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使用胸腔镜图像和深度学习预测临床 I 期肺腺癌的内脏胸膜侵犯。

Prediction of visceral pleural invasion of clinical stage I lung adenocarcinoma using thoracoscopic images and deep learning.

机构信息

Department of Thoracic Surgery, University of Toyama, 2630 Sugitani, Toyama, Japan.

Data Science Center for Medicine and Hospital Management, Toyama University Hospital, 2630 Sugitani, Toyama, Japan.

出版信息

Surg Today. 2024 Jun;54(6):540-550. doi: 10.1007/s00595-023-02756-z. Epub 2023 Oct 20.

Abstract

PURPOSE

To develop deep learning models using thoracoscopic images to identify visceral pleural invasion (VPI) in patients with clinical stage I lung adenocarcinoma, and to verify if these models can be applied clinically.

METHODS

Two deep learning models, one based on a convolutional neural network (CNN) and the other based on a vision transformer (ViT), were applied and trained via 463 images (VPI negative: 269 images, VPI positive: 194 images) captured from surgical videos of 81 patients. Model performances were validated via an independent test dataset containing 46 images (VPI negative: 28 images, VPI positive: 18 images) from 46 test patients.

RESULTS

The areas under the receiver operating characteristic curves of the CNN-based and ViT-based models were 0.77 and 0.84 (p = 0.304), respectively. The accuracy, sensitivity, specificity, and positive and negative predictive values were 73.91, 83.33, 67.86, 62.50, and 86.36% for the CNN-based model and 78.26, 77.78, 78.57, 70.00, and 84.62% for the ViT-based model, respectively. These models' diagnostic abilities were comparable to those of board-certified thoracic surgeons and tended to be superior to those of non-board-certified thoracic surgeons.

CONCLUSION

The deep learning model systems can be utilized in clinical applications via data expansion.

摘要

目的

利用胸腔镜图像开发深度学习模型,以识别临床 I 期肺腺癌患者的内脏胸膜侵犯(VPI),并验证这些模型是否可应用于临床。

方法

应用并训练了两种深度学习模型,一种基于卷积神经网络(CNN),另一种基于视觉转换器(ViT),通过 81 名患者的手术视频中捕获的 463 张图像(VPI 阴性:269 张,VPI 阳性:194 张)进行训练。通过包含来自 46 名测试患者的 46 张图像(VPI 阴性:28 张,VPI 阳性:18 张)的独立测试数据集验证模型性能。

结果

基于 CNN 的和基于 ViT 的模型的受试者工作特征曲线下面积分别为 0.77 和 0.84(p=0.304)。基于 CNN 的模型的准确性、敏感性、特异性、阳性预测值和阴性预测值分别为 73.91%、83.33%、67.86%、62.50%和 86.36%,基于 ViT 的模型分别为 78.26%、77.78%、78.57%、70.00%和 84.62%。这些模型的诊断能力与经过委员会认证的胸外科医生相当,且倾向于优于未经委员会认证的胸外科医生。

结论

通过数据扩展,深度学习模型系统可用于临床应用。

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