Zhang Jiayao, Li Zhimin, Lin Heng, Xue Mingdi, Wang Honglin, Fang Ying, Liu Songxiang, Huo Tongtong, Zhou Hong, Yang Jiaming, Xie Yi, Xie Mao, Lu Lin, Liu Pengran, Ye Zhewei
Department of Orthopedics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Intelligent Medical Laboratory, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Front Med (Lausanne). 2023 Aug 17;10:1224489. doi: 10.3389/fmed.2023.1224489. eCollection 2023.
To explore an intelligent detection technology based on deep learning algorithms to assist the clinical diagnosis of distal radius fractures (DRFs), and further compare it with human performance to verify the feasibility of this method.
A total of 3,240 patients (fracture: = 1,620, normal: = 1,620) were included in this study, with a total of 3,276 wrist joint anteroposterior (AP) X-ray films (1,639 fractured, 1,637 normal) and 3,260 wrist joint lateral X-ray films (1,623 fractured, 1,637 normal). We divided the patients into training set, validation set and test set in a ratio of 7:1.5:1.5. The deep learning models were developed using the data from the training and validation sets, and then their effectiveness were evaluated using the data from the test set. Evaluate the diagnostic performance of deep learning models using receiver operating characteristic (ROC) curves and area under the curve (AUC), accuracy, sensitivity, and specificity, and compare them with medical professionals.
The deep learning ensemble model had excellent accuracy (97.03%), sensitivity (95.70%), and specificity (98.37%) in detecting DRFs. Among them, the accuracy of the AP view was 97.75%, the sensitivity 97.13%, and the specificity 98.37%; the accuracy of the lateral view was 96.32%, the sensitivity 94.26%, and the specificity 98.37%. When the wrist joint is counted, the accuracy was 97.55%, the sensitivity 98.36%, and the specificity 96.73%. In terms of these variables, the performance of the ensemble model is superior to that of both the orthopedic attending physician group and the radiology attending physician group.
This deep learning ensemble model has excellent performance in detecting DRFs on plain X-ray films. Using this artificial intelligence model as a second expert to assist clinical diagnosis is expected to improve the accuracy of diagnosing DRFs and enhance clinical work efficiency.
探索一种基于深度学习算法的智能检测技术,以辅助桡骨远端骨折(DRF)的临床诊断,并进一步将其与人工诊断进行比较,以验证该方法的可行性。
本研究共纳入3240例患者(骨折组:n = 1620,正常组:n = 1620),共有3276张腕关节前后位(AP)X线片(骨折1639例,正常1637例)和3260张腕关节侧位X线片(骨折1623例,正常1637例)。我们按照7:1.5:1.5的比例将患者分为训练集、验证集和测试集。利用训练集和验证集的数据开发深度学习模型,然后使用测试集的数据评估其有效性。使用受试者工作特征(ROC)曲线和曲线下面积(AUC)、准确率、灵敏度和特异度评估深度学习模型的诊断性能,并与医学专业人员进行比较。
深度学习集成模型在检测DRF方面具有出色的准确率(97.03%)、灵敏度(95.70%)和特异度(98.37%)。其中,前后位片的准确率为97.75%,灵敏度为97.13%,特异度为98.37%;侧位片的准确率为96.32%,灵敏度为94.26%,特异度为98.37%。以腕关节计算时,准确率为97.55%,灵敏度为98.36%,特异度为96.73%。在这些变量方面,集成模型的性能优于骨科主治医师组和放射科主治医师组。
这种深度学习集成模型在普通X线片上检测DRF具有出色的性能。将这种人工智能模型作为第二专家辅助临床诊断,有望提高DRF的诊断准确性并提高临床工作效率。