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Objective:Based on the artificial intelligence (AI) technology in endoscopy and the internet platform, to explore and construct a safe, standardized, scientific and rigorous database for digestive endoscopy, and to provide reference and evidence for the data quality control of AI in digestive endoscopy in China.Methods:After referring to relevant guidelines and standards, data collection and labelling standards of digestive endoscopy of 12 common gastrointestinal diseases were determined. The software of online collection and labelling of multi-center digestive endoscopy data in Shandong Province was developed. Endoscopic equipment with a domestic market share of >5% was used and dozens of experienced endoscopists from 9 medical centers in Shandong Province were uniformly trained for data labelling. From July 2019 to July 2020, the endoscopic examination data from 9 medical centers including Qilu Hospital of Shandong University, Shandong Provincial Hospital , Liaocheng People′s Hospital, Linyi People′s Hospital, Weihai Municipal Hospital, Taian City Central Hospital, Binzhou Medical University Hospital, Yantai Yuhuangding Hospital and Qilu Hospital of Shandong University (Qingdao) were prospectively and continuously collected and labeled. The optimized, desensitized, and generalized data were uploaded to the server. After the file synchronization, data processing, and expert review, a multi-center digestive endoscopy AI database with standard data collection and labelling in Shandong Province was constructed, namely cloud platform. Descriptive methods were used for statistical analysis.Results:The collection and labelling standards for multi-center digestive endoscopy AI data in Shandong province was established. The software of online collection and labelling of multi-center digestive endoscopy AI data in Shandong province was developed. The database in Shandong province was successfully constructed. In the database, 43 010 lesions, 40 353 images, and 11 289 examinations were labeled. Among them, there were 2 906 cases of early esophageal cancer, 2 912 cases of early gastric cancer, 2 397 cases of early colorectal cancer, and 9 773 cases of colorectal polyps (5 539 cases of adenomatous polyps, 1 161 cases of non-adenomatous polyps and 3 073 case of undetermined polyps).Conclusions:The multi-center AI cloud platform for digestive endoscopy in Shandong Province adopts unified standards and collection and labeling software, which ensures the safety and standardization of endoscopy data. It provides a reference and basis for the construction of a quality control system for standardized data collection and labelling of digestive endoscopy AI data in our country and for the third-party data supervision.
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Objective To investigate the clinical value of 2 dimension late Gadolinium enhancement MRI (LGE-MRI) technique for the evaluation of atrial myocardial fibrosis in patients with atrial fibrillation. Methods Forty-nine cases of atrial fibrillation in our hospital from March 2015 to December 2016 were retrospectively collected. The LGE-MR was acquired by the Siemens 3.0 T MR machine before the catheter ablation.The findings of LGE-MR were evaluated by two experienced doctors. The left atrium(LA)were manually segmented into 8 regions in axial view.All patients were classified into 4 stages based on the extent of enhancement, stage 0: absence of enhancement, stage Ⅰ: enhancement appeared in minimal two consecutive slices in single region,stageⅡ:enhancement in two regions,stageⅢ:enhancement in three or more regions. All electroanatomic maps were obtained after electrical conversion during catheter ablation. The Kappa test was used to assess the consistency of LGE-MRI left atrial myocardial fibrosis and CARTO system of the left atrial endocardial voltage reconstruction. Results Forty-nine cases of atrial fibrillation with LGE-MRI and CARTO were included. There were 17 cases of atrial fibrosis stage 0,10 cases of stageⅠ,11 cases of stageⅡ,11 cases of stageⅢaccording to LGE-MRI findings;There were 17 cases of atrial fibrosis stage 0,19 cases of stageⅠ,12 cases of stageⅡ,11 cases of stage Ⅲ with reference to CARTO findings. The diagnostic accuracy of the LGE-MRI atrial fibrosis was 81.6%(40/49),of which the correlation was good(Kappa= 0.751,P<0.001). Conclusions LGE-MRI can accurately assess the degree of left atrial myocardial fibrosis in patients with atrial fibrillation,help to select the proper candidate and strategy in catheter ablation.
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Objective To investigate the computed tomography (CT) features of clear cell papillary renal cell carcinoma (CCPRCC).Methods The CT features of 6 patients with CCPRCC were analyzed retrospectively.The size,location,growth pattern,shape,texture,calcification,necrosis,hemorrhage,CT value,enhancement form and enhancement degree of the tumor and perirenal lymph nodes were observed.Results All 6 cases of CCPRCC were solitary lesions,of which 3 were located in the left kidney and 3 in the right kidney.Maximum tumor diameter ranged from 1.5 cm to 4.0 cm.The tumor margin was well-defined in 4 cases and ill-defined in two cases.All tumors showed expansive growth without invasion.There were three cases of endophytic growth and three cases of exophytic growth.Regarding tumor composition,only one case was cystic and the other five cases were solid.No calcification,necrosis and hemorrhage occurred in all the tumors.The CT value of tumors in unenhanced phase ranged from 31.2 HU to 42.5 HU.During the enhanced CT scan,5 cases showed highly enhancement and 1 case showed moderate enhancement.The CT value of tumors in corticomedullary phase ranged from 75.1 HU to 150.1 HU.In nephrographic phase,the enhancement degree in 1 case continued to increase,but it decreased in the other 5 cases.The CT value ranged from 73.3 HU to 102.2 HU.The enhancement degree in all 6 cases decreased in excretory phase and the CT value ranged from 52.6 HU to 79.1 HU.In the aspect of tumor enhancement form,only one case showed homogeneous enhancement and the other five cases showed heterogeneous enhancement.In addition,the peripheral renal lymph nodes were not enlarged in all patients,and no tumor invasion or tumor thrombus formation occurred in the renal vein.Conclusions CCPRCC has a relatively specific CT features that are easily distinguished from papillary renal cell carcinoma or chromophobe renal cell carcinoma,but it is difficult to identify from early-stage clear cell renal cell carcinoma.