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Deep learning algorithms for detecting and visualising intussusception on plain abdominal radiography in children: a
Gitaek Kwon1, Jongbin Ryu2, Jaehoon Oh3,4
1Department of Computer Science, Hanyang University, Seoul, Republic of Korea.
Insights
A deep convolutional neural network (CNN) algorithm effectively detects intussusception in children using abdominal X-rays. This AI tool shows promise for improving early diagnosis and screening of this condition.
Area of Science:
- Pediatric Radiology
- Artificial Intelligence in Medicine
- Medical Imaging Analysis
Background:
- Intussusception is a common surgical emergency in young children.
- Accurate and timely diagnosis of intussusception is crucial for effective treatment.
- Current diagnostic methods can be challenging, necessitating improved screening tools.
Purpose of the Study:
- To validate a deep convolutional neural network (CNN) algorithm for detecting intussusception.
- To assess the diagnostic performance of the CNN using a large dataset of pediatric abdominal X-rays.
- To evaluate the algorithm's efficacy in screening for intussusception in children.
Main Methods:
- Utilized a dataset of 1449 pediatric abdominal X-rays with intussusception and 9935 without.
- Employed Single Shot MultiBox Detector for abdominal detection and ResNet for classification.
- Performed internal and external validation to analyze diagnostic performance.
Main Results:
- Achieved high internal validation performance with Area Under the Curve (AUC) of 0.935 and Youden Index of 0.743.
- Internal test AUC ranged from 0.946 to 0.971, with accuracy up to 0.952.
- External validation showed lower but significant diagnostic values, indicating algorithm generalizability.
Conclusions:
- Deep CNN algorithm demonstrates significant potential for detecting intussusception in children.
- Plain abdominal X-rays analyzed by deep CNN can serve as an effective screening tool.
- This AI-driven approach may aid in earlier and more accurate diagnosis of pediatric intussusception.
Abstract:
This study aimed to verify a deep convolutional neural network (CNN) algorithm to detect intussusception in children using a human-annotated data set of plain abdominal X-rays from affected children. From January 2005 to August 2019, 1449 images were collected from plain abdominal X-rays of patients ≤ 6 years old who were diagnosed with intussusception while 9935 images were collected from patients without intussusception from three tertiary academic hospitals (A, B, and C data sets). Single Shot MultiBox Detector and ResNet were used for abdominal detection and intussusception classification, respectively. The diagnostic performance of the algorithm was analysed using internal and external validation tests. The internal test values after training with two hospital data sets were 0.946 to 0.971 for the area under the receiver operating characteristic curve (AUC), 0.927 to 0.952 for the highest accuracy, and 0.764 to 0.848 for the highest Youden index. The values from external test using the remaining data set were all lower (P-value < 0.001). The mean values of the internal test with all data sets were 0.935 and 0.743 for the AUC and Youden Index, respectively. Detection of intussusception by deep CNN and plain abdominal X-rays could aid in screening for intussusception in children.
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