Development of a deep learning model for intussusception using point-of-care ultrasound

Intussusception is a pediatric emergency with delays in diagnosis. We sought to develop a novel deep learning model for the detection of target sign on point-of-care ultrasound (POCUS) images.

POCUS image/video clip media files obtained during emergency department (ED) visits were included for study. Images underwent preprocessing to enhance and resize the region of interest (ROI), ImageNet high dimensional feature extraction and further training using various machine learning models, including classical machine learning, ensemble learning, transfer learning, and fine-tuning. Outputs were analyzed on a patient case, individual image frame and relative threshold bases.

A POCUS image database of originally 785 media files from 49 patients, 8 of whom were positive for intussusception, was converted to 1,582 intussusception and 1,965 normal images for training. The output results show that the fine-tuning models performed better than the classical machine, ensemble and transfer learning models across three different analyses, and that the threshold-based approach to intussusception cases resulted in the greatest predictive performance.

Intussusception is a potential candidate for development of deep learning tools due to limited capacity for pediatric focused imaging and accurate diagnosis. Prior studies are limited and have used either large private datasets or formal radiology studies. Modeling involved converting dynamic video files into several static images. Fine-tuning models were best adapted to the screening nature of POCUS images.

Our work demonstrated the feasibility of developing a deep learning model for the detection of intussusception using a smaller dataset of POCUS images.