Deep Learning–based Diagnosis of Pulmonary Tuberculosis on Chest X-ray in the Emergency Department: A Retrospective Study.

Prompt and correct detection of pulmonary tuberculosis (PTB) is critical in preventing its spread. We aimed to develop a deep learning–based algorithm for detecting PTB on chest X-ray (CXRs) in the emergency department. This retrospective study included 3498 CXRs acquired from the National Taiwan Un...

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Published in:Journal of Digital Imaging Vol. 37; no. 2; pp. 589 - 601
Main Authors: Wang, Chih-Hung, Chang, Weishan, Lee, Meng-Rui, Tay, Joyce, Wu, Cheng-Yi, Wu, Meng-Che, Roth, Holger R., Yang, Dong, Zhao, Can, Wang, Weichung, Huang, Chien-Hua
Format: diagnostic images research tables/charts Journal Article
Published: Springer Nature Apr2024
Online Access:View this record in EBSCOhost
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      dt: Apr2024
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      pub: Springer Nature
      place: New York, New York
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        atl: Deep Learning–based Diagnosis of Pulmonary Tuberculosis on Chest X-ray in the Emergency Department: A Retrospective Study.
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          Wang, Chih-Hung
          Chang, Weishan
          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 Methods
          Tuberculosis, Pulmonary Diagnosis
          Radiography, Thoracic
          Emergency Service
          Algorithms
          Computer-Aided Design Utilization
          Human
          Male
          Female
          Retrospective Design
          Aged
          Academic Medical Centers Taiwan
          Taiwan
          ROC Curve
          Confidence Intervals
          Comparative Studies
          Tuberculosis, Pulmonary Prevention and Control
          Funding Source
          Aged: 65+ years
          Male
          Female
      ab: Prompt and correct detection of pulmonary tuberculosis (PTB) is critical in preventing its spread. We aimed to develop a deep learning–based algorithm for detecting PTB on chest X-ray (CXRs) in the emergency department. This retrospective study included 3498 CXRs acquired from the National Taiwan University Hospital (NTUH). The images were chronologically split into a training dataset, NTUH-1519 (images acquired during the years 2015 to 2019; n = 2144), and a testing dataset, NTUH-20 (images acquired during the year 2020; n = 1354). Public databases, including the NIH ChestX-ray14 dataset (model training; 112,120 images), Montgomery County (model testing; 138 images), and Shenzhen (model testing; 662 images), were also used in model development. EfficientNetV2 was the basic architecture of the algorithm. Images from ChestX-ray14 were employed for pseudo-labelling to perform semi-supervised learning. The algorithm demonstrated excellent performance in detecting PTB (area under the receiver operating characteristic curve [AUC] 0.878, 95% confidence interval [CI] 0.854–0.900) in NTUH-20. The algorithm showed significantly better performance in posterior-anterior (PA) CXR (AUC 0.940, 95% CI 0.912–0.965, p-value < 0.001) compared with anterior–posterior (AUC 0.782, 95% CI 0.644–0.897) or portable anterior–posterior (AUC 0.869, 95% CI 0.814–0.918) CXR. The algorithm accurately detected cases of bacteriologically confirmed PTB (AUC 0.854, 95% CI 0.823–0.883). Finally, the algorithm tested favourably in Montgomery County (AUC 0.838, 95% CI 0.765–0.904) and Shenzhen (AUC 0.806, 95% CI 0.771–0.839). A deep learning–based algorithm could detect PTB on CXR with excellent performance, which may help shorten the interval between detection and airborne isolation for patients with PTB.
      pubtype: Academic Journal
      doctype:
        diagnostic images
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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