Deep Learning-based Diagnosis and Localization of Pneumothorax on Portable Supine Chest X-ray in Intensive and Emergency Medicine: A Retrospective Study.

Purpose: To develop two deep learning-based systems for diagnosing and localizing pneumothorax on portable supine chest X-rays (SCXRs). Methods: For this retrospective study, images meeting the following inclusion criteria were included: (1) patient age ≥ 20 years; (2) portable SCXR; (3) imaging obt...

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Publicado en:Journal of Medical Systems Vol. 48; no. 1; pp. 1 - 11
Autores principales: Wang, Chih-Hung, Lin, Tzuching, Chen, Guanru, Lee, Meng-Rui, Tay, Joyce, Wu, Cheng-Yi, Wu, Meng-Che, Roth, Holger R., Yang, Dong, Zhao, Can, Wang, Weichung, Huang, Chien-Hua
Formato: algorithm diagnostic images research tables/charts Journal Article
Publicado: Springer Nature 12/4/2023
Acceso en línea:Ver este registro en EBSCOhost
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      dt: 12/4/2023
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      pub: Springer Nature
      place: New York, New York
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        10.1007/s10916-023-02023-1
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        atl: Deep Learning-based Diagnosis and Localization of Pneumothorax on Portable Supine Chest X-ray in Intensive and Emergency Medicine: A Retrospective Study.
      aug:
        au:
          Wang, Chih-Hung
          Lin, Tzuching
          Chen, Guanru
          Lee, Meng-Rui
          Tay, Joyce
          Wu, Cheng-Yi
          Wu, Meng-Che
          Roth, Holger R.
          Yang, Dong
          Zhao, Can
          Wang, Weichung
          Huang, Chien-Hua
        affil: https://ror.org/05bqach95 Department of Emergency Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan
      sug:
        subj:
          Deep Learning Utilization
          Pneumothorax Diagnosis
          Supine Position
          Radiography, Thoracic
          Emergency Service
          Intensive Care Units
          Human
          Retrospective Design
          ROC Curve
          Pneumothorax Risk Factors
          Prediction Models
          Middle Age
          Aged
          Male
          Female
          Paired T-Tests
          Descriptive Statistics
          Confidence Intervals
          Two-Tailed Test
          Middle Aged: 45-64 years
          Aged: 65+ years
          Male
          Female
      ab: Purpose: To develop two deep learning-based systems for diagnosing and localizing pneumothorax on portable supine chest X-rays (SCXRs). Methods: For this retrospective study, images meeting the following inclusion criteria were included: (1) patient age ≥ 20 years; (2) portable SCXR; (3) imaging obtained in the emergency department or intensive care unit. Included images were temporally split into training (1571 images, between January 2015 and December 2019) and testing (1071 images, between January 2020 to December 2020) datasets. All images were annotated using pixel-level labels. Object detection and image segmentation were adopted to develop separate systems. For the detection-based system, EfficientNet-B2, DneseNet-121, and Inception-v3 were the architecture for the classification model; Deformable DETR, TOOD, and VFNet were the architecture for the localization model. Both classification and localization models of the segmentation-based system shared the UNet architecture. Results: In diagnosing pneumothorax, performance was excellent for both detection-based (Area under receiver operating characteristics curve [AUC]: 0.940, 95% confidence interval [CI]: 0.907–0.967) and segmentation-based (AUC: 0.979, 95% CI: 0.963–0.991) systems. For images with both predicted and ground-truth pneumothorax, lesion localization was highly accurate (detection-based Dice coefficient: 0.758, 95% CI: 0.707–0.806; segmentation-based Dice coefficient: 0.681, 95% CI: 0.642–0.721). The performance of the two deep learning-based systems declined as pneumothorax size diminished. Nonetheless, both systems were similar or better than human readers in diagnosis or localization performance across all sizes of pneumothorax. Conclusions: Both deep learning-based systems excelled when tested in a temporally different dataset with differing patient or image characteristics, showing favourable potential for external generalizability.
      pubtype: Academic Journal
      doctype:
        algorithm
        diagnostic images
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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