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基于 CT 扫描和深度学习的肺囊性疾病计算机辅助诊断。

Computer-aided diagnosis of cystic lung diseases using CT scans and deep learning.

机构信息

School of Information Science and Technology, Fudan University, Shanghai, China.

Academy for Engineering and Technology, Fudan University, Shanghai, China.

出版信息

Med Phys. 2024 Sep;51(9):5911-5926. doi: 10.1002/mp.17252. Epub 2024 Jun 22.

Abstract

BACKGROUND

Auxiliary diagnosis of different types of cystic lung diseases (CLDs) is important in the clinic and is instrumental in facilitating early and specific treatments. Current clinical methods heavily depend on accumulated experience, restricting their applicability in regions with less developed medical resources. Thus, how to realize the computer-aided diagnosis of CLDs is of great clinical value.

PURPOSE

This work proposed a deep learning-based method for automatically segmenting the lung parenchyma in computed tomography (CT) slice images and accurately diagnosing the CLDs using CT scans.

METHODS

A two-stage deep learning method was proposed for the automatic classification of normal cases and five different CLDs using CT scans. Lung parenchyma segmentation is the foundation of CT image analysis and auxiliary diagnosis. To meet the requirements of different sizes of the lung parenchyma, an adaptive region-growing and improved U-Net model was employed for mask acquisition and automatic segmentation. The former was achieved by a self-designed adaptive seed point selection method based on similarity measurement, and the latter introduced multiscale input and multichannel output into the original U-Net model and effectively achieved the lightweight design by adjusting the structure and parameters. After that, the middle 30 consecutive CT slice images of each sample were segmented to obtain lung parenchyma, which was employed for training and testing the proposed multichannel parallel input recursive MLP-Mixer network (MPIRMNet) model, achieving the computer-aided diagnosis of CLDs.

RESULTS

A total of 4718 and 16 290 CT slice images collected from 543 patients were employed to validate the proposed segmentation and classification methods, respectively. Experimental results showed that the improved U-Net model can accurately segment the lung parenchyma in CT slice images, with the Dice, precision, volumetric overlap error, and relative volume difference of 0.96 ± 0.01, 0.93 ± 0.04, 0.05 ± 0.02, and 0.05 ± 0.03, respectively. Meanwhile, the proposed MPIRMNet model achieved appreciable classification effect for normal cases and different CLDs, with the accuracy, sensitivity, specificity, and F1 score of 0.8823 ± 0.0324, 0.8897 ± 0.0325, 0.9746 ± 0.0078, and 0.8831 ± 0.0334, respectively. Compared with classical machine learning and convolutional neural networks-based methods for this task, the proposed classification method had a preferable performance, with a significant improvement of accuracy of 10.74%.

CONCLUSIONS

The work introduced a two-stage deep learning method, which can achieve the segmentation of lung parenchyma and the classification of CLDs. Compared to previous diagnostic tasks targeting single CLD, this work can achieve various CLDs' diagnosis in the early stage, thereby achieving targeted treatment and increasing the potential and value of clinical applications.

摘要

背景

辅助诊断不同类型的囊性肺疾病(CLD)在临床上很重要,有助于实现早期和特异性治疗。目前的临床方法主要依赖于积累的经验,限制了它们在医疗资源欠发达地区的适用性。因此,如何实现 CLD 的计算机辅助诊断具有重要的临床价值。

目的

本研究提出了一种基于深度学习的方法,用于自动分割 CT 切片图像中的肺实质,并使用 CT 扫描准确诊断 CLD。

方法

提出了一种两阶段深度学习方法,用于使用 CT 扫描对正常病例和五种不同的 CLD 进行自动分类。肺实质分割是 CT 图像分析和辅助诊断的基础。为了满足不同大小肺实质的要求,采用了自适应区域生长和改进的 U-Net 模型进行掩模获取和自动分割。前者通过基于相似性测量的自设计自适应种子点选择方法实现,后者将多尺度输入和多通道输出引入到原始 U-Net 模型中,并通过调整结构和参数有效地实现了轻量级设计。然后,对每个样本的连续 30 个 CT 切片图像进行分割,以获得肺实质,用于训练和测试所提出的多通道并行输入递归 MLP-Mixer 网络(MPIRMNet)模型,实现 CLD 的计算机辅助诊断。

结果

使用来自 543 名患者的总共 4718 和 16290 张 CT 切片图像验证了所提出的分割和分类方法。实验结果表明,改进的 U-Net 模型可以准确地分割 CT 切片图像中的肺实质,其 Dice、精度、体积重叠误差和相对体积差异分别为 0.96±0.01、0.93±0.04、0.05±0.02 和 0.05±0.03。同时,所提出的 MPIRMNet 模型对正常病例和不同 CLD 具有较好的分类效果,其准确性、灵敏度、特异性和 F1 分数分别为 0.8823±0.0324、0.8897±0.0325、0.9746±0.0078 和 0.8831±0.0334。与针对该任务的经典机器学习和卷积神经网络方法相比,所提出的分类方法具有更好的性能,准确性提高了 10.74%。

结论

本研究引入了一种两阶段深度学习方法,可实现肺实质分割和 CLD 分类。与以前针对单一 CLD 的诊断任务相比,本研究可以在早期对各种 CLD 进行诊断,从而实现针对性治疗,并增加临床应用的潜力和价值。

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