Liu Tong, Zhang Zheng-Hua, Zhou Qi-Hao, Cheng Qing-Zhao, Yang Yue, Li Jia-Shu, Zhang Xue-Mei, Zhang Jian-Qing
The Second Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Kunming Medical University, No. 295, Xichang Road, Wuhua District, Kunming, Yunnan, 650032, People's Republic of China.
Medical Imaging Department, The First Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, 650032, People's Republic of China.
Eur Radiol. 2024 Aug;34(8):5066-5076. doi: 10.1007/s00330-023-10578-3. Epub 2024 Jan 17.
To build and merge a diagnostic model called multi-input DenseNet fused with clinical features (MI-DenseCFNet) for discriminating between Staphylococcus aureus pneumonia (SAP) and Aspergillus pneumonia (ASP) and to evaluate the significant correlation of each clinical feature in determining these two types of pneumonia using a random forest dichotomous diagnosis model. This will enhance diagnostic accuracy and efficiency in distinguishing between SAP and ASP.
In this study, 60 patients with clinically confirmed SAP and ASP, who were admitted to four large tertiary hospitals in Kunming, China, were included. Thoracic high-resolution CT lung windows of all patients were extracted from the picture archiving and communication system, and the corresponding clinical data of each patient were collected.
The MI-DenseCFNet diagnosis model demonstrates an internal validation set with an area under the curve (AUC) of 0.92. Its external validation set demonstrates an AUC of 0.83. The model requires only 10.24s to generate a categorical diagnosis and produce results from 20 cases of data. Compared with high-, mid-, and low-ranking radiologists, the model achieves accuracies of 78% vs. 75% vs. 60% vs. 40%. Eleven significant clinical features were screened by the random forest dichotomous diagnosis model.
The MI-DenseCFNet multimodal diagnosis model can effectively diagnose SAP and ASP, and its diagnostic performance significantly exceeds that of junior radiologists. The 11 important clinical features were screened in the constructed random forest dichotomous diagnostic model, providing a reference for clinicians.
MI-DenseCFNet could provide diagnostic assistance for primary hospitals that do not have advanced radiologists, enabling patients with suspected infections like Staphylococcus aureus pneumonia or Aspergillus pneumonia to receive a quicker diagnosis and cut down on the abuse of antibiotics.
• MI-DenseCFNet combines deep learning neural networks with crucial clinical features to discern between Staphylococcus aureus pneumonia and Aspergillus pneumonia. • The comprehensive group had an area under the curve of 0.92, surpassing the proficiency of junior radiologists. • This model can enhance a primary radiologist's diagnostic capacity.
构建并融合一种名为多输入密集连接网络融合临床特征(MI-DenseCFNet)的诊断模型,用于鉴别金黄色葡萄球菌肺炎(SAP)和曲霉性肺炎(ASP),并使用随机森林二分诊断模型评估各临床特征在确定这两种类型肺炎中的显著相关性。这将提高区分SAP和ASP的诊断准确性和效率。
本研究纳入了在中国昆明四家大型三级医院住院的60例临床确诊的SAP和ASP患者。从图像存档与通信系统中提取所有患者的胸部高分辨率CT肺窗,并收集每位患者的相应临床数据。
MI-DenseCFNet诊断模型在内部验证集中曲线下面积(AUC)为0.92。其外部验证集的AUC为0.83。该模型仅需10.24秒即可生成分类诊断并得出20例数据的结果。与高、中、低年资放射科医生相比,该模型的准确率分别为78%、75%、60%和40%。随机森林二分诊断模型筛选出11个显著临床特征。
MI-DenseCFNet多模态诊断模型可有效诊断SAP和ASP,其诊断性能显著超过低年资放射科医生。在构建的随机森林二分诊断模型中筛选出11个重要临床特征,为临床医生提供了参考。
MI-DenseCFNet可为没有高年资放射科医生的基层医院提供诊断帮助,使疑似金黄色葡萄球菌肺炎或曲霉性肺炎等感染的患者能够更快得到诊断,并减少抗生素的滥用。
• MI-DenseCFNet将深度学习神经网络与关键临床特征相结合,以鉴别金黄色葡萄球菌肺炎和曲霉性肺炎。• 综合组的曲线下面积为0.92,超过了低年资放射科医生的水平。• 该模型可提高基层放射科医生的诊断能力。