25）de Groof AJ, Struyvenberg MR, van der Putten J, et al. Deep-learning system detects neoplasia in Patients with Barrett's esophagus with higher accuracy than endoscopists in a multistep training and validation study with benchmarking. Gastroenterology　158：915-929, 2020