Zhang Zishanbai, Feng Yang, Li Yanru, Zhao Liang, Wang Xingjun, Han Demin
Department of Otolaryngology Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing, China.
Key Laboratory of Otolaryngology Head and Neck Surgery, Ministry of Education, Capital Medical University, Beijing, China.
J Thorac Dis. 2023 Jan 31;15(1):90-100. doi: 10.21037/jtd-22-734. Epub 2022 Dec 12.
Obstructive sleep apnea (OSA) is a common sleep disorder. However, current diagnostic methods are labor-intensive and require professionally trained personnel. We aimed to develop a deep learning model using upper airway computed tomography (CT) to predict OSA and to warn the medical technician if a patient has OSA while the patient is undergoing any head and neck CT scan, even for other diseases.
A total of 219 patients with OSA [apnea-hypopnea index (AHI) ≥10/h] and 81 controls (AHI <10/h) were enrolled. We reconstructed each patient's CT into 3 types (skeletal structures, external skin structures, and airway structures) and captured reconstructed models in 6 directions (front, back, top, bottom, left profile, and right profile). The 6 images from each patient were imported into the ResNet-18 network to extract features and output the probability of OSA using two fusion methods: Add and Concat. Five-fold cross-validation was used to reduce bias. Finally, sensitivity, specificity, and area under the receiver operating characteristic curve (AUC) were calculated.
All 18 views with Add as the feature fusion performed better than did the other reconstruction and fusion methods. This gave the best performance for this prediction method with an AUC of 0.882.
We present a model for predicting OSA using upper airway CT and deep learning. The model has satisfactory performance and enables CT to accurately identify patients with moderate to severe OSA.
阻塞性睡眠呼吸暂停(OSA)是一种常见的睡眠障碍。然而,目前的诊断方法劳动强度大,且需要专业培训的人员。我们旨在开发一种利用上呼吸道计算机断层扫描(CT)的深度学习模型来预测OSA,并在患者进行任何头颈部CT扫描(即使是因其他疾病)时,向医疗技术人员发出患者患有OSA的警告。
共纳入219例OSA患者[呼吸暂停低通气指数(AHI)≥10次/小时]和81例对照者(AHI<10次/小时)。我们将每位患者的CT重建为3种类型(骨骼结构、外部皮肤结构和气道结构),并从6个方向(正面、背面、顶部、底部、左侧面和右侧面)获取重建模型。将每位患者的6张图像导入ResNet-18网络,使用两种融合方法(相加和拼接)提取特征并输出OSA的概率。采用五折交叉验证以减少偏差。最后,计算敏感性、特异性和受试者操作特征曲线下面积(AUC)。
以相加作为特征融合的所有18个视图的表现均优于其他重建和融合方法。这种预测方法的表现最佳,AUC为0.882。
我们提出了一种利用上呼吸道CT和深度学习预测OSA的模型。该模型具有令人满意的性能,能够使CT准确识别中度至重度OSA患者。