Estimation of non-alcoholic steatohepatitis (NASH) disease using clinical information based on the optimal combination of intelligent algorithms for feature selection and classification

Application of artificial intelligence techniques for non-alcoholic fatty liver disease diagnosis: A systematic review (2005-2023)

BACKGROUND AND OBJECTIVES

Non-alcoholic fatty liver disease (NAFLD) is a common liver disease with a rapidly growing incidence worldwide. For prognostication and therapeutic decisions, it is important to distinguish the pathological stages of NAFLD: steatosis, steatohepatitis, and liver fibrosis, which are definitively diagnosed on invasive biopsy. Non-invasive ultrasound (US) imaging, including US elastography technique, and clinical parameters can be used to diagnose and grade NAFLD and its complications. Artificial intelligence (AI) is increasingly being harnessed for developing NAFLD diagnostic models based on clinical, biomarker, or imaging data. In this work, we systemically reviewed the literature for AI-enabled NAFLD diagnostic models based on US (including elastography) and clinical (including serological) data.

METHODS

We performed a comprehensive search on Google Scholar, Scopus, and PubMed search engines for articles published between January 2005 and June 2023 related to AI models for NAFLD diagnosis based on US and/or clinical parameters using the following search terms: "non-alcoholic fatty liver disease", "non-alcoholic steatohepatitis", "deep learning", "machine learning", "artificial intelligence", "ultrasound imaging", "sonography", "clinical information".

RESULTS

We reviewed 64 published models that used either US (including elastography) or clinical data input to detect the presence of NAFLD, non-alcoholic steatohepatitis, and/or fibrosis, and in some cases, the severity of steatosis, inflammation, and/or fibrosis as well. The performances of the published models were summarized, and stratified by data input and algorithms used, which could be broadly divided into machine and deep learning approaches.

CONCLUSION

AI models based on US imaging and clinical data can reliably detect NAFLD and its complications, thereby reducing diagnostic costs and the need for invasive liver biopsy. The models offer advantages of efficiency, accuracy, and accessibility, and serve as virtual assistants for specialists to accelerate disease diagnosis and reduce treatment costs for patients and healthcare systems.

Machine learning approaches for early detection of non-alcoholic steatohepatitis based on clinical and blood parameters

This study aims to develop a machine learning approach leveraging clinical data and blood parameters to predict non-alcoholic steatohepatitis (NASH) based on the NAFLD Activity Score (NAS). Using a dataset of 181 patients, we performed preprocessing including normalization and categorical encoding. To identify predictive features, we applied sequential forward selection (SFS), chi-square, analysis of variance (ANOVA), and mutual information (MI). The selected features were used to train machine learning classifiers including SVM, random forest, AdaBoost, LightGBM, and XGBoost. Hyperparameter tuning was done for each classifier using randomized search. Model evaluation was performed using leave-one-out cross-validation over 100 repetitions. Among the classifiers, random forest, combined with SFS feature selection and 10 features, obtained the best performance: Accuracy: 81.32% ± 6.43%, Sensitivity: 86.04% ± 6.21%, Specificity: 70.49% ± 8.12% Precision: 81.59% ± 6.23%, and F1-score: 83.75% ± 6.23% percent. Our findings highlight the promise of machine learning in enhancing early diagnosis of NASH and provide a compelling alternative to conventional diagnostic techniques. Consequently, this study highlights the promise of machine learning techniques in enhancing early and non-invasive diagnosis of NASH based on readily available clinical and blood data. Our findings provide the basis for developing scalable approaches that can improve screening and monitoring of NASH progression.