Efficient Synchronous Real-Time CADe for Multicategory Lesions in Gastroscopy by Using Multiclass Detection Model.

Often more than one category of lesions in patients' gastrointestinal tracts need to be found in the endoscopic examination. Therefore, there is a need to establish an efficient synchronous real-time computer-aided detection (CADe) system for multicategory lesion detection. This paper proposes to build a system with a multiclass detection model based on the YOLOv5 to detect multicategory lesions synchronously in real-time. Two joint detection CADe systems using multiple single-class detection models with the same structure in parallel or series are established for comparison. A retrospective dataset containing 31117 images from 3747 patients is used in this study. To train the model, various online data augmentation methods and multiple loss functions are used. The proposed CADe system can synchronously detect cancers, gastrointestinal stromal tumours, polyps, and ulcers from different quality input images with 98% precision, 89% recall, and 90.2% mAP. The detection speed is 47 frames per second with a 0.04 s latency on a PC workstation. Compared to the two joint detection CADe systems, the proposed system is more accurate with faster speed and lower latency. Two extra experiments indicated that the lesion detection model based on YOLOv5x could provide better performance than other common YOLO structures and that different accuracy metrics and lesion categories have different requirements for the number of training images. The proposed synchronous real-time CADe system with the multiclass detection model can detect multicategory lesions with high accuracy and speed and low latency on limited hardware. It expands the clinical application of CADe in endoscopy and uses expensive labelled medical images more efficiently than multiple single-category lesion models for joint detection.