背景:对比增强CT扫描提供了一种检测未怀疑的结直肠癌的方法。然而,未经肠道准备的对比增强CT检查结直肠癌可能无法被放射科医师发现。我们的目标是开发一种用于准确检测结直肠癌的深度学习(DL)模型,并评估其是否可以提高放射科医生的检测性能。
方法:我们使用手动注释的数据集(1196癌症对1034正常)开发了DL模型。DL模型使用内部测试集进行测试(98vs115),两个外部测试集(202vs265in1,和252vs481in2),和一个真实世界的测试集(53vs1524)。我们将DL模型的检测性能与放射科医生进行了比较,并评估了其增强放射科医生检测性能的能力。
结果:在四个测试集中,DL模型的受试者工作特征曲线下面积(AUC)介于0.957和0.994之间。在内部测试集和外部测试集1中,DL模型的准确性均高于放射科医生(97.2%vs86.0%,p<0.0001;94.9%对85.3%,p<0.0001),并显著提高了放射科医生的准确率(93.4%vs86.0%,p<0.0001;93.6%对85.3%,p<0.0001)。在现实世界的测试集中,DL模型的灵敏度与被告知大多数癌症病例的临床适应症的放射科医生相当(94.3%vs96.2%,p>0.99),它发现了2例放射科医生漏诊的病例。
结论:开发的DL模型可以准确检测结直肠癌并提高放射科医生的检测性能,显示其作为一种有效的计算机辅助检测工具的潜力。
背景:本研究得到了国家杰出青年科学基金的支持(编号:81925023);国家自然科学基金区域创新发展联合基金(编号:U22A20345);国家自然科学基金(编号:82072090和编号82371954);医学影像人工智能分析与应用广东省重点实验室(第2022B1212010011);高级医院建设项目(编号:DFJHBF202105)。
BACKGROUND: Contrast-enhanced CT scans provide a means to detect unsuspected colorectal cancer. However, colorectal cancers in contrast-enhanced CT without bowel preparation may elude detection by radiologists. We aimed to develop a deep learning (DL) model for accurate detection of colorectal cancer, and evaluate whether it could improve the detection performance of radiologists.
METHODS: We developed a DL model using a manually annotated dataset (1196 cancer vs 1034 normal). The DL model was tested using an internal test set (98 vs 115), two external test sets (202 vs 265 in 1, and 252 vs 481 in 2), and a real-world test set (53 vs 1524). We compared the detection performance of the DL model with radiologists, and evaluated its capacity to enhance radiologists\' detection performance.
RESULTS: In the four test sets, the DL model had the area under the receiver operating characteristic curves (AUCs) ranging between 0.957 and 0.994. In both the internal test set and external test set 1, the DL model yielded higher accuracy than that of radiologists (97.2% vs 86.0%, p < 0.0001; 94.9% vs 85.3%, p < 0.0001), and significantly improved the accuracy of radiologists (93.4% vs 86.0%, p < 0.0001; 93.6% vs 85.3%, p < 0.0001). In the real-world test set, the DL model delivered sensitivity comparable to that of radiologists who had been informed about clinical indications for most cancer cases (94.3% vs 96.2%, p > 0.99), and it detected 2 cases that had been missed by radiologists.
CONCLUSIONS: The developed DL model can accurately detect colorectal cancer and improve radiologists\' detection performance, showing its potential as an effective computer-aided detection tool.
BACKGROUND: This study was supported by National Science Fund for Distinguished Young Scholars of China (No. 81925023); Regional Innovation and Development Joint Fund of National Natural Science Foundation of China (No. U22A20345); National Natural Science Foundation of China (No. 82072090 and No. 82371954); Guangdong Provincial Key Laboratory of Artificial Intelligence in Medical Image Analysis and Application (No. 2022B1212010011); High-level Hospital Construction Project (No. DFJHBF202105).