Deep Learning–Based Prediction of Hepatic Decompensation in Patients With Primary Sclerosing Cholangitis With Computed Tomography

Objective

To investigate a deep learning model for predicting hepatic decompensation using computed tomography (CT) imaging in patients with primary sclerosing cholangitis (PSC).

Patients and Methods

Retrospective cohort study involving 277 adult patients with large-duct PSC who underwent an abdominal CT scan. The portal venous phase CT images were used as input to a 3D-DenseNet121 model, which was trained using 5-fold crossvalidation to classify hepatic decompensation. To further investigate the role of each anatomic region in the model’s decision-making process, we trained the model on different sections of 3-dimensional CT images. This included training on the right, left, anterior, posterior, inferior, and superior halves of the image data set. For each half, as well as for the entire scan, we performed area under the receiving operating curve (AUROC) analysis.

Results

Hepatic decompensation occurred in 128 individuals after a median (interquartile range) of 1.5 years (142-1318 days) after the CT scan. The deep learning model exhibited promising results, with a mean ± SD AUROC of 0.89±0.04 for the baseline model. The mean ± SD AUROC for left, right, anterior, posterior, superior, and inferior halves were 0.83±0.03, 0.83±0.03, 0.82±0.09, 0.79±0.02, 0.78±0.02, and 0.76±0.04, respectively.

Conclusion

The study illustrates the potential of examining CT imaging using 3D-DenseNet121 deep learning model to predict hepatic decompensation in patients with PSC.