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Guo Y, Li T, Zhao Z, Sun Q, Chen M, Jiang Y, Yao Z, Hu B. Liver fibrosis automatic diagnosis utilizing dense-fusion attention contrastive learning network. Med Phys 2024; 51:5550-5562. [PMID: 38753547 DOI: 10.1002/mp.17130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Revised: 04/07/2024] [Accepted: 04/22/2024] [Indexed: 05/18/2024] Open
Abstract
BACKGROUND Liver fibrosis poses a significant public health challenge given its elevated incidence and associated mortality rates. Diffusion-Weighted Imaging (DWI) serves as a non-invasive diagnostic tool for supporting the identification of liver fibrosis. Deep learning, as a computer-aided diagnostic technology, can assist in recognizing the stage of liver fibrosis by extracting abstract features from DWI images. However, gathering samples is often challenging, posing a common dilemma in previous research. Moreover, previous studies frequently overlooked the cross-comparison information and latent connections among different DWI parameters. Thus, it is becoming a challenge to identify effective DWI parameters and dig potential features from multiple categories in a dataset with limited samples. PURPOSE A self-defined Multi-view Contrastive Learning Network is developed to automatically classify multi-parameter DWI images and explore synergies between different DWI parameters. METHODS A Dense-fusion Attention Contrastive Learning Network (DACLN) is designed and used to recognize DWI images. Concretely, a multi-view contrastive learning framework is constructed to train and extract features from raw multi-parameter DWI. Besides, a Dense-fusion module is designed to integrate feature and output predicted labels. RESULTS We evaluated the performance of the proposed model on a set of real clinical data and analyzed the interpretability by Grad-CAM and annotation analysis, achieving average scores of 0.8825, 0.8702, 0.8933, 0.8727, and 0.8779 for accuracy, precision, recall, specificity and F-1 score. Of note, the experimental results revealed that IVIM-f, CTRW-β, and MONO-ADC exhibited significant recognition ability and complementarity. CONCLUSION Our method achieves competitive accuracy in liver fibrosis diagnosis using the limited multi-parameter DWI dataset and finds three types of DWI parameters with high sensitivity for diagnosing liver fibrosis, which suggests potential directions for future research.
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Affiliation(s)
- Yuhui Guo
- School of Mathematics and Statistics, Lanzhou University, Lanzhou, China
- Gansu Provincial Key Laboratory of Wearable Computing, Lanzhou University, Lanzhou, China
| | - Tongtong Li
- Gansu Provincial Key Laboratory of Wearable Computing, Lanzhou University, Lanzhou, China
- School of Information Science and Engineering, Lanzhou University, Lanzhou, China
| | - Ziyang Zhao
- Gansu Provincial Key Laboratory of Wearable Computing, Lanzhou University, Lanzhou, China
- School of Information Science and Engineering, Lanzhou University, Lanzhou, China
| | - Qi Sun
- Gansu Provincial Key Laboratory of Wearable Computing, Lanzhou University, Lanzhou, China
- School of Information Science and Engineering, Lanzhou University, Lanzhou, China
| | - Miao Chen
- Gansu Provincial Key Laboratory of Wearable Computing, Lanzhou University, Lanzhou, China
- School of Information Science and Engineering, Lanzhou University, Lanzhou, China
| | - Yanli Jiang
- Department of Magnetic Resonance, Lanzhou University Second Hospital, Lanzhou, China
| | - Zhijun Yao
- Gansu Provincial Key Laboratory of Wearable Computing, Lanzhou University, Lanzhou, China
- School of Information Science and Engineering, Lanzhou University, Lanzhou, China
| | - Bin Hu
- Gansu Provincial Key Laboratory of Wearable Computing, Lanzhou University, Lanzhou, China
- School of Medical Technology, Beijing Institute of Technology, Beijing, China
- CAS Center for Excellence in Brain Science and Intelligence Technology, Shanghai Institutes for Biological Sciences, Chinese Academy of Sciences, Shanghai, China
- Joint Research Center for Cognitive Neurosensor Technology of Lanzhou University & Institute of Semiconductors, Chinese Academy of Sciences, Lanzhou, China
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Kraus M, Anteby R, Konen E, Eshed I, Klang E. Artificial intelligence for X-ray scaphoid fracture detection: a systematic review and diagnostic test accuracy meta-analysis. Eur Radiol 2024; 34:4341-4351. [PMID: 38097728 PMCID: PMC11213739 DOI: 10.1007/s00330-023-10473-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Revised: 09/22/2023] [Accepted: 09/28/2023] [Indexed: 06/29/2024]
Abstract
OBJECTIVES Scaphoid fractures are usually diagnosed using X-rays, a low-sensitivity modality. Artificial intelligence (AI) using Convolutional Neural Networks (CNNs) has been explored for diagnosing scaphoid fractures in X-rays. The aim of this systematic review and meta-analysis is to evaluate the use of AI for detecting scaphoid fractures on X-rays and analyze its accuracy and usefulness. MATERIALS AND METHODS This study followed the guidelines of Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) and PRISMA-Diagnostic Test Accuracy. A literature search was conducted in the PubMed database for original articles published until July 2023. The risk of bias and applicability were evaluated using the QUADAS-2 tool. A bivariate diagnostic random-effects meta-analysis was conducted, and the results were analyzed using the Summary Receiver Operating Characteristic (SROC) curve. RESULTS Ten studies met the inclusion criteria and were all retrospective. The AI's diagnostic performance for detecting scaphoid fractures ranged from AUC 0.77 to 0.96. Seven studies were included in the meta-analysis, with a total of 3373 images. The meta-analysis pooled sensitivity and specificity were 0.80 and 0.89, respectively. The meta-analysis overall AUC was 0.88. The QUADAS-2 tool found high risk of bias and concerns about applicability in 9 out of 10 studies. CONCLUSIONS The current results of AI's diagnostic performance for detecting scaphoid fractures in X-rays show promise. The results show high overall sensitivity and specificity and a high SROC result. Further research is needed to compare AI's diagnostic performance to human diagnostic performance in a clinical setting. CLINICAL RELEVANCE STATEMENT Scaphoid fractures are prone to be missed secondary to assessment with a low sensitivity modality and a high occult fracture rate. AI systems can be beneficial for clinicians and radiologists to facilitate early diagnosis, and avoid missed injuries. KEY POINTS • Scaphoid fractures are common and some can be easily missed in X-rays. • Artificial intelligence (AI) systems demonstrate high diagnostic performance for the diagnosis of scaphoid fractures in X-rays. • AI systems can be beneficial in diagnosing both obvious and occult scaphoid fractures.
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Affiliation(s)
- Matan Kraus
- Department of Diagnostic Imaging, Sheba Medical Center, 2 Sheba Road, 5262000, Ramat Gan, Israel.
- Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.
| | - Roi Anteby
- Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
- Department of General Surgery, Sheba Medical Center, 2 Sheba Road, 5262000, Ramat Gan, Israel
| | - Eli Konen
- Department of Diagnostic Imaging, Sheba Medical Center, 2 Sheba Road, 5262000, Ramat Gan, Israel
- Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Iris Eshed
- Department of Diagnostic Imaging, Sheba Medical Center, 2 Sheba Road, 5262000, Ramat Gan, Israel
- Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Eyal Klang
- Department of Diagnostic Imaging, Sheba Medical Center, 2 Sheba Road, 5262000, Ramat Gan, Israel
- Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
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Hassoun S, Bruckmann C, Ciardullo S, Perseghin G, Marra F, Curto A, Arena U, Broccolo F, Di Gaudio F. NAIF: A novel artificial intelligence-based tool for accurate diagnosis of stage F3/F4 liver fibrosis in the general adult population, validated with three external datasets. Int J Med Inform 2024; 185:105373. [PMID: 38395017 DOI: 10.1016/j.ijmedinf.2024.105373] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Revised: 02/05/2024] [Accepted: 02/07/2024] [Indexed: 02/25/2024]
Abstract
OBJECTIVE The purpose of this study was to determine the effectiveness of a new AI-based tool called NAIF (NAFLD-AI-Fibrosis) in identifying individuals from the general population with advanced liver fibrosis (stage F3/F4). We compared NAIF's performance to two existing risk score calculators, aspartate aminotransferase-to-platelet ratio index (APRI) and fibrosis-4 (Fib4). METHODS To set up the algorithm for diagnosing severe liver fibrosis (defined as Fibroscan® values E ≥ 9.7 KPa), we used 19 blood biochemistry parameters and two demographic parameters in a group of 5,962 individuals from the NHANES population (2017-2020 pre-pandemic, public database). We then assessed the algorithm's performance by comparing its accuracy, precision, sensitivity, specificity, and F1 score values to those of APRI and Fib4 scoring systems. RESULTS In a kept-out sub dataset of the NHANES population, NAIF achieved a predictive precision of 72 %, a sensitivity of 61 %, and a specificity of 77 % in correctly identifying adults (aged 18-79 years) with severe liver fibrosis. Additionally, NAIF performed well when tested with two external datasets of Italian patients with a Fibroscan® score E ≥ 9.7 kPa, and with an external dataset of patients with diagnosis of severe liver fibrosis through biopsy. CONCLUSIONS The results of our study suggest that NAIF, using routinely available parameters, outperforms in sensitivity existing scoring methods (Fib4 and APRI) in diagnosing severe liver fibrosis, even when tested with external validation datasets. NAIF uses routinely available parameters, making it a promising tool for identifying individuals with advanced liver fibrosis from the general population. Word count abstract: 236.
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Affiliation(s)
- Samir Hassoun
- Unità Operativa Centro Controllo Qualità e Rischio Chimico (CQRC), Azienda Ospedaliera Villa Sofia Cervello, viale Strasburgo 233, 90146 Palermo, Italy.
| | - Chiara Bruckmann
- Unità Operativa Centro Controllo Qualità e Rischio Chimico (CQRC), Azienda Ospedaliera Villa Sofia Cervello, viale Strasburgo 233, 90146 Palermo, Italy.
| | - Stefano Ciardullo
- Department of Medicine and Surgery, University of Milano-Bicocca, via Modigliani 10, 20900 Monza, Italy; Department of Medicine and Rehabilitation, Policlinico di Monza, Monza, via Modigliani 10, 20900 Monza, Italy
| | - Gianluca Perseghin
- Department of Medicine and Surgery, University of Milano-Bicocca, via Modigliani 10, 20900 Monza, Italy; Department of Medicine and Rehabilitation, Policlinico di Monza, Monza, via Modigliani 10, 20900 Monza, Italy
| | - Fabio Marra
- Dipartimento di Medicina Sperimentale e Clinica, University of Florence, Largo Giovanni Alessandro Brambilla, 3, 50134 Firenze Italy
| | - Armando Curto
- Dipartimento di Medicina Sperimentale e Clinica, University of Florence, Largo Giovanni Alessandro Brambilla, 3, 50134 Firenze Italy
| | - Umberto Arena
- Dipartimento di Medicina Sperimentale e Clinica, University of Florence, Largo Giovanni Alessandro Brambilla, 3, 50134 Firenze Italy
| | - Francesco Broccolo
- Department of Experimental Medicine, University of Salento, 73100 Lecce, Italy.
| | - Francesca Di Gaudio
- Unità Operativa Centro Controllo Qualità e Rischio Chimico (CQRC), Azienda Ospedaliera Villa Sofia Cervello, viale Strasburgo 233, 90146 Palermo, Italy; PROMISE-Promotion of Health, Maternal-Childhood, Internal and Specialized Medicine of Excellence G. D'Alessandro, Piazza delle Cliniche, 2, 90127 Palermo, Italy
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Ghosh A. B-mode US and Deep Learning Rivals Shear-Wave Elastography in Screening for Fibrosis. Radiology 2024; 311:e240868. [PMID: 38652032 DOI: 10.1148/radiol.240868] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/25/2024]
Affiliation(s)
- Adarsh Ghosh
- From the Cincinnati Children's Hospital Medical Center, 3333 Burnet Ave, Cincinnati, OH 45229
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Chen LD, Huang ZR, Yang H, Cheng MQ, Hu HT, Lu XZ, Li MD, Lu RF, He DN, Lin P, Ma QP, Huang H, Ruan SM, Ke WP, Liao B, Zhong BH, Ren J, Lu MD, Xie XY, Wang W. US-based Sequential Algorithm Integrating an AI Model for Advanced Liver Fibrosis Screening. Radiology 2024; 311:e231461. [PMID: 38652028 DOI: 10.1148/radiol.231461] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/25/2024]
Abstract
Background Noninvasive tests can be used to screen patients with chronic liver disease for advanced liver fibrosis; however, the use of single tests may not be adequate. Purpose To construct sequential clinical algorithms that include a US deep learning (DL) model and compare their ability to predict advanced liver fibrosis with that of other noninvasive tests. Materials and Methods This retrospective study included adult patients with a history of chronic liver disease or unexplained abnormal liver function test results who underwent B-mode US of the liver between January 2014 and September 2022 at three health care facilities. A US-based DL network (FIB-Net) was trained on US images to predict whether the shear-wave elastography (SWE) value was 8.7 kPa or higher, indicative of advanced fibrosis. In the internal and external test sets, a two-step algorithm (Two-step#1) using the Fibrosis-4 Index (FIB-4) followed by FIB-Net and a three-step algorithm (Three-step#1) using FIB-4 followed by FIB-Net and SWE were used to simulate screening scenarios where liver stiffness measurements were not or were available, respectively. Measures of diagnostic accuracy were calculated using liver biopsy as the reference standard and compared between FIB-4, SWE, FIB-Net, and European Association for the Study of the Liver guidelines (ie, FIB-4 followed by SWE), along with sequential algorithms. Results The training, validation, and test data sets included 3067 (median age, 42 years [IQR, 33-53 years]; 2083 male), 1599 (median age, 41 years [IQR, 33-51 years]; 1124 male), and 1228 (median age, 44 years [IQR, 33-55 years]; 741 male) patients, respectively. FIB-Net obtained a noninferior specificity with a margin of 5% (P < .001) compared with SWE (80% vs 82%). The Two-step#1 algorithm showed higher specificity and positive predictive value (PPV) than FIB-4 (specificity, 79% vs 57%; PPV, 44% vs 32%) while reducing unnecessary referrals by 42%. The Three-step#1 algorithm had higher specificity and PPV compared with European Association for the Study of the Liver guidelines (specificity, 94% vs 88%; PPV, 73% vs 64%) while reducing unnecessary referrals by 35%. Conclusion A sequential algorithm combining FIB-4 and a US DL model showed higher diagnostic accuracy and improved referral management for all-cause advanced liver fibrosis compared with FIB-4 or the DL model alone. © RSNA, 2024 Supplemental material is available for this article. See also the editorial by Ghosh in this issue.
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Affiliation(s)
- Li-Da Chen
- From the Department of Medical Ultrasonics, Institute of Diagnostic and Interventional Ultrasound (L.D.C., Z.R.H., M.Q.C., H.T.H., M.D. Li, R.F.L., H.H., S.M.R., W.P.K., M.D. Lu, X.Y.X., W.W.), Department of Traditional Chinese Medicine (X.Z.L.), Department of Pathology (B.L.), Department of Gastroenterology (B.H.Z.), and Department of Hepatobiliary Surgery (M.D. Lu), the First Affiliated Hospital of Sun Yat-sen University, No. 58 Zhongshan Rd 2, Guangzhou 510080, People's Republic of China; Department of Medical Ultrasound, the First Affiliated Hospital of Guangxi Medical University, Nanning, People's Republic of China (H.Y., P.L.); Department of Medical Ultrasonics, the Seventh Affiliated Hospital of Sun Yat-sen University, Shenzhen, People's Republic of China (D.N.H.); and Department of Medical Ultrasonics, the Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, People's Republic of China (Q.P.M., J.R.)
| | - Ze-Rong Huang
- From the Department of Medical Ultrasonics, Institute of Diagnostic and Interventional Ultrasound (L.D.C., Z.R.H., M.Q.C., H.T.H., M.D. Li, R.F.L., H.H., S.M.R., W.P.K., M.D. Lu, X.Y.X., W.W.), Department of Traditional Chinese Medicine (X.Z.L.), Department of Pathology (B.L.), Department of Gastroenterology (B.H.Z.), and Department of Hepatobiliary Surgery (M.D. Lu), the First Affiliated Hospital of Sun Yat-sen University, No. 58 Zhongshan Rd 2, Guangzhou 510080, People's Republic of China; Department of Medical Ultrasound, the First Affiliated Hospital of Guangxi Medical University, Nanning, People's Republic of China (H.Y., P.L.); Department of Medical Ultrasonics, the Seventh Affiliated Hospital of Sun Yat-sen University, Shenzhen, People's Republic of China (D.N.H.); and Department of Medical Ultrasonics, the Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, People's Republic of China (Q.P.M., J.R.)
| | - Hong Yang
- From the Department of Medical Ultrasonics, Institute of Diagnostic and Interventional Ultrasound (L.D.C., Z.R.H., M.Q.C., H.T.H., M.D. Li, R.F.L., H.H., S.M.R., W.P.K., M.D. Lu, X.Y.X., W.W.), Department of Traditional Chinese Medicine (X.Z.L.), Department of Pathology (B.L.), Department of Gastroenterology (B.H.Z.), and Department of Hepatobiliary Surgery (M.D. Lu), the First Affiliated Hospital of Sun Yat-sen University, No. 58 Zhongshan Rd 2, Guangzhou 510080, People's Republic of China; Department of Medical Ultrasound, the First Affiliated Hospital of Guangxi Medical University, Nanning, People's Republic of China (H.Y., P.L.); Department of Medical Ultrasonics, the Seventh Affiliated Hospital of Sun Yat-sen University, Shenzhen, People's Republic of China (D.N.H.); and Department of Medical Ultrasonics, the Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, People's Republic of China (Q.P.M., J.R.)
| | - Mei-Qing Cheng
- From the Department of Medical Ultrasonics, Institute of Diagnostic and Interventional Ultrasound (L.D.C., Z.R.H., M.Q.C., H.T.H., M.D. Li, R.F.L., H.H., S.M.R., W.P.K., M.D. Lu, X.Y.X., W.W.), Department of Traditional Chinese Medicine (X.Z.L.), Department of Pathology (B.L.), Department of Gastroenterology (B.H.Z.), and Department of Hepatobiliary Surgery (M.D. Lu), the First Affiliated Hospital of Sun Yat-sen University, No. 58 Zhongshan Rd 2, Guangzhou 510080, People's Republic of China; Department of Medical Ultrasound, the First Affiliated Hospital of Guangxi Medical University, Nanning, People's Republic of China (H.Y., P.L.); Department of Medical Ultrasonics, the Seventh Affiliated Hospital of Sun Yat-sen University, Shenzhen, People's Republic of China (D.N.H.); and Department of Medical Ultrasonics, the Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, People's Republic of China (Q.P.M., J.R.)
| | - Hang-Tong Hu
- From the Department of Medical Ultrasonics, Institute of Diagnostic and Interventional Ultrasound (L.D.C., Z.R.H., M.Q.C., H.T.H., M.D. Li, R.F.L., H.H., S.M.R., W.P.K., M.D. Lu, X.Y.X., W.W.), Department of Traditional Chinese Medicine (X.Z.L.), Department of Pathology (B.L.), Department of Gastroenterology (B.H.Z.), and Department of Hepatobiliary Surgery (M.D. Lu), the First Affiliated Hospital of Sun Yat-sen University, No. 58 Zhongshan Rd 2, Guangzhou 510080, People's Republic of China; Department of Medical Ultrasound, the First Affiliated Hospital of Guangxi Medical University, Nanning, People's Republic of China (H.Y., P.L.); Department of Medical Ultrasonics, the Seventh Affiliated Hospital of Sun Yat-sen University, Shenzhen, People's Republic of China (D.N.H.); and Department of Medical Ultrasonics, the Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, People's Republic of China (Q.P.M., J.R.)
| | - Xiao-Zhou Lu
- From the Department of Medical Ultrasonics, Institute of Diagnostic and Interventional Ultrasound (L.D.C., Z.R.H., M.Q.C., H.T.H., M.D. Li, R.F.L., H.H., S.M.R., W.P.K., M.D. Lu, X.Y.X., W.W.), Department of Traditional Chinese Medicine (X.Z.L.), Department of Pathology (B.L.), Department of Gastroenterology (B.H.Z.), and Department of Hepatobiliary Surgery (M.D. Lu), the First Affiliated Hospital of Sun Yat-sen University, No. 58 Zhongshan Rd 2, Guangzhou 510080, People's Republic of China; Department of Medical Ultrasound, the First Affiliated Hospital of Guangxi Medical University, Nanning, People's Republic of China (H.Y., P.L.); Department of Medical Ultrasonics, the Seventh Affiliated Hospital of Sun Yat-sen University, Shenzhen, People's Republic of China (D.N.H.); and Department of Medical Ultrasonics, the Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, People's Republic of China (Q.P.M., J.R.)
| | - Ming-De Li
- From the Department of Medical Ultrasonics, Institute of Diagnostic and Interventional Ultrasound (L.D.C., Z.R.H., M.Q.C., H.T.H., M.D. Li, R.F.L., H.H., S.M.R., W.P.K., M.D. Lu, X.Y.X., W.W.), Department of Traditional Chinese Medicine (X.Z.L.), Department of Pathology (B.L.), Department of Gastroenterology (B.H.Z.), and Department of Hepatobiliary Surgery (M.D. Lu), the First Affiliated Hospital of Sun Yat-sen University, No. 58 Zhongshan Rd 2, Guangzhou 510080, People's Republic of China; Department of Medical Ultrasound, the First Affiliated Hospital of Guangxi Medical University, Nanning, People's Republic of China (H.Y., P.L.); Department of Medical Ultrasonics, the Seventh Affiliated Hospital of Sun Yat-sen University, Shenzhen, People's Republic of China (D.N.H.); and Department of Medical Ultrasonics, the Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, People's Republic of China (Q.P.M., J.R.)
| | - Rui-Fang Lu
- From the Department of Medical Ultrasonics, Institute of Diagnostic and Interventional Ultrasound (L.D.C., Z.R.H., M.Q.C., H.T.H., M.D. Li, R.F.L., H.H., S.M.R., W.P.K., M.D. Lu, X.Y.X., W.W.), Department of Traditional Chinese Medicine (X.Z.L.), Department of Pathology (B.L.), Department of Gastroenterology (B.H.Z.), and Department of Hepatobiliary Surgery (M.D. Lu), the First Affiliated Hospital of Sun Yat-sen University, No. 58 Zhongshan Rd 2, Guangzhou 510080, People's Republic of China; Department of Medical Ultrasound, the First Affiliated Hospital of Guangxi Medical University, Nanning, People's Republic of China (H.Y., P.L.); Department of Medical Ultrasonics, the Seventh Affiliated Hospital of Sun Yat-sen University, Shenzhen, People's Republic of China (D.N.H.); and Department of Medical Ultrasonics, the Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, People's Republic of China (Q.P.M., J.R.)
| | - Dan-Ni He
- From the Department of Medical Ultrasonics, Institute of Diagnostic and Interventional Ultrasound (L.D.C., Z.R.H., M.Q.C., H.T.H., M.D. Li, R.F.L., H.H., S.M.R., W.P.K., M.D. Lu, X.Y.X., W.W.), Department of Traditional Chinese Medicine (X.Z.L.), Department of Pathology (B.L.), Department of Gastroenterology (B.H.Z.), and Department of Hepatobiliary Surgery (M.D. Lu), the First Affiliated Hospital of Sun Yat-sen University, No. 58 Zhongshan Rd 2, Guangzhou 510080, People's Republic of China; Department of Medical Ultrasound, the First Affiliated Hospital of Guangxi Medical University, Nanning, People's Republic of China (H.Y., P.L.); Department of Medical Ultrasonics, the Seventh Affiliated Hospital of Sun Yat-sen University, Shenzhen, People's Republic of China (D.N.H.); and Department of Medical Ultrasonics, the Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, People's Republic of China (Q.P.M., J.R.)
| | - Peng Lin
- From the Department of Medical Ultrasonics, Institute of Diagnostic and Interventional Ultrasound (L.D.C., Z.R.H., M.Q.C., H.T.H., M.D. Li, R.F.L., H.H., S.M.R., W.P.K., M.D. Lu, X.Y.X., W.W.), Department of Traditional Chinese Medicine (X.Z.L.), Department of Pathology (B.L.), Department of Gastroenterology (B.H.Z.), and Department of Hepatobiliary Surgery (M.D. Lu), the First Affiliated Hospital of Sun Yat-sen University, No. 58 Zhongshan Rd 2, Guangzhou 510080, People's Republic of China; Department of Medical Ultrasound, the First Affiliated Hospital of Guangxi Medical University, Nanning, People's Republic of China (H.Y., P.L.); Department of Medical Ultrasonics, the Seventh Affiliated Hospital of Sun Yat-sen University, Shenzhen, People's Republic of China (D.N.H.); and Department of Medical Ultrasonics, the Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, People's Republic of China (Q.P.M., J.R.)
| | - Qiu-Ping Ma
- From the Department of Medical Ultrasonics, Institute of Diagnostic and Interventional Ultrasound (L.D.C., Z.R.H., M.Q.C., H.T.H., M.D. Li, R.F.L., H.H., S.M.R., W.P.K., M.D. Lu, X.Y.X., W.W.), Department of Traditional Chinese Medicine (X.Z.L.), Department of Pathology (B.L.), Department of Gastroenterology (B.H.Z.), and Department of Hepatobiliary Surgery (M.D. Lu), the First Affiliated Hospital of Sun Yat-sen University, No. 58 Zhongshan Rd 2, Guangzhou 510080, People's Republic of China; Department of Medical Ultrasound, the First Affiliated Hospital of Guangxi Medical University, Nanning, People's Republic of China (H.Y., P.L.); Department of Medical Ultrasonics, the Seventh Affiliated Hospital of Sun Yat-sen University, Shenzhen, People's Republic of China (D.N.H.); and Department of Medical Ultrasonics, the Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, People's Republic of China (Q.P.M., J.R.)
| | - Hui Huang
- From the Department of Medical Ultrasonics, Institute of Diagnostic and Interventional Ultrasound (L.D.C., Z.R.H., M.Q.C., H.T.H., M.D. Li, R.F.L., H.H., S.M.R., W.P.K., M.D. Lu, X.Y.X., W.W.), Department of Traditional Chinese Medicine (X.Z.L.), Department of Pathology (B.L.), Department of Gastroenterology (B.H.Z.), and Department of Hepatobiliary Surgery (M.D. Lu), the First Affiliated Hospital of Sun Yat-sen University, No. 58 Zhongshan Rd 2, Guangzhou 510080, People's Republic of China; Department of Medical Ultrasound, the First Affiliated Hospital of Guangxi Medical University, Nanning, People's Republic of China (H.Y., P.L.); Department of Medical Ultrasonics, the Seventh Affiliated Hospital of Sun Yat-sen University, Shenzhen, People's Republic of China (D.N.H.); and Department of Medical Ultrasonics, the Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, People's Republic of China (Q.P.M., J.R.)
| | - Si-Min Ruan
- From the Department of Medical Ultrasonics, Institute of Diagnostic and Interventional Ultrasound (L.D.C., Z.R.H., M.Q.C., H.T.H., M.D. Li, R.F.L., H.H., S.M.R., W.P.K., M.D. Lu, X.Y.X., W.W.), Department of Traditional Chinese Medicine (X.Z.L.), Department of Pathology (B.L.), Department of Gastroenterology (B.H.Z.), and Department of Hepatobiliary Surgery (M.D. Lu), the First Affiliated Hospital of Sun Yat-sen University, No. 58 Zhongshan Rd 2, Guangzhou 510080, People's Republic of China; Department of Medical Ultrasound, the First Affiliated Hospital of Guangxi Medical University, Nanning, People's Republic of China (H.Y., P.L.); Department of Medical Ultrasonics, the Seventh Affiliated Hospital of Sun Yat-sen University, Shenzhen, People's Republic of China (D.N.H.); and Department of Medical Ultrasonics, the Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, People's Republic of China (Q.P.M., J.R.)
| | - Wei-Ping Ke
- From the Department of Medical Ultrasonics, Institute of Diagnostic and Interventional Ultrasound (L.D.C., Z.R.H., M.Q.C., H.T.H., M.D. Li, R.F.L., H.H., S.M.R., W.P.K., M.D. Lu, X.Y.X., W.W.), Department of Traditional Chinese Medicine (X.Z.L.), Department of Pathology (B.L.), Department of Gastroenterology (B.H.Z.), and Department of Hepatobiliary Surgery (M.D. Lu), the First Affiliated Hospital of Sun Yat-sen University, No. 58 Zhongshan Rd 2, Guangzhou 510080, People's Republic of China; Department of Medical Ultrasound, the First Affiliated Hospital of Guangxi Medical University, Nanning, People's Republic of China (H.Y., P.L.); Department of Medical Ultrasonics, the Seventh Affiliated Hospital of Sun Yat-sen University, Shenzhen, People's Republic of China (D.N.H.); and Department of Medical Ultrasonics, the Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, People's Republic of China (Q.P.M., J.R.)
| | - Bing Liao
- From the Department of Medical Ultrasonics, Institute of Diagnostic and Interventional Ultrasound (L.D.C., Z.R.H., M.Q.C., H.T.H., M.D. Li, R.F.L., H.H., S.M.R., W.P.K., M.D. Lu, X.Y.X., W.W.), Department of Traditional Chinese Medicine (X.Z.L.), Department of Pathology (B.L.), Department of Gastroenterology (B.H.Z.), and Department of Hepatobiliary Surgery (M.D. Lu), the First Affiliated Hospital of Sun Yat-sen University, No. 58 Zhongshan Rd 2, Guangzhou 510080, People's Republic of China; Department of Medical Ultrasound, the First Affiliated Hospital of Guangxi Medical University, Nanning, People's Republic of China (H.Y., P.L.); Department of Medical Ultrasonics, the Seventh Affiliated Hospital of Sun Yat-sen University, Shenzhen, People's Republic of China (D.N.H.); and Department of Medical Ultrasonics, the Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, People's Republic of China (Q.P.M., J.R.)
| | - Bi-Hui Zhong
- From the Department of Medical Ultrasonics, Institute of Diagnostic and Interventional Ultrasound (L.D.C., Z.R.H., M.Q.C., H.T.H., M.D. Li, R.F.L., H.H., S.M.R., W.P.K., M.D. Lu, X.Y.X., W.W.), Department of Traditional Chinese Medicine (X.Z.L.), Department of Pathology (B.L.), Department of Gastroenterology (B.H.Z.), and Department of Hepatobiliary Surgery (M.D. Lu), the First Affiliated Hospital of Sun Yat-sen University, No. 58 Zhongshan Rd 2, Guangzhou 510080, People's Republic of China; Department of Medical Ultrasound, the First Affiliated Hospital of Guangxi Medical University, Nanning, People's Republic of China (H.Y., P.L.); Department of Medical Ultrasonics, the Seventh Affiliated Hospital of Sun Yat-sen University, Shenzhen, People's Republic of China (D.N.H.); and Department of Medical Ultrasonics, the Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, People's Republic of China (Q.P.M., J.R.)
| | - Jie Ren
- From the Department of Medical Ultrasonics, Institute of Diagnostic and Interventional Ultrasound (L.D.C., Z.R.H., M.Q.C., H.T.H., M.D. Li, R.F.L., H.H., S.M.R., W.P.K., M.D. Lu, X.Y.X., W.W.), Department of Traditional Chinese Medicine (X.Z.L.), Department of Pathology (B.L.), Department of Gastroenterology (B.H.Z.), and Department of Hepatobiliary Surgery (M.D. Lu), the First Affiliated Hospital of Sun Yat-sen University, No. 58 Zhongshan Rd 2, Guangzhou 510080, People's Republic of China; Department of Medical Ultrasound, the First Affiliated Hospital of Guangxi Medical University, Nanning, People's Republic of China (H.Y., P.L.); Department of Medical Ultrasonics, the Seventh Affiliated Hospital of Sun Yat-sen University, Shenzhen, People's Republic of China (D.N.H.); and Department of Medical Ultrasonics, the Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, People's Republic of China (Q.P.M., J.R.)
| | - Ming-De Lu
- From the Department of Medical Ultrasonics, Institute of Diagnostic and Interventional Ultrasound (L.D.C., Z.R.H., M.Q.C., H.T.H., M.D. Li, R.F.L., H.H., S.M.R., W.P.K., M.D. Lu, X.Y.X., W.W.), Department of Traditional Chinese Medicine (X.Z.L.), Department of Pathology (B.L.), Department of Gastroenterology (B.H.Z.), and Department of Hepatobiliary Surgery (M.D. Lu), the First Affiliated Hospital of Sun Yat-sen University, No. 58 Zhongshan Rd 2, Guangzhou 510080, People's Republic of China; Department of Medical Ultrasound, the First Affiliated Hospital of Guangxi Medical University, Nanning, People's Republic of China (H.Y., P.L.); Department of Medical Ultrasonics, the Seventh Affiliated Hospital of Sun Yat-sen University, Shenzhen, People's Republic of China (D.N.H.); and Department of Medical Ultrasonics, the Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, People's Republic of China (Q.P.M., J.R.)
| | - Xiao-Yan Xie
- From the Department of Medical Ultrasonics, Institute of Diagnostic and Interventional Ultrasound (L.D.C., Z.R.H., M.Q.C., H.T.H., M.D. Li, R.F.L., H.H., S.M.R., W.P.K., M.D. Lu, X.Y.X., W.W.), Department of Traditional Chinese Medicine (X.Z.L.), Department of Pathology (B.L.), Department of Gastroenterology (B.H.Z.), and Department of Hepatobiliary Surgery (M.D. Lu), the First Affiliated Hospital of Sun Yat-sen University, No. 58 Zhongshan Rd 2, Guangzhou 510080, People's Republic of China; Department of Medical Ultrasound, the First Affiliated Hospital of Guangxi Medical University, Nanning, People's Republic of China (H.Y., P.L.); Department of Medical Ultrasonics, the Seventh Affiliated Hospital of Sun Yat-sen University, Shenzhen, People's Republic of China (D.N.H.); and Department of Medical Ultrasonics, the Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, People's Republic of China (Q.P.M., J.R.)
| | - Wei Wang
- From the Department of Medical Ultrasonics, Institute of Diagnostic and Interventional Ultrasound (L.D.C., Z.R.H., M.Q.C., H.T.H., M.D. Li, R.F.L., H.H., S.M.R., W.P.K., M.D. Lu, X.Y.X., W.W.), Department of Traditional Chinese Medicine (X.Z.L.), Department of Pathology (B.L.), Department of Gastroenterology (B.H.Z.), and Department of Hepatobiliary Surgery (M.D. Lu), the First Affiliated Hospital of Sun Yat-sen University, No. 58 Zhongshan Rd 2, Guangzhou 510080, People's Republic of China; Department of Medical Ultrasound, the First Affiliated Hospital of Guangxi Medical University, Nanning, People's Republic of China (H.Y., P.L.); Department of Medical Ultrasonics, the Seventh Affiliated Hospital of Sun Yat-sen University, Shenzhen, People's Republic of China (D.N.H.); and Department of Medical Ultrasonics, the Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, People's Republic of China (Q.P.M., J.R.)
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Zhang W, Zhao N, Gao Y, Huang B, Wang L, Zhou X, Li Z. Automatic liver segmentation and assessment of liver fibrosis using deep learning with MR T1-weighted images in rats. Magn Reson Imaging 2024; 107:1-7. [PMID: 38147969 DOI: 10.1016/j.mri.2023.12.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2022] [Revised: 12/15/2023] [Accepted: 12/22/2023] [Indexed: 12/28/2023]
Abstract
OBJECTIVES To validate the performance of nnU-Net in segmentation and CNN in classification for liver fibrosis using T1-weighted images. MATERIALS AND METHODS In this prospective study, animal models of liver fibrosis were induced by injecting subcutaneously a mixture of Carbon tetrachloride and olive oil. A total of 99 male Wistar rats were successfully induced and underwent MR scanning with no contrast agent to get T1-weighted images. The regions of interest (ROIs) of the whole liver were delineated layer by layer along the liver edge by 3D Slicer. For segmentation task, all T1-weighted images were randomly divided into training and test cohorts in a ratio of 7:3. For classification, images containing the hepatic maximum diameter of every rat were selected and 80% images of no liver fibrosis (NLF), early liver fibrosis (ELF) and progressive liver fibrosis (PLF) stages were randomly selected for training, while the rest were used for testing. Liver segmentation was performed by the nnU-Net model. The convolutional neural network (CNN) was used for classification task of liver fibrosis stages. The Dice similarity coefficient was used to evaluate the segmentation performance of nnU-Net. Confusion matrix, ROC curve and accuracy were used to show the classification performance of CNN. RESULTS A total of 2628 images were obtained from 99 Wistar rats by MR scanning. For liver segmentation by nnU-Net, the Dice similarity coefficient in the test set was 0.8477. The accuracies of CNN in staging NLF, ELF and PLF were 0.73, 0.89 and 0.84, respectively. The AUCs were 0.76, 0.88 and 0.79, respectively. CONCLUSION The nnU-Net architecture is of high accuracy for liver segmentation and CNN for assessment of liver fibrosis with T1-weighted images.
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Affiliation(s)
- Wenjing Zhang
- Department of Radiology, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Nan Zhao
- College of Computer Science and Technology of Qingdao University, Qingdao, China
| | - Yuanxiang Gao
- Department of Radiology, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Baoxiang Huang
- College of Computer Science and Technology of Qingdao University, Qingdao, China
| | - Lili Wang
- Department of Pathology, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Xiaoming Zhou
- Department of Radiology, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Zhiming Li
- Department of Radiology, The Affiliated Hospital of Qingdao University, Qingdao, China.
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Lu F, Meng Y, Song X, Li X, Liu Z, Gu C, Zheng X, Jing Y, Cai W, Pinyopornpanish K, Mancuso A, Romeiro FG, Méndez-Sánchez N, Qi X. Artificial Intelligence in Liver Diseases: Recent Advances. Adv Ther 2024; 41:967-990. [PMID: 38286960 DOI: 10.1007/s12325-024-02781-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Accepted: 01/03/2024] [Indexed: 01/31/2024]
Abstract
Liver diseases cause a significant burden on public health worldwide. In spite of great advances during recent years, there are still many challenges in the diagnosis and treatment of liver diseases. During recent years, artificial intelligence (AI) has been widely used for the diagnosis, risk stratification, and prognostic prediction of various diseases based on clinical datasets and medical images. Accumulative studies have shown its performance for diagnosing patients with nonalcoholic fatty liver disease and liver fibrosis and assessing their severity, and for predicting treatment response and recurrence of hepatocellular carcinoma, outcomes of liver transplantation recipients, and risk of drug-induced liver injury. Herein, we aim to comprehensively summarize the current evidence regarding diagnostic, prognostic, and/or therapeutic role of AI in these common liver diseases.
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Affiliation(s)
- Feifei Lu
- College of Medicine and Biological Information Engineering, Northeastern University, Shenyang, China
- Liver Cirrhosis Study Group, Department of Gastroenterology, General Hospital of Northern Theater Command, No. 83 Wenhua Road, Shenyang, 110840, Liaoning Province, China
| | - Yao Meng
- Liver Cirrhosis Study Group, Department of Gastroenterology, General Hospital of Northern Theater Command, No. 83 Wenhua Road, Shenyang, 110840, Liaoning Province, China
- Postgraduate College, Dalian Medical University, Dalian, China
| | - Xiaoting Song
- Liver Cirrhosis Study Group, Department of Gastroenterology, General Hospital of Northern Theater Command, No. 83 Wenhua Road, Shenyang, 110840, Liaoning Province, China
- Postgraduate College, Dalian Medical University, Dalian, China
| | - Xiaotong Li
- Liver Cirrhosis Study Group, Department of Gastroenterology, General Hospital of Northern Theater Command, No. 83 Wenhua Road, Shenyang, 110840, Liaoning Province, China
- Postgraduate College, China Medical University, Shenyang, China
| | - Zhuang Liu
- Liver Cirrhosis Study Group, Department of Gastroenterology, General Hospital of Northern Theater Command, No. 83 Wenhua Road, Shenyang, 110840, Liaoning Province, China
- Postgraduate College, China Medical University, Shenyang, China
| | - Chunru Gu
- Liver Cirrhosis Study Group, Department of Gastroenterology, General Hospital of Northern Theater Command, No. 83 Wenhua Road, Shenyang, 110840, Liaoning Province, China
- Postgraduate College, China Medical University, Shenyang, China
| | - Xiaojie Zheng
- Liver Cirrhosis Study Group, Department of Gastroenterology, General Hospital of Northern Theater Command, No. 83 Wenhua Road, Shenyang, 110840, Liaoning Province, China
- Postgraduate College, China Medical University, Shenyang, China
| | - Yi Jing
- Neusoft Research of Intelligent Healthcare Technology, Co. Ltd., Shenyang, China
| | - Wei Cai
- Neusoft Research of Intelligent Healthcare Technology, Co. Ltd., Shenyang, China
| | - Kanokwan Pinyopornpanish
- Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Andrea Mancuso
- Medicina Interna 1, Azienda di Rilievo Nazionale Ad Alta Specializzazione Civico-Di Cristina-Benfratelli, Palermo, Italy.
| | | | - Nahum Méndez-Sánchez
- Liver Research Unit, Medica Sur Clinic and Foundation, National Autonomous University of Mexico, Mexico City, Mexico.
| | - Xingshun Qi
- College of Medicine and Biological Information Engineering, Northeastern University, Shenyang, China.
- Liver Cirrhosis Study Group, Department of Gastroenterology, General Hospital of Northern Theater Command, No. 83 Wenhua Road, Shenyang, 110840, Liaoning Province, China.
- Postgraduate College, Dalian Medical University, Dalian, China.
- Postgraduate College, China Medical University, Shenyang, China.
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Kolasa K, Admassu B, Hołownia-Voloskova M, Kędzior KJ, Poirrier JE, Perni S. Systematic reviews of machine learning in healthcare: a literature review. Expert Rev Pharmacoecon Outcomes Res 2024; 24:63-115. [PMID: 37955147 DOI: 10.1080/14737167.2023.2279107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Accepted: 10/31/2023] [Indexed: 11/14/2023]
Abstract
INTRODUCTION The increasing availability of data and computing power has made machine learning (ML) a viable approach to faster, more efficient healthcare delivery. METHODS A systematic literature review (SLR) of published SLRs evaluating ML applications in healthcare settings published between1 January 2010 and 27 March 2023 was conducted. RESULTS In total 220 SLRs covering 10,462 ML algorithms were reviewed. The main application of AI in medicine related to the clinical prediction and disease prognosis in oncology and neurology with the use of imaging data. Accuracy, specificity, and sensitivity were provided in 56%, 28%, and 25% SLRs respectively. Internal and external validation was reported in 53% and less than 1% of the cases respectively. The most common modeling approach was neural networks (2,454 ML algorithms), followed by support vector machine and random forest/decision trees (1,578 and 1,522 ML algorithms, respectively). EXPERT OPINION The review indicated considerable reporting gaps in terms of the ML's performance, both internal and external validation. Greater accessibility to healthcare data for developers can ensure the faster adoption of ML algorithms into clinical practice.
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Affiliation(s)
- Katarzyna Kolasa
- Division of Health Economics and Healthcare Management, Kozminski University, Warsaw, Poland
| | - Bisrat Admassu
- Division of Health Economics and Healthcare Management, Kozminski University, Warsaw, Poland
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Punn NS, Patel B, Banerjee I. Liver fibrosis classification from ultrasound using machine learning: a systematic literature review. Abdom Radiol (NY) 2024; 49:69-80. [PMID: 37950068 DOI: 10.1007/s00261-023-04081-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Revised: 09/27/2023] [Accepted: 09/28/2023] [Indexed: 11/12/2023]
Abstract
PURPOSE Liver biopsy was considered the gold standard for diagnosing liver fibrosis; however, with advancements in medical technology and increasing awareness of potential complications, the reliance on liver biopsy has diminished. Ultrasound is gaining popularity due to its wider availability and cost-effectiveness. This study examined the machine learning / deep learning (ML/DL) models for non-invasive liver fibrosis classification from ultrasound. METHODS Following the preferred reporting items for systematic reviews and meta-analyses (PRISMA) protocol, we searched five academic databases using the query. We defined population, intervention, comparison, outcomes, and study design (PICOS) framework for the inclusion. Furthermore, Joana Briggs Institute (JBI) checklist for analytical cross-sectional studies is used for quality assessment. RESULTS Among the 188 screened studies, 17 studies are selected. The methods are categorized as off-the-shelf (OTS), attention, generative, and ensemble classifiers. Most studies used OTS classifiers that combined pre-trained ML/DL methods with radiomics features to determine fibrosis staging. Although machine learning shows potential for fibrosis classification, there are limited external comparisons of interventions and prospective clinical trials, which limits their applicability. CONCLUSION With the recent success of ML/DL toward biomedical image analysis, automated solutions using ultrasound are developed for predicting liver diseases. However, their applicability is bounded by the limited and imbalanced retrospective studies having high heterogeneity. This challenge could be addressed by generating a standard protocol for study design by selecting appropriate population, interventions, outcomes, and comparison.
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Affiliation(s)
| | - Bhavik Patel
- Department of Radiology, Mayo Clinic, Phoenix, AZ, USA
| | - Imon Banerjee
- Department of Radiology, Mayo Clinic, Phoenix, AZ, USA
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Liu Z, Li W, Zhu Z, Wen H, Li MD, Hou C, Shen H, Huang B, Luo Y, Wang W, Chen X. A deep learning model with data integration of ultrasound contrast-enhanced micro-flow cines, B-mode images, and clinical parameters for diagnosing significant liver fibrosis in patients with chronic hepatitis B. Eur Radiol 2023; 33:5871-5881. [PMID: 36735040 DOI: 10.1007/s00330-023-09436-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2022] [Revised: 01/03/2023] [Accepted: 01/08/2023] [Indexed: 02/04/2023]
Abstract
OBJECTIVE To develop and investigate a deep learning model with data integration of ultrasound contrast-enhanced micro-flow (CEMF) cines, B-mode images, and patients' clinical parameters to improve the diagnosis of significant liver fibrosis (≥ F2) in patients with chronic hepatitis B (CHB). METHODS Of 682 CHB patients who underwent ultrasound and histopathological examinations between October 2016 and May 2020, 218 subjects were included in this retrospective study. We devised a data integration-based deep learning (DIDL) model for assessing ≥ F2 in CHB patients. The model contained three convolutional neural network branches to automatically extract features from ultrasound CEMF cines, B-mode images, and clinical data. The extracted features were fused at the backend of the model for decision-making. The diagnostic performance was evaluated across fivefold cross-validation and compared against the other methods in terms of the area under the receiver operating characteristic curve (AUC), with histopathological results as the reference standard. RESULTS The mean AUC achieved by the DIDL model was 0.901 [95% CI, 0.857-0.939], which was significantly higher than those of the comparative methods, including the models trained by using only CEMF cines (0.850 [0.794-0.893]), B-mode images (0.813 [0.754-0.862]), or clinical data (0.757 [0.694-0.812]), as well as the conventional TIC method (0.752 [0.689-0.808]), APRI (0.792 [0.734-0.845]), FIB-4 (0.776 [0.714-0.829]), and visual assessments of two radiologists (0.812 [0.754-0.862], and 0.800 [0.739-0.849]), all ps < 0.01, DeLong test. CONCLUSION The DIDL model with data integration of ultrasound CEMF cines, B-mode images, and clinical parameters showed promising performance in diagnosing significant liver fibrosis for CHB patients. KEY POINTS • The combined use of ultrasound contrast-enhanced micro-flow cines, B-mode images, and clinical data in a deep learning model has potential to improve the diagnosis of significant liver fibrosis. • The deep learning model with the fusion of features extracted from multimodality data outperformed the conventional methods including mono-modality data-based models, the time-intensity curve-based recognizer, fibrosis biomarkers, and visual assessments by experienced radiologists. • The interpretation of the feature attention maps in the deep learning model may help radiologists get better understanding of liver fibrosis-related features and hence potentially enhancing their diagnostic capacities.
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Affiliation(s)
- Zhong Liu
- National-Regional Key Technology Engineering Laboratory for Medical Ultrasound, Guangdong Key Laboratory for Biomedical Measurements and Ultrasound Imaging, School of Biomedical Engineering, Shenzhen University Medical School, Shenzhen University, 1066 Xueyuan Road, Shenzhen, 518055, People's Republic of China
| | - Wei Li
- Department of Medical Ultrasonics, Institute of Diagnostic and Interventional Ultrasound, The First Affiliated Hospital of Sun Yat-Sen University, 58 Zhongshan Road 2, Guangzhou, 510080, People's Republic of China
| | - Ziqi Zhu
- National-Regional Key Technology Engineering Laboratory for Medical Ultrasound, Guangdong Key Laboratory for Biomedical Measurements and Ultrasound Imaging, School of Biomedical Engineering, Shenzhen University Medical School, Shenzhen University, 1066 Xueyuan Road, Shenzhen, 518055, People's Republic of China
| | - Huiying Wen
- National-Regional Key Technology Engineering Laboratory for Medical Ultrasound, Guangdong Key Laboratory for Biomedical Measurements and Ultrasound Imaging, School of Biomedical Engineering, Shenzhen University Medical School, Shenzhen University, 1066 Xueyuan Road, Shenzhen, 518055, People's Republic of China
| | - Ming-de Li
- Department of Medical Ultrasonics, Institute of Diagnostic and Interventional Ultrasound, The First Affiliated Hospital of Sun Yat-Sen University, 58 Zhongshan Road 2, Guangzhou, 510080, People's Republic of China
| | - Chao Hou
- National-Regional Key Technology Engineering Laboratory for Medical Ultrasound, Guangdong Key Laboratory for Biomedical Measurements and Ultrasound Imaging, School of Biomedical Engineering, Shenzhen University Medical School, Shenzhen University, 1066 Xueyuan Road, Shenzhen, 518055, People's Republic of China
| | - Hui Shen
- Department of Medical Ultrasonics, Institute of Diagnostic and Interventional Ultrasound, The First Affiliated Hospital of Sun Yat-Sen University, 58 Zhongshan Road 2, Guangzhou, 510080, People's Republic of China
| | - Bin Huang
- National-Regional Key Technology Engineering Laboratory for Medical Ultrasound, Guangdong Key Laboratory for Biomedical Measurements and Ultrasound Imaging, School of Biomedical Engineering, Shenzhen University Medical School, Shenzhen University, 1066 Xueyuan Road, Shenzhen, 518055, People's Republic of China
| | - Yudi Luo
- National-Regional Key Technology Engineering Laboratory for Medical Ultrasound, Guangdong Key Laboratory for Biomedical Measurements and Ultrasound Imaging, School of Biomedical Engineering, Shenzhen University Medical School, Shenzhen University, 1066 Xueyuan Road, Shenzhen, 518055, People's Republic of China
| | - Wei Wang
- Department of Medical Ultrasonics, Institute of Diagnostic and Interventional Ultrasound, The First Affiliated Hospital of Sun Yat-Sen University, 58 Zhongshan Road 2, Guangzhou, 510080, People's Republic of China.
| | - Xin Chen
- National-Regional Key Technology Engineering Laboratory for Medical Ultrasound, Guangdong Key Laboratory for Biomedical Measurements and Ultrasound Imaging, School of Biomedical Engineering, Shenzhen University Medical School, Shenzhen University, 1066 Xueyuan Road, Shenzhen, 518055, People's Republic of China.
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Lakshmipriya B, Pottakkat B, Ramkumar G. Deep learning techniques in liver tumour diagnosis using CT and MR imaging - A systematic review. Artif Intell Med 2023; 141:102557. [PMID: 37295904 DOI: 10.1016/j.artmed.2023.102557] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Revised: 04/15/2023] [Accepted: 04/18/2023] [Indexed: 06/12/2023]
Abstract
Deep learning has become a thriving force in the computer aided diagnosis of liver cancer, as it solves extremely complicated challenges with high accuracy over time and facilitates medical experts in their diagnostic and treatment procedures. This paper presents a comprehensive systematic review on deep learning techniques applied for various applications pertaining to liver images, challenges faced by the clinicians in liver tumour diagnosis and how deep learning bridges the gap between clinical practice and technological solutions with an in-depth summary of 113 articles. Since, deep learning is an emerging revolutionary technology, recent state-of-the-art research implemented on liver images are reviewed with more focus on classification, segmentation and clinical applications in the management of liver diseases. Additionally, similar review articles in literature are reviewed and compared. The review is concluded by presenting the contemporary trends and unaddressed research issues in the field of liver tumour diagnosis, offering directions for future research in this field.
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Affiliation(s)
- B Lakshmipriya
- Department of Surgical Gastroenterology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - Biju Pottakkat
- Department of Surgical Gastroenterology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India.
| | - G Ramkumar
- Department of Radio Diagnosis, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
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Atzori S, Pasha Y, Maurice JB, Taylor-Robinson SD, Campbell L, Lim AKP. The Accuracy of Ultrasound Controlled Attenuation Parameter in Diagnosing Hepatic Fat Content. Hepat Med 2023; 15:51-61. [PMID: 37325088 PMCID: PMC10263157 DOI: 10.2147/hmer.s411619] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Accepted: 06/02/2023] [Indexed: 06/17/2023] Open
Abstract
Purpose The Controlled Attenuation Parameter (CAP score) is based on ultrasonic properties of retropropagated radiofrequency signals acquired by FibroscanTM (Echosens, Paris, France). Since ultrasound propagation is influenced by the presence of fat, CAP score was developed to quantify steatosis. The aim of this study was to delineate the accuracy of CAP in diagnosing hepatic steatosis, compared to the gold standard of liver biopsy. Patients and Methods A total of 150 patients underwent same-day liver biopsy and measurement of hepatic steatosis with Fibroscan. Only examinations with 10 satisfactory measurements, and an inter-quartile range of less than 30% of the median liver stiffness values were included for data analysis. Histological staging was then correlated with median values and Spearman correlation calculated. P values of <0.05 were considered statistically significant. Results For diagnosis of hepatic steatosis (HS), CAP could predict the steatosis S2 with AUROC 0.815 (95% CI 0.741-0.889), sensitivity (0.81) and specificity (0.73) when the optimal cut-off value was set at 288 dB/m. CAP detected histological grade S3 with AUROC 0.735 (95% CI 0.618-0.851), sensitivity (0.71) and specificity (0.74), with a cut-off value of 330 dB/m. The AUROC for steatosis grade S1 was 0.741 (95% CI 0.650-0.824), with a cut-off value of 263 dB/m with sensitivity 0.75 and specificity 0.70. Univariate analysis showed a correlation between CAP and diabetes (p 0.048). Conclusion The performance of CAP to diagnose steatosis severity decreases as steatosis progresses. CAP is associated with diabetes but not other clinical factors and parameters of the metabolic syndrome.
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Affiliation(s)
- Sebastiana Atzori
- Department of Surgery and Cancer, Imperial College London, London, W1 1NY, UK
- Department of Medicine, Sassari University Hospital, Sassari, 07100, Italy
| | - Yasmin Pasha
- Department of Surgery and Cancer, Imperial College London, London, W1 1NY, UK
| | - James B Maurice
- Department of Surgery and Cancer, Imperial College London, London, W1 1NY, UK
- UCL Institute for Liver and Digestive Health, Royal Free Hospital Campus, London, NW3 2QG, UK
| | | | - Louise Campbell
- Department of Surgery and Cancer, Imperial College London, London, W1 1NY, UK
- Office of the Clinical Director, Tawazun Health, London, W1G 9QN, UK
| | - Adrian K P Lim
- Department of Surgery and Cancer, Imperial College London, London, W1 1NY, UK
- Department of Imaging, Charing Cross Hospital, Imperial College Healthcare NHS Trust, London, W6 8RF, UK
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13
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Zhao D, Wang W, Tang T, Zhang YY, Yu C. Current progress in artificial intelligence-assisted medical image analysis for chronic kidney disease: A literature review. Comput Struct Biotechnol J 2023; 21:3315-3326. [PMID: 37333860 PMCID: PMC10275698 DOI: 10.1016/j.csbj.2023.05.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Revised: 05/28/2023] [Accepted: 05/28/2023] [Indexed: 06/20/2023] Open
Abstract
Chronic kidney disease (CKD) causes irreversible damage to kidney structure and function. Arising from various etiologies, risk factors for CKD include hypertension and diabetes. With a progressively increasing global prevalence, CKD is an important public health problem worldwide. Medical imaging has become an important diagnostic tool for CKD through the non-invasive identification of macroscopic renal structural abnormalities. Artificial intelligence (AI)-assisted medical imaging techniques aid clinicians in the analysis of characteristics that cannot be easily discriminated by the naked eye, providing valuable information for the identification and management of CKD. Recent studies have demonstrated the effectiveness of AI-assisted medical image analysis as a clinical support tool using radiomics- and deep learning-based AI algorithms for improving the early detection, pathological assessment, and prognostic evaluation of various forms of CKD, including autosomal dominant polycystic kidney disease. Herein, we provide an overview of the potential roles of AI-assisted medical image analysis for the diagnosis and management of CKD.
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Affiliation(s)
- Dan Zhao
- Department of Nephrology, Tongji Hospital, School of Medicine, Tongji University, Shanghai 200065, China
| | - Wei Wang
- Department of Radiology, Tongji Hospital, School of Medicine, Tongji University, Shanghai 200065, China
| | - Tian Tang
- Department of Nephrology, Tongji Hospital, School of Medicine, Tongji University, Shanghai 200065, China
| | - Ying-Ying Zhang
- Department of Nephrology, Tongji Hospital, School of Medicine, Tongji University, Shanghai 200065, China
| | - Chen Yu
- Department of Nephrology, Tongji Hospital, School of Medicine, Tongji University, Shanghai 200065, China
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14
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Assessing Liver Fibrosis Using 2D-SWE Liver Ultrasound Elastography and Dynamic Liver Scintigraphy with 99mTc-mebrofenin: A Comparative Prospective Single-Center Study. Medicina (B Aires) 2023; 59:medicina59030479. [PMID: 36984480 PMCID: PMC10055019 DOI: 10.3390/medicina59030479] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Revised: 02/17/2023] [Accepted: 02/23/2023] [Indexed: 03/05/2023] Open
Abstract
Background and Objectives: Many quantitative imaging modalities are available that quantify chronic liver disease, although only a few of them are included in clinical guidelines. Many more imaging options are still competing to find their place in the area of diagnosing chronic liver disease. We report our first prospective single-center study evaluating different imaging modalities that stratify viral hepatitis-associated liver fibrosis in a treatment-naïve patient group. Materials and Methods: The aim of our study is to compare and to combine already employed 2D shear wave elastography (2D-SWE) with dynamic liver scintigraphy with 99mTc-mebrofenin in chronic viral hepatitis patients for the staging of liver fibrosis. Results: Seventy-two patients were enrolled in the study. We found that both 2D-SWE ultrasound imaging, with dynamic liver scintigraphy with 99mTc-mebrofenin are able to stratify CLD patients into different liver fibrosis categories based on histological examination findings. We did not find any statistically significant difference between these imaging options, which means that dynamic liver scintigraphy with 99mTc-mebrofenin is not an inferior imaging technique. A combination of these imaging modalities showed increased accuracy in the non-invasive staging of liver cirrhosis. Conclusions: Our study presents that 2D-SWE and dynamic liver scintigraphy with 99mTc-mebrofenin could be used for staging liver fibrosis, both in singular application and in a combined way, adding a potential supplementary value that represents different aspects of liver fibrosis in CLD.
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15
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Atasever S, Azginoglu N, Terzi DS, Terzi R. A comprehensive survey of deep learning research on medical image analysis with focus on transfer learning. Clin Imaging 2023; 94:18-41. [PMID: 36462229 DOI: 10.1016/j.clinimag.2022.11.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Revised: 10/17/2022] [Accepted: 11/01/2022] [Indexed: 11/13/2022]
Abstract
This survey aims to identify commonly used methods, datasets, future trends, knowledge gaps, constraints, and limitations in the field to provide an overview of current solutions used in medical image analysis in parallel with the rapid developments in transfer learning (TL). Unlike previous studies, this survey grouped the last five years of current studies for the period between January 2017 and February 2021 according to different anatomical regions and detailed the modality, medical task, TL method, source data, target data, and public or private datasets used in medical imaging. Also, it provides readers with detailed information on technical challenges, opportunities, and future research trends. In this way, an overview of recent developments is provided to help researchers to select the most effective and efficient methods and access widely used and publicly available medical datasets, research gaps, and limitations of the available literature.
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Affiliation(s)
- Sema Atasever
- Computer Engineering Department, Nevsehir Hacı Bektas Veli University, Nevsehir, Turkey.
| | - Nuh Azginoglu
- Computer Engineering Department, Kayseri University, Kayseri, Turkey.
| | | | - Ramazan Terzi
- Computer Engineering Department, Amasya University, Amasya, Turkey.
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16
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Hou J, Wong VWS, Qian Y, Jiang B, Chan AWH, Leung HHW, Wong GLH, Yu SCH, Chu WCW, Chen W. Detecting Early-Stage Liver Fibrosis Using Macromolecular Proton Fraction Mapping Based on Spin-Lock MRI: Preliminary Observations. J Magn Reson Imaging 2023; 57:485-492. [PMID: 35753084 DOI: 10.1002/jmri.28308] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Revised: 06/03/2022] [Accepted: 06/03/2022] [Indexed: 01/20/2023] Open
Abstract
BACKGROUND Liver fibrosis is characterized by macromolecule depositions. Recently, a novel technology termed macromolecular proton fraction quantification based on spin-lock magnetic resonance imaging (MPF-SL) is reported to measure macromolecule levels. HYPOTHESIS MPF-SL can detect early-stage liver fibrosis by measuring macromolecule levels in the liver. STUDY TYPE Retrospective. SUBJECTS Fifty-five participants, including 22 with no fibrosis (F0) and 33 with early-stage fibrosis (F1-2), were recruited. FIELD STRENGTH/SEQUENCE 3 T; two-dimensional (2D) MPF-SL turbo spin-echo sequence, 2D spin-lock T1rho turbo spin-echo sequence, and multi-slice 2D gradient echo sequence. ASSESSMENT Macromolecular proton fraction (MPF), T1rho, liver iron concentration (LIC), and fat fraction (FF) biomarkers were quantified within regions of interest. STATISTICAL TESTS Group comparison of the biomarkers using Mann-Whitney U tests; correlation between the biomarkers assessed using Spearman's rank correlation coefficient and linear regression with goodness-of-fit; fibrosis stage differentiation using receiver operating characteristic curve (ROC) analysis. P-value < 0.05 was considered statistically significant. RESULTS Average T1rho was 41.76 ± 2.94 msec for F0 and 41.15 ± 3.73 msec for F1-2 (P = 0.60). T1rho showed nonsignificant correlation with either liver fibrosis (ρ = -0.07; P = 0.61) or FF (ρ = -0.14; P = 0.35) but indicated a negative correlation with LIC (ρ = -0.66). MPF was 4.73 ± 0.45% and 5.65 ± 0.81% for F0 and F1-2 participants, respectively. MPF showed a positive correlation with liver fibrosis (ρ = 0.59), and no significant correlations with LIC (ρ = 0.02; P = 0.89) or FF (ρ = 0.05; P = 0.72). The area under the ROC curve was 0.85 (95% confidence interval [CI] 0.75-0.95) and 0.55 (95% CI 0.39-0.71; P = 0.55) for MPF and T1rho to discriminate between F0 and F1-2 fibrosis, respectively. DATA CONCLUSION MPF-SL has the potential to diagnose early-stage liver fibrosis and does not appear to be confounded by either LIC or FF. LEVEL OF EVIDENCE 3 TECHNICAL EFFICACY STAGE: 3.
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Affiliation(s)
- Jian Hou
- Department of Imaging and Interventional Radiology, Chinese University of Hong Kong, Hong Kong
| | - Vincent W-S Wong
- Department of Medicine and Therapeutics, Chinese University of Hong Kong, Hong Kong.,State Key Laboratory of Digestive Disease, Chinese University of Hong Kong, Hong Kong.,Medical Data Analytics Centre, Chinese University of Hong Kong, Hong Kong
| | - Yurui Qian
- Department of Imaging and Interventional Radiology, Chinese University of Hong Kong, Hong Kong
| | - Baiyan Jiang
- Department of Imaging and Interventional Radiology, Chinese University of Hong Kong, Hong Kong
| | - Anthony W-H Chan
- Department of Anatomical and Cellular Pathology, Chinese University of Hong Kong, Hong Kong
| | - Howard H-W Leung
- Department of Anatomical and Cellular Pathology, Chinese University of Hong Kong, Hong Kong
| | - Grace L-H Wong
- Department of Medicine and Therapeutics, Chinese University of Hong Kong, Hong Kong.,State Key Laboratory of Digestive Disease, Chinese University of Hong Kong, Hong Kong.,Medical Data Analytics Centre, Chinese University of Hong Kong, Hong Kong
| | - Simon C-H Yu
- Department of Imaging and Interventional Radiology, Chinese University of Hong Kong, Hong Kong
| | - Winnie C-W Chu
- Department of Imaging and Interventional Radiology, Chinese University of Hong Kong, Hong Kong
| | - Weitian Chen
- Department of Imaging and Interventional Radiology, Chinese University of Hong Kong, Hong Kong
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17
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Martinez-Millana A, Saez-Saez A, Tornero-Costa R, Azzopardi-Muscat N, Traver V, Novillo-Ortiz D. Artificial intelligence and its impact on the domains of universal health coverage, health emergencies and health promotion: An overview of systematic reviews. Int J Med Inform 2022; 166:104855. [PMID: 35998421 PMCID: PMC9551134 DOI: 10.1016/j.ijmedinf.2022.104855] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Revised: 08/01/2022] [Accepted: 08/11/2022] [Indexed: 12/04/2022]
Abstract
An overview of systematic reviews on the application of AI including 129 studies. AI use is prominent in Universal Health Coverage, featuring image analysis in neoplasms. Half of the reviews did not evaluate validation procedures nor reporting guidelines. Risk of bias was only included un a third of the reviews. There is not sufficient evidence to transfer AI to actual healthcare delivery.
Background Artificial intelligence is fueling a new revolution in medicine and in the healthcare sector. Despite the growing evidence on the benefits of artificial intelligence there are several aspects that limit the measure of its impact in people’s health. It is necessary to assess the current status on the application of AI towards the improvement of people’s health in the domains defined by WHO’s Thirteenth General Programme of Work (GPW13) and the European Programme of Work (EPW), to inform about trends, gaps, opportunities, and challenges. Objective To perform a systematic overview of systematic reviews on the application of artificial intelligence in the people’s health domains as defined in the GPW13 and provide a comprehensive and updated map on the application specialties of artificial intelligence in terms of methodologies, algorithms, data sources, outcomes, predictors, performance, and methodological quality. Methods A systematic search in MEDLINE, EMBASE, Cochrane and IEEEXplore was conducted between January 2015 and June 2021 to collect systematic reviews using a combination of keywords related to the domains of universal health coverage, health emergencies protection, and better health and wellbeing as defined by the WHO’s PGW13 and EPW. Eligibility criteria was based on methodological quality and the inclusion of practical implementation of artificial intelligence. Records were classified and labeled using ICD-11 categories into the domains of the GPW13. Descriptors related to the area of implementation, type of modeling, data entities, outcomes and implementation on care delivery were extracted using a structured form and methodological aspects of the included reviews studies was assessed using the AMSTAR checklist. Results The search strategy resulted in the screening of 815 systematic reviews from which 203 were assessed for eligibility and 129 were included in the review. The most predominant domain for artificial intelligence applications was Universal Health Coverage (N = 98) followed by Health Emergencies (N = 16) and Better Health and Wellbeing (N = 15). Neoplasms area on Universal Health Coverage was the disease area featuring most of the applications (21.7 %, N = 28). The reviews featured analytics primarily over both public and private data sources (67.44 %, N = 87). The most used type of data was medical imaging (31.8 %, N = 41) and predictors based on regions of interest and clinical data. The most prominent subdomain of Artificial Intelligence was Machine Learning (43.4 %, N = 56), in which Support Vector Machine method was predominant (20.9 %, N = 27). Regarding the purpose, the application of Artificial Intelligence I is focused on the prediction of the diseases (36.4 %, N = 47). With respect to the validation, more than a half of the reviews (54.3 %, N = 70) did not report a validation procedure and, whenever available, the main performance indicator was the accuracy (28.7 %, N = 37). According to the methodological quality assessment, a third of the reviews (34.9 %, N = 45) implemented methods for analysis the risk of bias and the overall AMSTAR score below was 5 (4.01 ± 1.93) on all the included systematic reviews. Conclusion Artificial intelligence is being used for disease modelling, diagnose, classification and prediction in the three domains of GPW13. However, the evidence is often limited to laboratory and the level of adoption is largely unbalanced between ICD-11 categoriesand diseases. Data availability is a determinant factor on the developmental stage of artificial intelligence applications. Most of the reviewed studies show a poor methodological quality and are at high risk of bias, which limits the reproducibility of the results and the reliability of translating these applications to real clinical scenarios. The analyzed papers show results only in laboratory and testing scenarios and not in clinical trials nor case studies, limiting the supporting evidence to transfer artificial intelligence to actual care delivery.
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Affiliation(s)
- Antonio Martinez-Millana
- Instituto Universitario de Investigación de Aplicaciones de las Tecnologías de la Información y de las Comunicaciones Avanzadas (ITACA), Universitat Politècnica de València, Camino de Vera S/N, Valencia 46022, Spain
| | - Aida Saez-Saez
- Instituto Universitario de Investigación de Aplicaciones de las Tecnologías de la Información y de las Comunicaciones Avanzadas (ITACA), Universitat Politècnica de València, Camino de Vera S/N, Valencia 46022, Spain
| | - Roberto Tornero-Costa
- Instituto Universitario de Investigación de Aplicaciones de las Tecnologías de la Información y de las Comunicaciones Avanzadas (ITACA), Universitat Politècnica de València, Camino de Vera S/N, Valencia 46022, Spain
| | - Natasha Azzopardi-Muscat
- Division of Country Health Policies and Systems, World Health Organization, Regional Office for Europe, Copenhagen, Denmark
| | - Vicente Traver
- Instituto Universitario de Investigación de Aplicaciones de las Tecnologías de la Información y de las Comunicaciones Avanzadas (ITACA), Universitat Politècnica de València, Camino de Vera S/N, Valencia 46022, Spain
| | - David Novillo-Ortiz
- Division of Country Health Policies and Systems, World Health Organization, Regional Office for Europe, Copenhagen, Denmark.
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18
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Survarachakan S, Prasad PJR, Naseem R, Pérez de Frutos J, Kumar RP, Langø T, Alaya Cheikh F, Elle OJ, Lindseth F. Deep learning for image-based liver analysis — A comprehensive review focusing on malignant lesions. Artif Intell Med 2022; 130:102331. [DOI: 10.1016/j.artmed.2022.102331] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2021] [Revised: 05/23/2022] [Accepted: 05/30/2022] [Indexed: 11/26/2022]
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19
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Bhat M, Rabindranath M. The promise of artificial intelligence for predictive biomarkers in hepatology. Hepatol Int 2022; 16:523-525. [PMID: 35575965 DOI: 10.1007/s12072-022-10342-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2022] [Accepted: 04/13/2022] [Indexed: 11/28/2022]
Affiliation(s)
- Mamatha Bhat
- Ajmera Transplant Program, University Health Network, Toronto, ON, Canada.
- Division of Gastroenterology & Hepatology, Department of Medicine, University of Toronto, Toronto, ON, Canada.
- Toronto General Hospital Research Institute, University Health Network, Toronto, ON, Canada.
| | - Madhumitha Rabindranath
- Toronto General Hospital Research Institute, University Health Network, Toronto, ON, Canada
- Institute of Medical Science, University of Toronto, Toronto, ON, Canada
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20
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Mitani Y, Fisher RB, Fujita Y, Hamamoto Y, Sakaida I. Image Correction Methods for Regions of Interest in Liver Cirrhosis Classification on CNNs. SENSORS (BASEL, SWITZERLAND) 2022; 22:3378. [PMID: 35591069 PMCID: PMC9105852 DOI: 10.3390/s22093378] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Revised: 04/24/2022] [Accepted: 04/26/2022] [Indexed: 06/15/2023]
Abstract
The average error rate in liver cirrhosis classification on B-mode ultrasound images using the traditional pattern recognition approach is still too high. In order to improve the liver cirrhosis classification performance, image correction methods and a convolution neural network (CNN) approach are focused on. The impact of image correction methods on region of interest (ROI) images that are input into the CNN for the purpose of classifying liver cirrhosis based on data from B-mode ultrasound images is investigated. In this paper, image correction methods based on tone curves are developed. The experimental results show positive benefits from the image correction methods by improving the image quality of ROI images. By enhancing the image contrast of ROI images, the image quality improves and thus the generalization ability of the CNN also improves.
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Affiliation(s)
- Yoshihiro Mitani
- National Institute of Technology, Ube College, Ube 755-8555, Japan
| | - Robert B. Fisher
- School of Informatics, The University of Edinburgh, Edinburgh EH8 9BT, UK;
| | - Yusuke Fujita
- Faculty of Engineering, Yamaguchi University, Ube 755-8611, Japan; (Y.F.); (Y.H.)
| | - Yoshihiko Hamamoto
- Faculty of Engineering, Yamaguchi University, Ube 755-8611, Japan; (Y.F.); (Y.H.)
| | - Isao Sakaida
- School of Medicine and Health Sciences, Yamaguchi University, Ube 755-8505, Japan;
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