Artificial intelligence diagnosis of Helicobacter pylori infection using blue laser imaging-bright and linked color imaging: a single-center prospective study

Background: Deep learning is a type of artificial intelligence (AI) that imitates the neural network in the brain. We generated an AI to diagnose Helicobacter pylori (H. pylori) infection using blue laser imaging (BLI)-bright and linked color imaging (LCI). The aim of this pilot study was to establish an AI diagnosing system that predicts H. pylori infection status using endoscopic images to improve the accuracy and productivity of endoscopic examination. Methods: A total of 222 enrolled subjects (105 H. pylori-positive) underwent esophagogastroduodenoscopy and a serum test for H. pylori IgG antibodies. During esophagogastroduodenoscopy, an endoscopist sequentially took 3 still images of the lesser curvature of the stomach using white light imaging (WLI), BLI-bright, and LCI. EG-L580NW endoscopic equipment (FUJIFILM Co., Japan) was used for the study. The specifications of the AI were as follows: operating system, Linux; neural network, GoogLeNet; framework, Caffe; graphic processor unit, Geforce GTX TITAN X (NVIDIA Co., USA). Results: The area under the curve (AUC) on receiver operating characteristics analysis was 0.66 for WLI. In contrast, the AUCs of BLI-bright and LCI were 0.96 and 0.95, respectively. The AUCs obtained for BLI-bright and LCI were significantly larger than those for WLI (P<0.01). Conclusions: The results demonstrate that the developed AI has an excellent ability to diagnose H. pylori infection using BLI-bright and LCI. AI technology with image-enhanced endoscopy is likely to become a useful image diagnostic tool.