Intestinal fibrosis classification in patients with Crohn's disease using CT enterography-based deep learning: comparisons with radiomics and radiologists.

Objectives: Accurate evaluation of bowel fibrosis in patients with Crohn's disease (CD) remains challenging. Computed tomography enterography (CTE)-based radiomics enables the assessment of bowel fibrosis; however, it has some deficiencies. We aimed to develop and validate a CTE-based deep learning...

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Publicado en:European Radiology Vol. 32; no. 12; pp. 8692 - 8706
Autores principales: Meng, Jixin, Luo, Zixin, Chen, Zhihui, Zhou, Jie, Chen, Zhao, Lu, Baolan, Zhang, Mengchen, Wang, Yangdi, Yuan, Chenglang, Shen, Xiaodi, Huang, Qinqin, Zhang, Zhuya, Ye, Ziyin, Cao, Qinghua, Zhou, Zhiyang, Xu, Yikai, Mao, Ren, Chen, Minhu, Sun, Canhui, Li, Ziping
Formato: Journal Article
Publicado: Springer Nature Dec2022
Acceso en línea:Ver este registro en EBSCOhost
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        atl: Intestinal fibrosis classification in patients with Crohn's disease using CT enterography-based deep learning: comparisons with radiomics and radiologists.
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          Meng, Jixin
          Luo, Zixin
          Chen, Zhihui
          Zhou, Jie
          Chen, Zhao
          Lu, Baolan
          Zhang, Mengchen
          Wang, Yangdi
          Yuan, Chenglang
          Shen, Xiaodi
          Huang, Qinqin
          Zhang, Zhuya
          Ye, Ziyin
          Cao, Qinghua
          Zhou, Zhiyang
          Xu, Yikai
          Mao, Ren
          Chen, Minhu
          Sun, Canhui
          Li, Ziping
        affil: Department of Radiology, The First Affiliated Hospital, Sun Yat-sen University, 58 Zhongshan II Road, 510080, Guangzhou, People's Republic of China
      sug:
        subj:
          Crohn Disease Pathology
          Radiomics
          Cross Sectional Studies
          Tomography, X-Ray Computed Methods
          Retrospective Design
          Adult
          Fibrosis
          Intestine, Small Pathology
          Funding Source
          Adult: 19-44 years
      ab: Objectives: Accurate evaluation of bowel fibrosis in patients with Crohn's disease (CD) remains challenging. Computed tomography enterography (CTE)-based radiomics enables the assessment of bowel fibrosis; however, it has some deficiencies. We aimed to develop and validate a CTE-based deep learning model (DLM) for characterizing bowel fibrosis more efficiently.Methods: We enrolled 312 bowel segments of 235 CD patients (median age, 33 years old) from three hospitals in this retrospective study. A training cohort and test cohort 1 were recruited from center 1, while test cohort 2 from centers 2 and 3. All patients performed CTE within 3 months before surgery. The histological fibrosis was semi-quantitatively assessed. A DLM was constructed in the training cohort based on a 3D deep convolutional neural network with 10-fold cross-validation, and external independent validation was conducted on the test cohorts. The radiomics model (RM) was developed with 4 selected radiomics features extracted from CTE images by using logistic regression. The evaluation of CTE images was performed by two radiologists. DeLong's test and a non-inferiority test were used to compare the models' performance.Results: DLM distinguished none-mild from moderate-severe bowel fibrosis with an area under the receiver operator characteristic curve (AUC) of 0.828 in the training cohort and 0.811, 0.808, and 0.839 in the total test cohort, test cohorts 1 and 2, respectively. In the total test cohort, DLM achieved better performance than two radiologists (*1 AUC = 0.579, *2 AUC = 0.646; both p < 0.05) and was not inferior to RM (AUC = 0.813, p < 0.05). The total processing time for DLM was much shorter than that of RM (p < 0.001).Conclusion: DLM is better than radiologists in diagnosing intestinal fibrosis on CTE in patients with CD and not inferior to RM; furthermore, it is more time-saving compared to RM.Key Points: • Question Could computed tomography enterography (CTE)-based deep learning model (DLM) accurately distinguish intestinal fibrosis severity in patients with Crohn's disease (CD)? • Findings In this cross-sectional study that included 235 patients with CD, DLM achieved better performance than that of two radiologists' interpretation and was not inferior to RM with significant differences and much shorter processing time. • Meaning This DLM may accurately distinguish the degree of intestinal fibrosis in patients with CD and guide gastroenterologists to formulate individualized treatment strategies for those with bowel strictures.
      pubtype: Academic Journal
      doctype: Journal Article
      ougenre: Article
    language: English
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