Department of Radiology, Applied Chest Imaging Laboratory, Harvard Medical School, Brigham and Women's Hospital, Boston, Massachusetts, United States of America.
Division of Pulmonary and Critical Care Medicine, Chest Imaging Laboratory, Harvard Medical School, Brigham and Women's Hospital, Boston, Massachusetts, United States of America.
PLoS One. 2024 Jul 25;19(7):e0306703. doi: 10.1371/journal.pone.0306703. eCollection 2024.
The scarcity of data for training deep learning models in pediatrics has prompted questions about the feasibility of employing CNNs trained with adult images for pediatric populations. In this work, a pneumonia classification CNN was used as an exploratory example to showcase the adaptability and efficacy of such models in pediatric healthcare settings despite the inherent data constraints.
To develop a curated training dataset with reduced biases, 46,947 chest X-ray images from various adult datasets were meticulously selected. Two preprocessing approaches were tried to assess the impact of thoracic segmentation on model attention outside the thoracic area. Evaluation of our approach was carried out on a dataset containing 5,856 chest X-rays of children from 1 to 5 years old.
An analysis of attention maps indicated that networks trained with thorax segmentation placed less attention on regions outside the thorax, thus eliminating potential bias. The ensuing network exhibited impressive performance when evaluated on an adult dataset, achieving a pneumonia discrimination AUC of 0.95. When tested on a pediatric dataset, the pneumonia discrimination AUC reached 0.82.
The results of this study show that adult-trained CNNs can be effectively applied to pediatric populations. This could potentially shift focus towards validating adult models over pediatric population instead of training new CNNs with limited pediatric data. To ensure the generalizability of deep learning models, it is important to implement techniques aimed at minimizing biases, such as image segmentation or low-quality image exclusion.
儿科深度学习模型训练数据的稀缺性引发了人们对于使用成人图像训练的卷积神经网络(CNN)是否适用于儿科人群的疑问。本研究以肺炎分类 CNN 为例,探索了即使在数据固有局限性的情况下,这些模型在儿科医疗保健环境中的适应性和有效性。
为了开发具有较低偏差的精选训练数据集,我们精心选择了来自多个成人数据集的 46947 张胸部 X 射线图像。我们尝试了两种预处理方法,以评估胸部分割对模型在胸部区域外注意力的影响。我们的方法在一个包含 1 至 5 岁儿童 5856 张胸部 X 射线的数据集上进行了评估。
注意力图分析表明,经过胸部分割训练的网络对胸部以外区域的注意力减少,从而消除了潜在的偏差。在评估成人数据集时,由此产生的网络表现出色,肺炎鉴别 AUC 达到 0.95。在对儿科数据集进行测试时,肺炎鉴别 AUC 达到 0.82。
本研究结果表明,成人训练的 CNN 可有效地应用于儿科人群。这可能会将重点转移到验证成人模型上,而不是使用有限的儿科数据来训练新的 CNN。为了确保深度学习模型的泛化能力,实施旨在最小化偏差的技术(如图像分割或排除低质量图像)非常重要。