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Published in: European Radiology 2/2020

01-02-2020 | Imaging Informatics and Artificial Intelligence

Deep learning with ultrasonography: automated classification of liver fibrosis using a deep convolutional neural network

Authors: Jeong Hyun Lee, Ijin Joo, Tae Wook Kang, Yong Han Paik, Dong Hyun Sinn, Sang Yun Ha, Kyunga Kim, Choonghwan Choi, Gunwoo Lee, Jonghyon Yi, Won-Chul Bang

Published in: European Radiology | Issue 2/2020

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Abstract

Objectives

The aim of this study was to develop a deep convolutional neural network (DCNN) for the prediction of the METAVIR score using B-mode ultrasonography images.

Methods

Datasets from two tertiary academic referral centers were used. A total of 13,608 ultrasonography images from 3446 patients who underwent surgical resection, biopsy, or transient elastography were used for training a DCNN for the prediction of the METAVIR score. Pathological specimens or estimated METAVIR scores derived from transient elastography were used as a reference standard. A four-class model (F0 vs. F1 vs. F23 vs. F4) was developed. Diagnostic performance of the algorithm was validated on a separate internal test set of 266 patients with 300 images and external test set of 572 patients with 1232 images. Performance in classification of cirrhosis was compared between the DCNN and five radiologists.

Results

The accuracy of the four-class model was 83.5% and 76.4% on the internal and external test set, respectively. The area under the receiver operating characteristic curve (AUC) for classification of cirrhosis (F4) was 0.901 (95% confidence interval [CI], 0.865–0.937) on the internal test set and 0.857 (95% CI, 0.825–0.889) on the external test set, respectively. The AUC of the DCNN for classification of cirrhosis (0.857) was significantly higher than that of all five radiologists (AUC range, 0.656–0.816; p value < 0.05) using the external test set.

Conclusions

The DCNN showed high accuracy for determining METAVIR score using ultrasonography images and achieved better performance than that of radiologists in the diagnosis of cirrhosis.

Key Points

DCNN accurately classified the ultrasonography images according to the METAVIR score.
The AUROC of this algorithm for cirrhosis assessment was significantly higher than that of radiologists.
DCNN using US images may offer an alternative tool for monitoring liver fibrosis.
Appendix
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Metadata
Title
Deep learning with ultrasonography: automated classification of liver fibrosis using a deep convolutional neural network
Authors
Jeong Hyun Lee
Ijin Joo
Tae Wook Kang
Yong Han Paik
Dong Hyun Sinn
Sang Yun Ha
Kyunga Kim
Choonghwan Choi
Gunwoo Lee
Jonghyon Yi
Won-Chul Bang
Publication date
01-02-2020
Publisher
Springer Berlin Heidelberg
Published in
European Radiology / Issue 2/2020
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-019-06407-1

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