Development and Validation of a Deep Learning System for Staging Liver Fibrosis by Using Contrast Agent-enhanced CT Images in the Liver
Development and Validation of a Deep Learning System for Staging Liver Fibrosis by Using Contrast Agent-enhanced CT Images in the Liver
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DOI：
10.1148/radiol.2018180763
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发表时间：
2018-12-01
期刊：
影响因子：
19.7
通讯作者：
Yu, Eun Sil
中科院分区：
文献类型：
--
作者：
Choi, Kyu Jin;Jang, Jong Keon;Yu, Eun Sil
目的：开发和验证利用肝脏 CT 图像对肝纤维化进行分期的深度学习系统 (DLS)。 材料和方法：通过使用包含 7461 名经病理证实的肝纤维化患者的门静脉期 CT 图像的开发数据集，创建用于基于 CT 的肝纤维化分期的 DLS。 DLS 的诊断性能在 891 名患者的单独测试数据集中进行了评估。通过逻辑回归分析评估患者特征和 CT 技术对 DLS 分期准确性的影响。在 421 名患者的子集中，通过使用受试者工作特征曲线下面积 (AUROC) 和 Obuchowski 指数，将 DLS 的诊断性能与放射科医生的评估、转氨酶与血小板比率指数 (APRI) 和纤维化 4 指数进行比较。结果：在测试数据集中，DLS 的分期准确性为 79.4% （891 中的 707），诊断显着纤维化 (F2-4)、晚期纤维化 (F3-4) 和肝硬化 (F4) 的 AUROC 分别为 0.96、0.97 和 0.95。在多变量分析中，只有病理性纤维化分期显着影响 DLS 的分期准确性（与 F4 相比，F1 和 F2 的 P 值分别为 0.016 和 0.013），而肝病病因和 CT 技术则没有影响。 DLS（Obuchowski 指数，0.94）优于放射科医生的解释、APRI 和纤维化 4 指数（Obuchowski 指数范围，0.71-0.81；P
Purpose: To develop and validate a deep learning system (DLS) for staging liver fibrosis by using CT images in the liver.Materials and Methods: DLS for CT-based staging of liver fibrosis was created by using a development data set that included portal venous phase CT images in 7461 patients with pathologically confirmed liver fibrosis. The diagnostic performance of the DLS was evaluated in separate test data sets for 891 patients. The influence of patient characteristics and CT techniques on the staging accuracy of the DLS was evaluated by logistic regression analysis. In a subset of 421 patients, the diagnostic performance of the DLS was compared with that of the radiologist's assessment, aminotransferase-to-platelet ratio index (APRI), and fibrosis-4 index by using the area under the receiver operating characteristic curve (AUROC) and Obuchowski index.Results: In the test data sets, the DLS had a staging accuracy of 79.4% (707 of 891) and an AUROC of 0.96, 0.97, and 0.95 for diagnosing significant fibrosis (F2-4), advanced fibrosis (F3-4), and cirrhosis (F4), respectively. At multivariable analysis, only pathologic fibrosis stage significantly affected the staging accuracy of the DLS (P =.016 and.013 for F1 and F2, respectively, compared with F4), whereas etiology of liver disease and CT technique did not. The DLS (Obuchowski index, 0.94) outperformed the radiologist's interpretation, APRI, and fibrosis-4 index (Obuchowski index range, 0.71-0.81; P