Min Xiangde, Feng Zhaoyan, Gao Junfeng, Chen Shu, Zhang Peipei, Fu Tianyu, Shen Hong, Wang Nan
Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
College of Biomedical Engineering, South-Central of University for Nationalities, Wuhan, China.
Front Med (Lausanne). 2022 Jun 29;9:762091. doi: 10.3389/fmed.2022.762091. eCollection 2022.
Active abdominal arterial bleeding is an emergency medical condition. Herein, we present our use of this two-stage InterNet model for detection of active abdominal arterial bleeding using emergency DSA imaging.
Firstly, 450 patients who underwent abdominal DSA procedures were randomly selected for development of the region localization stage (RLS). Secondly, 160 consecutive patients with active abdominal arterial bleeding were included for development of the bleeding site detection stage (BSDS) and InterNet (cascade network of RLS and BSDS). Another 50 patients that ruled out active abdominal arterial bleeding were used as negative samples to evaluate InterNet performance. We evaluated the mode's efficacy using the precision-recall (PR) curve. The classification performance of a doctor with and without InterNet was evaluated using a receiver operating characteristic (ROC) curve analysis.
The AP, precision, and recall of the RLS were 0.99, 0.95, and 0.99 in the validation dataset, respectively. Our InterNet reached a recall of 0.7, the precision for detection of bleeding sites was 53% in the evaluation set. The AUCs of doctors with and without InterNet were 0.803 and 0.759, respectively. In addition, the doctor with InterNet assistant could significantly reduce the elapsed time for the interpretation of each DSA sequence from 84.88 to 43.78 s.
Our InterNet system could assist interventional radiologists in identifying bleeding foci quickly and may improve the workflow of the DSA operation to a more real-time procedure.
腹部动脉活动性出血是一种紧急医疗状况。在此，我们展示了我们使用这种两阶段的InterNet模型，通过急诊数字减影血管造影（DSA）成像来检测腹部动脉活动性出血。
首先，随机选择450例行腹部DSA检查的患者用于区域定位阶段（RLS）的开发。其次，纳入160例连续的腹部动脉活动性出血患者用于出血部位检测阶段（BSDS）和InterNet（RLS和BSDS的级联网络）的开发。另外50例排除腹部动脉活动性出血的患者用作阴性样本以评估InterNet的性能。我们使用精确召回率（PR）曲线评估该模型的有效性。使用受试者工作特征（ROC）曲线分析评估有和没有InterNet辅助的医生的分类性能。
在验证数据集中，RLS的平均精度（AP）、精确率和召回率分别为0.99、0.95和0.99。我们的InterNet在评估集中召回率达到0.7，出血部位检测的精确率为53%。有和没有InterNet辅助的医生的曲线下面积（AUC）分别为0.803和0.759。此外，有InterNet辅助的医生可以将每个DSA序列的解读时间从84.88秒显著减少到43.78秒。
我们的InterNet系统可以帮助介入放射科医生快速识别出血病灶，并可能将DSA操作流程改进为更实时的程序。
