Edge Artificial Intelligence Device in Real-Time Endoscopy for Classification of Gastric Neoplasms: Development and Validation Study

Abstract

Objective: We previously developed artificial intelligence (AI) diagnosis algorithms for predicting the six classes of stomach lesions. However, this required significant computational resources. The incorporation of AI into medical devices has evolved from centralized models to decentralized edge computing devices. In this study, a deep learning endoscopic image classification model was created to automatically categorize all phases of gastric carcinogenesis using an edge computing device. Design: A total of 15,910 endoscopic images were collected retrospectively and randomly assigned to train, validation, and internal-test datasets in an 8:1:1 ratio. The major outcomes were as follows: 1. lesion classification accuracy in six categories: normal/atrophy/intestinal metaplasia/dysplasia/early/advanced gastric cancer; and 2. the prospective evaluation of classification accuracy in real-world procedures. Results: The internal-test lesion-classification accuracy was 93.8% (95% confidence interval: 93.4–94.2%); precision was 88.6%, recall was 88.3%, and F1 score was 88.4%. For the prospective performance test, the established model attained an accuracy of 93.3% (91.5–95.1%). The established model’s lesion classification inference speed was 2–3 ms on GPU and 5–6 ms on CPU. The expert endoscopists reported no delays in lesion classification or any interference from the deep learning model throughout their exams. Conclusions: We established a deep learning endoscopic image classification model to automatically classify all stages of gastric carcinogenesis using an edge computing device.