Department of Radiology, Tokyo Women's Medical University Medical Center East, Arakawa-ku.
Department of Radiology, Graduate School of Medicine, University of Tokyo, Bunkyo-ku.
Medicine (Baltimore). 2021 May 21;100(20):e26024. doi: 10.1097/MD.0000000000026024.
To evaluate the rib fracture detection performance in computed tomography (CT) images using a software based on a deep convolutional neural network (DCNN) and compare it with the rib fracture diagnostic performance of doctors.We included CT images from 39 patients with thoracic injuries who underwent CT scans. In these images, 256 rib fractures were detected by two radiologists. This result was defined as the gold standard. The performances of rib fracture detection by the software and two interns were compared via the McNemar test and the jackknife alternative free-response receiver operating characteristic (JAFROC) analysis.The sensitivity of the DCNN software was significantly higher than those of both Intern A (0.645 vs 0.313; P < .001) and Intern B (0.645 vs 0.258; P < .001). Based on the JAFROC analysis, the differences in the figure-of-merits between the results obtained via the DCNN software and those by Interns A and B were 0.057 (95% confidence interval: -0.081, 0.195) and 0.071 (-0.082, 0.224), respectively. As the non-inferiority margin was set to -0.10, the DCNN software is non-inferior to the rib fracture detection performed by both interns.In the detection of rib fractures, detection by the DCNN software could be an alternative to the interpretation performed by doctors who do not have intensive training experience in image interpretation.
评估基于深度卷积神经网络（DCNN）的软件在计算机断层扫描（CT）图像中检测肋骨骨折的性能，并将其与医生对肋骨骨折的诊断性能进行比较。我们纳入了 39 例胸部外伤患者的 CT 图像，这些患者均行 CT 扫描。在这些图像中，2 名放射科医生检测到 256 处肋骨骨折，该结果被定义为金标准。采用 McNemar 检验和刀切自由响应接收者操作特征（JAFROC）分析比较软件和 2 名住院医师对肋骨骨折检测的性能。DCNN 软件的灵敏度明显高于 Intern A（0.645 比 0.313；P<0.001）和 Intern B（0.645 比 0.258；P<0.001）。基于 JAFROC 分析，DCNN 软件与 Interns A 和 B 结果的优势比差异分别为 0.057（95%置信区间：-0.081，0.195）和 0.071（-0.082，0.224）。由于非劣效性边界设定为-0.10，DCNN 软件与放射科医生的检测结果无显著差异。在肋骨骨折检测中，DCNN 软件可能是对不具备丰富影像学解读经验的医生进行解释的替代方法。
