Children Are Not Small Adults: Addressing Limited Generalizability of an Adult Deep Learning CT Organ Segmentation Model to the Pediatric Population.

Deep learning (DL) tools developed on adult data sets may not generalize well to pediatric patients, posing potential safety risks. We evaluated the performance of TotalSegmentator, a state-of-the-art adult-trained CT organ segmentation model, on a subset of organs in a pediatric CT dataset and expl...

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Publicado en:Journal of Imaging Informatics in Medicine Vol. 38; no. 3; pp. 1628 - 1642
Autores principales: Chatterjee, Devina, Kanhere, Adway, Doo, Florence X., Zhao, Jerry, Chan, Andrew, Welsh, Alexander, Kulkarni, Pranav, Trang, Annie, Parekh, Vishwa S., Yi, Paul H.
Formato: diagnostic images research tables/charts Journal Article
Publicado: Springer Nature Jun2025
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Jun2025
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      pub: Springer Nature
      place: New York, New York
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        10.1007/s10278-024-01273-w
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        atl: Children Are Not Small Adults: Addressing Limited Generalizability of an Adult Deep Learning CT Organ Segmentation Model to the Pediatric Population.
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          Chatterjee, Devina
          Kanhere, Adway
          Doo, Florence X.
          Zhao, Jerry
          Chan, Andrew
          Welsh, Alexander
          Kulkarni, Pranav
          Trang, Annie
          Parekh, Vishwa S.
          Yi, Paul H.
        affil: https://ror.org/055yg0521 Department of Diagnostic Radiology and Nuclear Medicine, University of Maryland School of Medicine, Baltimore, MD, USA
      sug:
        subj:
          Radiography, Abdominal Methods
          Tomography, X-Ray Computed Methods
          Deep Learning
          Image Processing, Computer Assisted Methods
          Prediction Models Evaluation
          Predictive Value of Tests Evaluation
          Human
          Funding Source
          Child
          Retrospective Design
          Record Review
          Descriptive Statistics
          Mann-Whitney U Test
          Confidence Intervals
          Wilcoxon Rank Sum Test
          Data Analysis Software
          Imaging, Three-Dimensional
          Adrenal Glands Radiography
          Duodenum Radiography
          Pancreas Radiography
          Age Factors
          Child: 6-12 years
      ab: Deep learning (DL) tools developed on adult data sets may not generalize well to pediatric patients, posing potential safety risks. We evaluated the performance of TotalSegmentator, a state-of-the-art adult-trained CT organ segmentation model, on a subset of organs in a pediatric CT dataset and explored optimization strategies to improve pediatric segmentation performance. TotalSegmentator was retrospectively evaluated on abdominal CT scans from an external adult dataset (n = 300) and an external pediatric data set (n = 359). Generalizability was quantified by comparing Dice scores between adult and pediatric external data sets using Mann–Whitney U tests. Two DL optimization approaches were then evaluated: (1) 3D nnU-Net model trained on only pediatric data, and (2) an adult nnU-Net model fine-tuned on the pediatric cases. Our results show TotalSegmentator had significantly lower overall mean Dice scores on pediatric vs. adult CT scans (0.73 vs. 0.81, P <.001) demonstrating limited generalizability to pediatric CT scans. Stratified by organ, there was lower mean pediatric Dice score for four organs (P <.001, all): right and left adrenal glands (right adrenal, 0.41 [0.39–0.43] vs. 0.69 [0.66–0.71]; left adrenal, 0.35 [0.32–0.37] vs. 0.68 [0.65–0.71]); duodenum (0.47 [0.45–0.49] vs. 0.67 [0.64–0.69]); and pancreas (0.73 [0.72–0.74] vs. 0.79 [0.77–0.81]). Performance on pediatric CT scans improved by developing pediatric-specific models and fine-tuning an adult-trained model on pediatric images where both methods significantly improved segmentation accuracy over TotalSegmentator for all organs, especially for smaller anatomical structures (e.g., > 0.2 higher mean Dice for adrenal glands; P <.001).
      pubtype: Academic Journal
      doctype:
        diagnostic images
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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