{"title":"多中心评估磁共振成像上直肠癌淋巴结诊断的弱监督深度学习模型","authors":"Wei Xia, Dandan Li, Wenguang He, Perry J Pickhardt, Junming Jian, Rui Zhang, Junjie Zhang, Ruirui Song, Tong Tong, Xiaotang Yang, Xin Gao, Yanfen Cui","doi":"10.1148/ryai.230152","DOIUrl":null,"url":null,"abstract":"<p><p>Purpose To develop a Weakly supervISed model DevelOpment fraMework (WISDOM) model to construct a lymph node (LN) diagnosis model for patients with rectal cancer (RC) that uses preoperative MRI data coupled with postoperative patient-level pathologic information. Materials and Methods In this retrospective study, the WISDOM model was built using MRI (T2-weighted and diffusion-weighted imaging) and patient-level pathologic information (the number of postoperatively confirmed metastatic LNs and resected LNs) based on the data of patients with RC between January 2016 and November 2017. The incremental value of the model in assisting radiologists was investigated. The performances in binary and ternary N staging were evaluated using area under the receiver operating characteristic curve (AUC) and the concordance index (C index), respectively. Results A total of 1014 patients (median age, 62 years; IQR, 54-68 years; 590 male) were analyzed, including the training cohort (<i>n</i> = 589) and internal test cohort (<i>n</i> = 146) from center 1 and two external test cohorts (cohort 1: 117; cohort 2: 162) from centers 2 and 3. The WISDOM model yielded an overall AUC of 0.81 and C index of 0.765, significantly outperforming junior radiologists (AUC = 0.69, <i>P</i> < .001; C index = 0.689, <i>P</i> < .001) and performing comparably with senior radiologists (AUC = 0.79, <i>P</i> = .21; C index = 0.788, <i>P</i> = .22). Moreover, the model significantly improved the performance of junior radiologists (AUC = 0.80, <i>P</i> < .001; C index = 0.798, <i>P</i> < .001) and senior radiologists (AUC = 0.88, <i>P</i> < .001; C index = 0.869, <i>P</i> < .001). Conclusion This study demonstrates the potential of WISDOM as a useful LN diagnosis method using routine rectal MRI data. The improved radiologist performance observed with model assistance highlights the potential clinical utility of WISDOM in practice. <b>Keywords:</b> MR Imaging, Abdomen/GI, Rectum, Computer Applications-Detection/Diagnosis <i>Supplemental material is available for this article</i>. Published under a CC BY 4.0 license.</p>","PeriodicalId":29787,"journal":{"name":"Radiology-Artificial Intelligence","volume":" ","pages":"e230152"},"PeriodicalIF":8.1000,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10982819/pdf/","citationCount":"0","resultStr":"{\"title\":\"Multicenter Evaluation of a Weakly Supervised Deep Learning Model for Lymph Node Diagnosis in Rectal Cancer at MRI.\",\"authors\":\"Wei Xia, Dandan Li, Wenguang He, Perry J Pickhardt, Junming Jian, Rui Zhang, Junjie Zhang, Ruirui Song, Tong Tong, Xiaotang Yang, Xin Gao, Yanfen Cui\",\"doi\":\"10.1148/ryai.230152\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p>Purpose To develop a Weakly supervISed model DevelOpment fraMework (WISDOM) model to construct a lymph node (LN) diagnosis model for patients with rectal cancer (RC) that uses preoperative MRI data coupled with postoperative patient-level pathologic information. Materials and Methods In this retrospective study, the WISDOM model was built using MRI (T2-weighted and diffusion-weighted imaging) and patient-level pathologic information (the number of postoperatively confirmed metastatic LNs and resected LNs) based on the data of patients with RC between January 2016 and November 2017. The incremental value of the model in assisting radiologists was investigated. The performances in binary and ternary N staging were evaluated using area under the receiver operating characteristic curve (AUC) and the concordance index (C index), respectively. Results A total of 1014 patients (median age, 62 years; IQR, 54-68 years; 590 male) were analyzed, including the training cohort (<i>n</i> = 589) and internal test cohort (<i>n</i> = 146) from center 1 and two external test cohorts (cohort 1: 117; cohort 2: 162) from centers 2 and 3. The WISDOM model yielded an overall AUC of 0.81 and C index of 0.765, significantly outperforming junior radiologists (AUC = 0.69, <i>P</i> < .001; C index = 0.689, <i>P</i> < .001) and performing comparably with senior radiologists (AUC = 0.79, <i>P</i> = .21; C index = 0.788, <i>P</i> = .22). Moreover, the model significantly improved the performance of junior radiologists (AUC = 0.80, <i>P</i> < .001; C index = 0.798, <i>P</i> < .001) and senior radiologists (AUC = 0.88, <i>P</i> < .001; C index = 0.869, <i>P</i> < .001). Conclusion This study demonstrates the potential of WISDOM as a useful LN diagnosis method using routine rectal MRI data. The improved radiologist performance observed with model assistance highlights the potential clinical utility of WISDOM in practice. <b>Keywords:</b> MR Imaging, Abdomen/GI, Rectum, Computer Applications-Detection/Diagnosis <i>Supplemental material is available for this article</i>. Published under a CC BY 4.0 license.</p>\",\"PeriodicalId\":29787,\"journal\":{\"name\":\"Radiology-Artificial Intelligence\",\"volume\":\" \",\"pages\":\"e230152\"},\"PeriodicalIF\":8.1000,\"publicationDate\":\"2024-03-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10982819/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Radiology-Artificial Intelligence\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.1148/ryai.230152\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"COMPUTER SCIENCE, ARTIFICIAL INTELLIGENCE\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Radiology-Artificial Intelligence","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1148/ryai.230152","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"COMPUTER SCIENCE, ARTIFICIAL INTELLIGENCE","Score":null,"Total":0}
Multicenter Evaluation of a Weakly Supervised Deep Learning Model for Lymph Node Diagnosis in Rectal Cancer at MRI.
Purpose To develop a Weakly supervISed model DevelOpment fraMework (WISDOM) model to construct a lymph node (LN) diagnosis model for patients with rectal cancer (RC) that uses preoperative MRI data coupled with postoperative patient-level pathologic information. Materials and Methods In this retrospective study, the WISDOM model was built using MRI (T2-weighted and diffusion-weighted imaging) and patient-level pathologic information (the number of postoperatively confirmed metastatic LNs and resected LNs) based on the data of patients with RC between January 2016 and November 2017. The incremental value of the model in assisting radiologists was investigated. The performances in binary and ternary N staging were evaluated using area under the receiver operating characteristic curve (AUC) and the concordance index (C index), respectively. Results A total of 1014 patients (median age, 62 years; IQR, 54-68 years; 590 male) were analyzed, including the training cohort (n = 589) and internal test cohort (n = 146) from center 1 and two external test cohorts (cohort 1: 117; cohort 2: 162) from centers 2 and 3. The WISDOM model yielded an overall AUC of 0.81 and C index of 0.765, significantly outperforming junior radiologists (AUC = 0.69, P < .001; C index = 0.689, P < .001) and performing comparably with senior radiologists (AUC = 0.79, P = .21; C index = 0.788, P = .22). Moreover, the model significantly improved the performance of junior radiologists (AUC = 0.80, P < .001; C index = 0.798, P < .001) and senior radiologists (AUC = 0.88, P < .001; C index = 0.869, P < .001). Conclusion This study demonstrates the potential of WISDOM as a useful LN diagnosis method using routine rectal MRI data. The improved radiologist performance observed with model assistance highlights the potential clinical utility of WISDOM in practice. Keywords: MR Imaging, Abdomen/GI, Rectum, Computer Applications-Detection/Diagnosis Supplemental material is available for this article. Published under a CC BY 4.0 license.
期刊介绍:
Radiology: Artificial Intelligence is a bi-monthly publication that focuses on the emerging applications of machine learning and artificial intelligence in the field of imaging across various disciplines. This journal is available online and accepts multiple manuscript types, including Original Research, Technical Developments, Data Resources, Review articles, Editorials, Letters to the Editor and Replies, Special Reports, and AI in Brief.