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Wang Q, Lai MW, Bin G, Ding Q, Wu S, Zhou Z, Tsui PH. MBR-Net: A multi-branch residual network based on ultrasound backscattered signals for characterizing pediatric hepatic steatosis. ULTRASONICS 2023; 135:107093. [PMID: 37482038 DOI: 10.1016/j.ultras.2023.107093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Revised: 05/18/2023] [Accepted: 06/23/2023] [Indexed: 07/25/2023]
Abstract
The evaluation of pediatric hepatic steatosis and early detection of fatty liver in children are of critical importance. In this paper, a deep learning model based on the convolutional neural network (CNN) of ultrasound backscattered signals, multi-branch residual network (MBR-Net), was proposed for characterizing pediatric hepatic steatosis. The MBR-Net was composed of three convolutional branches. Each branch used different sizes of convolution blocks to enhance the capability of local feature acquisition, and leveraged the residual mechanism with skip connections to guide the network to effectively capture features. A total of 393 frames of ultrasound backscattered signals collected from 131 children were included in the experiments. The hepatic steatosis index was used as the reference standard for diagnosing the steatosis grade, G0-G3. The ultrasound backscattered signals within the liver region of interests (ROIs) were normalized and augmented using a sliding gate method. The gated ROI signals were randomly divided into training, validation, and test sets with the ratio of 8:1:1. The area under the operating characteristic curve (AUC), accuracy (ACC), sensitivity (SEN), and specificity (SPE) were used as the evaluation metrics. Experimental results showed that the MBR-Net yields AUCs for diagnosing pediatric hepatic steatosis grade ≥G1, ≥G2, and ≥G3 of 0.94 (ACC: 93.65%; SEN: 89.79%; SPE: 84.48%), 0.93 (ACC: 90.48%; SEN: 87.75%; SPE: 82.65%), and 0.93 (ACC: 87.76%; SEN: 84.84%; SPE: 86.55%), respectively, which were superior to the conventional one-branch CNNs without residual mechanisms. The proposed MBR-Net can be used as a new deep learning method for ultrasound backscattered signal analysis to characterize pediatric hepatic steatosis.
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Affiliation(s)
- Qian Wang
- Department of Biomedical Engineering, Faculty of Environment and Life, Beijing University of Technology, Beijing, China
| | - Ming-Wei Lai
- Division of Pediatric Gastroenterology, Department of Pediatrics, Chang Gung Children's Medical Center, Chang Gung Memorial Hospital, Linkou, College of Medicine, Chang Gung University, Taoyuan, Taiwan; Liver Research Center, Chang Gung Memorial Hospital, Linkou, Taoyuan, Taiwan
| | - Guangyu Bin
- Department of Biomedical Engineering, Faculty of Environment and Life, Beijing University of Technology, Beijing, China
| | - Qiying Ding
- Department of Ultrasound, BJUT Hospital, Beijing University of Technology, Beijing, China
| | - Shuicai Wu
- Department of Biomedical Engineering, Faculty of Environment and Life, Beijing University of Technology, Beijing, China
| | - Zhuhuang Zhou
- Department of Biomedical Engineering, Faculty of Environment and Life, Beijing University of Technology, Beijing, China.
| | - Po-Hsiang Tsui
- Department of Medical Imaging and Radiological Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan; Institute for Radiological Research, Chang Gung University, Taoyuan, Taiwan; Division of Pediatric Gastroenterology, Department of Pediatrics, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan.
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Ko HH, Patel NH, Haylock-Jacobs S, Doucette K, Ma MM, Cooper C, Kelly E, Elkhashab M, Tam E, Bailey R, Wong A, Minuk G, Wong P, Fung SK, Sebastiani G, Ramji A, Coffin CS. Severe Hepatic Steatosis Is Associated With Low-Level Viremia and Advanced Fibrosis in Patients With Chronic Hepatitis B in North America. GASTRO HEP ADVANCES 2022; 1:106-116. [PMID: 39129930 PMCID: PMC11307651 DOI: 10.1016/j.gastha.2021.09.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Accepted: 09/14/2021] [Indexed: 08/13/2024]
Abstract
Background and Aims The obesity epidemic has increased the risk of nonalcoholic fatty liver disease (NAFLD) in both the general and chronic hepatitis B (CHB) populations. Our study aims to determine the prevalence of NAFLD in patients with CHB based on controlled attenuation parameter (CAP) and the epidemiological, clinical, and virological factors associated with severe hepatic steatosis. Methods The Canadian Hepatitis B Network cohort was utilized to provide a cross-sectional description of demographics, comorbidities, antiviral treatment, and hepatits B virus (HBV) tests. Liver fibrosis and steatosis were measured by transient elastography and CAP, respectively. Any grade and severe steatosis were defined as CAP >248 and >280 dB/m, respectively. Advanced liver fibrosis was defined as transient elastography measurement >10.7 kPa. Results In 1178 patients with CHB (median age: 47.4%, 57.7% males, 75.7% Asian, 13% African, 6.5% White, 86% HBV e antigen negative, median HBV DNA of 2.44 log10IU/mL, 42.7% receiving treatment), the prevalence of any grade and severe steatosis was 53% and 36%, respectively. In the multivariate analysis, obesity was a significant predictor for severe steatosis (adjusted odds ratio: 5.046, 95% confidence interval: 1.22-20.93). Severe steatosis was a determinant associated with viral load (adjusted odds ratio: 0.385, 95% confidence interval: 0.20-0.75, P < .01; r = -0.096, P = .007) regardless of antiviral therapy, age, and alanine aminotransferase levels. Conclusion In this large multiethnic CHB population, hepatic steatosis is common. Severe steatosis is independently associated with higher fibrosis, but negatively with HBV DNA, regardless of antiviral therapy history.
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Affiliation(s)
- Hin Hin Ko
- Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Nishi H. Patel
- Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | | | - Karen Doucette
- Department of Medicine, University of Alberta, Edmonton, Alberta, Canada
| | - Mang M. Ma
- Department of Medicine, University of Alberta, Edmonton, Alberta, Canada
| | - Curtis Cooper
- Department of Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | - Erin Kelly
- Department of Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | - Magdy Elkhashab
- Depatment of Medicine, Toronto Liver Centre, Toronto, Ontario, Canada
| | - Edward Tam
- Depatment of Medicine, Pacific Gastroenterology Associates, Vancouver, British Columbia, Canada
| | - Robert Bailey
- Department of Medicine, University of Alberta, Edmonton, Alberta, Canada
| | - Alexander Wong
- Department of Medicine, University of Saskatchewan, Regina, Saskatchewan, Canada
| | - Gerald Minuk
- Department of Medicine, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Philip Wong
- Department of Medicine, McGill University Health Centre, Montreal, Quebec, Canada
| | - Scott K. Fung
- Department of Medicine, University Health Network, Toronto, Ontario, Canada
| | - Giada Sebastiani
- Department of Medicine, McGill University Health Centre, Montreal, Quebec, Canada
| | - Alnoor Ramji
- Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Carla S. Coffin
- Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
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