ArticleBMC medicine2025
Deep learning-aided optical biopsy achieves whole-chain diagnosis of Correa cascade of gastric cancer: a prospective study.
Article in BMC medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03784209 (Automatic Real-time Diagnosis of Gastric Mucosal Disease Using Probe-based Confocal Laser Endomicroscopy With Artificial Intelligence), which is not on this map. Cited by 6 papers.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Automatic Real-time Diagnosis of Gastric Mucosal Disease Using Probe-based Confocal Laser Endomicroscopy With Artificial Intelligence
Who cites it
6 citing papers in PubMed.
- Artificial Intelligence for Endoscopic Diagnosis of Gastric Premalignant Lesions.The Korean journal of helicobacter and upper gastrointestinal research · 2026Review
- Development and Validation of an Interpretable Machine Learning Model for StagingJournal of medical Internet research · 2026Article
- Application of Artificial Intelligence in the Endoscopic Diagnosis of Gastric Cancer and Precancerous Lesions.Diagnostics (Basel, Switzerland) · 2026Review
- EGID: A Comprehensive Multi-label Endoscopic Image Dataset for Gastritis Classification.Scientific data · 2026Article
- Early Detection of Gastric Cancer: Linking Epidemiology, Pathophysiology, and Innovations in Digestive Endoscopy.Diseases (Basel, Switzerland) · 2026Review
- Special Issue "Raman Spectroscopy and Machine Learning in Human Disease".International journal of molecular sciences · 2025Article
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Authors and funding
14 authors.
Funding
Abstract
backgroundBiopsies are essential in differentiating benign from malignant lesions in routine gastroscopy. Nevertheless, redundant biopsies increase patients' expenses and pathologists' workload. Probe-based confocal laser endomicroscopy (pCLE) enables real-time in vivo histological evaluation for gastric neoplasms and precancerous conditions. However, endoscopists vary widely in skill, and the use of pCLE requires histopathology expertise, which limits its application in nonacademic settings. This study aimed to develop a pCLE computer-aided diagnosis system (CCADS) for real-time whole-chain diagnosis of Correa cascade of gastric cancer and evaluate it in a real clinical setting.
methodsGastric pCLE images and videos from 5771 examinations were retrospectively collected. CCADS was constructed using deep learning networks. It was developed using 47,462 pCLE images and 461 video segments and evaluated via multistep validation. A total of 11,439 images and 667 videos were identified for offline validation. Consecutive patients from October 2019 to September 2021 were enrolled in a prospective diagnostic study for real-time validation, which included 951 patients in the statistics. Blinded expert endoscopists and CCADS independently performed real-time pCLE diagnosis of gastric mucosal lesions in routine examinations, with double-read histopathology as the gold standard. The real-time diagnostic performance of CCADS was evaluated and compared with that of experts.
resultsCCADS achieved high diagnostic performance in image test, video test, and a prospective diagnostic study with a large sample size. Overall, 1254 lesions from 951 patients were included in the prospective test. The real-time diagnostic accuracies of CCADS for inflammation, atrophy, gastric intestinal metaplasia (GIM), low-grade intraepithelial neoplasia (LGIN), and high-grade intraepithelial neoplasia and gastric cancer (HGIN/CA) were 91.71%-97.13%. CCADS achieved high sensitivity (98.44%) and specificity (97.06%) for HGIN/CA. Compared with experts, CCADS achieved similar accuracies in diagnosing atrophy, GIM, and LGIN and similar sensitivities in all five categories. Further, CCADS showed a significantly higher sensitivity (96.70% vs. 89.01%, p = 0.044) for gastric neoplasms (LGIN + HGIN/CA) and reduced the misdiagnosis of neoplasms.
conclusionsCCADS achieved expert-level whole-chain diagnosis of Correa cascade. It could assist endoscopists in improved surveillance of gastric neoplasms and precancerous conditions, promote the application of pCLE, and reduce biopsies.
trial registrationClinicalTrials.gov Identifier: NCT03784209.
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