Establishing an AI model and application for automated capsule endoscopy recognition based on convolutional neural networks (with video).

Background: Although capsule endoscopy (CE) is a crucial tool for diagnosing small bowel diseases, the need to process a vast number of images imposes a significant workload on physicians, leading to a high risk of missed diagnoses. This study aims to develop an artificial intelligence (AI) model and application based on convolutional neural networks that can automatically recognize various lesions in small bowel capsule endoscopy.

Methods: Three small bowel capsule endoscopy datasets were used for AI model training, validation, and testing, encompassing 12 categories of images. The model's performance was evaluated using metrics such as AUC, sensitivity, specificity, precision, accuracy, and F1 score to select the best model. A human-machine comparison experiment was conducted using the best model and endoscopists with varying levels of experience. Model interpretability was analyzed using Grad-CAM and SHAP techniques. Finally, a clinical application was developed based on the best model using PyQt5 technology.

Results: A total of 34,303 images were included in this study. The best model, MobileNetv3-large, achieved a weighted average sensitivity of 87.17%, specificity of 98.77%, and an AUC of 0.9897 across all categories. The application developed based on this model performed exceptionally well in comparison with endoscopists, achieving an accuracy of 87.17% and a processing speed of 75.04 frames per second, surpassing endoscopists of varying experience levels.

Conclusion: The AI model and application developed based on convolutional neural networks can quickly and accurately identify 12 types of small bowel lesions. With its high sensitivity, this system can effectively assist physicians in interpreting small bowel capsule endoscopy images.Future studies will validate the AI system for video evaluations and real-world clinical integration.