Cheng Chi-Yung, Chiu I-Min, Hsu Ming-Ya, Pan Hsiu-Yung, Tsai Chih-Min, Lin Chun-Hung Richard
Department of Emergency Medicine, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan.
Department of Computer Science and Engineering, National Sun Yat-sen University, Kaohsiung, Taiwan.
Front Med (Lausanne). 2021 Sep 23;8:707437. doi: 10.3389/fmed.2021.707437. eCollection 2021.
The use of focused assessment with sonography in trauma (FAST) enables clinicians to rapidly screen for injury at the bedsides of patients. Pre-hospital FAST improves diagnostic accuracy and streamlines patient care, leading to dispositions to appropriate treatment centers. In this study, we determine the accuracy of artificial intelligence model-assisted free-fluid detection in FAST examinations, and subsequently establish an automated feedback system, which can help inexperienced sonographers improve their interpretation ability and image acquisition skills. This is a single-center study of patients admitted to the emergency room from January 2020 to March 2021. We collected 324 patient records for the training model, 36 patient records for validation, and another 36 patient records for testing. We balanced positive and negative Morison's pouch free-fluid detection groups in a 1:1 ratio. The deep learning (DL) model Residual Networks 50-Version 2 (ResNet50-V2) was used for training and validation. The accuracy, sensitivity, and specificity of the model performance for ascites prediction were 0.961, 0.976, and 0.947, respectively, in the validation set and 0.967, 0.985, and 0.913, respectively, in the test set. Regarding feedback prediction, the model correctly classified qualified and non-qualified images with an accuracy of 0.941 in both the validation and test sets. The DL algorithm in ResNet50-V2 is able to detect free fluid in Morison's pouch with high accuracy. The automated feedback and instruction system could help inexperienced sonographers improve their interpretation ability and image acquisition skills.
创伤超声重点评估(FAST)的应用使临床医生能够在患者床边快速筛查损伤情况。院前FAST提高了诊断准确性并简化了患者护理流程,从而促使患者被转至合适的治疗中心。在本研究中,我们确定了人工智能模型辅助的FAST检查中游离液体检测的准确性,随后建立了一个自动反馈系统,该系统可帮助经验不足的超声检查人员提高其解读能力和图像采集技能。这是一项针对2020年1月至2021年3月入住急诊室患者的单中心研究。我们收集了324份患者记录用于训练模型,36份患者记录用于验证,另有36份患者记录用于测试。我们以1:1的比例平衡了莫里森隐窝游离液体检测的阳性和阴性组。深度学习(DL)模型残差网络50版本2(ResNet50-V2)用于训练和验证。在验证集中,模型预测腹水的性能准确性、敏感性和特异性分别为0.961、0.976和0.947,在测试集中分别为0.967、0.985和0.913。关于反馈预测,该模型在验证集和测试集中对合格和不合格图像的正确分类准确率均为0.941。ResNet50-V2中的DL算法能够高精度检测莫里森隐窝中的游离液体。自动反馈和指导系统可帮助经验不足的超声检查人员提高其解读能力和图像采集技能。