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In Journal of endourology ; h5-index 0.0

Introduction Non-muscle-invasive bladder cancer has a relatively high postoperative recurrence rate despite the implementation of conventional treatment methods. Cystoscopy is essential for diagnosing and monitoring bladder cancer, but lesions are overlooked while using white-light imaging. Using cystoscopy, tumors with a small diameter; flat tumors, such as carcinoma in situ; and the extent of flat lesions associated with the elevated lesions are difficult to identify. In addition, the accuracy of diagnosis and treatment using cystoscopy varies according to the skill and experience of physicians. Therefore, to improve the quality of bladder cancer diagnosis, we aimed to support the cystoscopic diagnosis of bladder cancer using artificial intelligence (AI). Materials/Methods: A total of 2,102 cystoscopic images, consisting of 1,671 images of normal tissue and 431 images of tumor lesions, were used to create a dataset with an 8:2 ratio of training and test images. We constructed a tumor classifier based on a convolutional neural network (CNN). The performance of the trained classifier was evaluated using test data. True positive rate and false positive rate were plotted when the threshold was changed as the receiver operating characteristic (ROC) curve. Results In the test data (tumor image: 87, normal image: 335), 78 images were true positive, 315 true negative, 20 false positive, and 9 false negative. The area under the ROC curve was 0.98, with a maximum Youden-index of 0.837, sensitivity of 89.7%, and specificity of 94.0%. Conclusion By objectively evaluating the cystoscopic image with CNN, it was possible to classify the image, including tumor lesions and normality. The objective evaluation of cystoscopic images using AI is expected to contribute to improvement in the accuracy of the diagnosis and treatment of bladder cancer.

Ikeda Atsushi, Nosato Hirokazu, Kochi Yuta, Kojima Takahiro, Kawai Koji, Sakanashi Hidenori, Murakawa Masahiro, Nishiyama Hiroyuki