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- Title
Neural network algorithm for detection of erosions and ankylosis on CT of the sacroiliac joints: multicentre development and validation of diagnostic accuracy.
- Authors
Van Den Berghe, Thomas; Babin, Danilo; Chen, Min; Callens, Martijn; Brack, Denim; Maes, Helena; Lievens, Jan; Lammens, Marie; Van Sumere, Maxime; Morbée, Lieve; Hautekeete, Simon; Schatteman, Stijn; Jacobs, Tom; Thooft, Willem-Jan; Herregods, Nele; Huysse, Wouter; Jaremko, Jacob L.; Lambert, Robert; Maksymowych, Walter; Laloo, Frederiek
- Abstract
Objectives: To evaluate the feasibility and diagnostic accuracy of a deep learning network for detection of structural lesions of sacroiliitis on multicentre pelvic CT scans. Methods: Pelvic CT scans of 145 patients (81 female, 121 Ghent University/24 Alberta University, 18–87 years old, mean 40 ± 13 years, 2005–2021) with a clinical suspicion of sacroiliitis were retrospectively included. After manual sacroiliac joint (SIJ) segmentation and structural lesion annotation, a U-Net for SIJ segmentation and two separate convolutional neural networks (CNN) for erosion and ankylosis detection were trained. In-training validation and tenfold validation testing (U-Net—n = 10 × 58; CNN—n = 10 × 29) on a test dataset were performed to assess performance on a slice-by-slice and patient level (dice coefficient/accuracy/sensitivity/specificity/positive and negative predictive value/ROC AUC). Patient-level optimisation was applied to increase the performance regarding predefined statistical metrics. Gradient-weighted class activation mapping (Grad-CAM++) heatmap explainability analysis highlighted image parts with statistically important regions for algorithmic decisions. Results: Regarding SIJ segmentation, a dice coefficient of 0.75 was obtained in the test dataset. For slice-by-slice structural lesion detection, a sensitivity/specificity/ROC AUC of 95%/89%/0.92 and 93%/91%/0.91 were obtained in the test dataset for erosion and ankylosis detection, respectively. For patient-level lesion detection after pipeline optimisation for predefined statistical metrics, a sensitivity/specificity of 95%/85% and 82%/97% were obtained for erosion and ankylosis detection, respectively. Grad-CAM++ explainability analysis highlighted cortical edges as focus for pipeline decisions. Conclusions: An optimised deep learning pipeline, including an explainability analysis, detects structural lesions of sacroiliitis on pelvic CT scans with excellent statistical performance on a slice-by-slice and patient level. Clinical relevance statement: An optimised deep learning pipeline, including a robust explainability analysis, detects structural lesions of sacroiliitis on pelvic CT scans with excellent statistical metrics on a slice-by-slice and patient level. Key Points: • Structural lesions of sacroiliitis can be detected automatically in pelvic CT scans. • Both automatic segmentation and disease detection yield excellent statistical outcome metrics. • The algorithm takes decisions based on cortical edges, rendering an explainable solution.
- Subjects
GHENT University; SACROILIAC joint; ANKYLOSIS; CONVOLUTIONAL neural networks; COMPUTED tomography; DEEP learning
- Publication
European Radiology, 2023, Vol 33, Issue 11, p8310
- ISSN
0938-7994
- Publication type
Article
- DOI
10.1007/s00330-023-09704-y