Deep Learning Model for Automated Detection and Classification of Central Canal, Lateral Recess, and Neural Foraminal Stenosis at Lumbar Spine MRI.

Autor:	Hallinan JTPD; From the Department of Diagnostic Imaging, National University Hospital, 5 Lower Kent Ridge Rd, Singapore 119074 (J.T.P.D.H., A.M., Y.L.T., S.L., Y.S.C., S.E.E., S.T.Q.); Department of Diagnostic Radiology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore (J.T.P.D.H., A.M., Y.L.T., S.L., Y.S.C., S.E.E., S.T.Q.); NUS Graduate School, Integrative Sciences and Engineering Programme, National University of Singapore, Singapore (L.Z.); Department of Computer Science, School of Computing, National University of Singapore, Singapore (K.Y., B.C.O.); Department of Radiology, Dammam Medical Complex, Dammam, Saudi Arabia (D.A.R.A.); Biostatistics Unit, Yong Loo Lin School of Medicine, Singapore (Q.V.Y., Y.H.C.); University Spine Centre, Department of Orthopaedic Surgery, National University Health System, Singapore (J.H.T., N.K.); and Department of Radiological Sciences, University of California, Irvine, Orange, Calif (H.Y.)., Zhu L; From the Department of Diagnostic Imaging, National University Hospital, 5 Lower Kent Ridge Rd, Singapore 119074 (J.T.P.D.H., A.M., Y.L.T., S.L., Y.S.C., S.E.E., S.T.Q.); Department of Diagnostic Radiology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore (J.T.P.D.H., A.M., Y.L.T., S.L., Y.S.C., S.E.E., S.T.Q.); NUS Graduate School, Integrative Sciences and Engineering Programme, National University of Singapore, Singapore (L.Z.); Department of Computer Science, School of Computing, National University of Singapore, Singapore (K.Y., B.C.O.); Department of Radiology, Dammam Medical Complex, Dammam, Saudi Arabia (D.A.R.A.); Biostatistics Unit, Yong Loo Lin School of Medicine, Singapore (Q.V.Y., Y.H.C.); University Spine Centre, Department of Orthopaedic Surgery, National University Health System, Singapore (J.H.T., N.K.); and Department of Radiological Sciences, University of California, Irvine, Orange, Calif (H.Y.)., Yang K; From the Department of Diagnostic Imaging, National University Hospital, 5 Lower Kent Ridge Rd, Singapore 119074 (J.T.P.D.H., A.M., Y.L.T., S.L., Y.S.C., S.E.E., S.T.Q.); Department of Diagnostic Radiology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore (J.T.P.D.H., A.M., Y.L.T., S.L., Y.S.C., S.E.E., S.T.Q.); NUS Graduate School, Integrative Sciences and Engineering Programme, National University of Singapore, Singapore (L.Z.); Department of Computer Science, School of Computing, National University of Singapore, Singapore (K.Y., B.C.O.); Department of Radiology, Dammam Medical Complex, Dammam, Saudi Arabia (D.A.R.A.); Biostatistics Unit, Yong Loo Lin School of Medicine, Singapore (Q.V.Y., Y.H.C.); University Spine Centre, Department of Orthopaedic Surgery, National University Health System, Singapore (J.H.T., N.K.); and Department of Radiological Sciences, University of California, Irvine, Orange, Calif (H.Y.)., Makmur A; From the Department of Diagnostic Imaging, National University Hospital, 5 Lower Kent Ridge Rd, Singapore 119074 (J.T.P.D.H., A.M., Y.L.T., S.L., Y.S.C., S.E.E., S.T.Q.); Department of Diagnostic Radiology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore (J.T.P.D.H., A.M., Y.L.T., S.L., Y.S.C., S.E.E., S.T.Q.); NUS Graduate School, Integrative Sciences and Engineering Programme, National University of Singapore, Singapore (L.Z.); Department of Computer Science, School of Computing, National University of Singapore, Singapore (K.Y., B.C.O.); Department of Radiology, Dammam Medical Complex, Dammam, Saudi Arabia (D.A.R.A.); Biostatistics Unit, Yong Loo Lin School of Medicine, Singapore (Q.V.Y., Y.H.C.); University Spine Centre, Department of Orthopaedic Surgery, National University Health System, Singapore (J.H.T., N.K.); and Department of Radiological Sciences, University of California, Irvine, Orange, Calif (H.Y.)., Algazwi DAR; From the Department of Diagnostic Imaging, National University Hospital, 5 Lower Kent Ridge Rd, Singapore 119074 (J.T.P.D.H., A.M., Y.L.T., S.L., Y.S.C., S.E.E., S.T.Q.); Department of Diagnostic Radiology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore (J.T.P.D.H., A.M., Y.L.T., S.L., Y.S.C., S.E.E., S.T.Q.); NUS Graduate School, Integrative Sciences and Engineering Programme, National University of Singapore, Singapore (L.Z.); Department of Computer Science, School of Computing, National University of Singapore, Singapore (K.Y., B.C.O.); Department of Radiology, Dammam Medical Complex, Dammam, Saudi Arabia (D.A.R.A.); Biostatistics Unit, Yong Loo Lin School of Medicine, Singapore (Q.V.Y., Y.H.C.); University Spine Centre, Department of Orthopaedic Surgery, National University Health System, Singapore (J.H.T., N.K.); and Department of Radiological Sciences, University of California, Irvine, Orange, Calif (H.Y.)., Thian YL; From the Department of Diagnostic Imaging, National University Hospital, 5 Lower Kent Ridge Rd, Singapore 119074 (J.T.P.D.H., A.M., Y.L.T., S.L., Y.S.C., S.E.E., S.T.Q.); Department of Diagnostic Radiology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore (J.T.P.D.H., A.M., Y.L.T., S.L., Y.S.C., S.E.E., S.T.Q.); NUS Graduate School, Integrative Sciences and Engineering Programme, National University of Singapore, Singapore (L.Z.); Department of Computer Science, School of Computing, National University of Singapore, Singapore (K.Y., B.C.O.); Department of Radiology, Dammam Medical Complex, Dammam, Saudi Arabia (D.A.R.A.); Biostatistics Unit, Yong Loo Lin School of Medicine, Singapore (Q.V.Y., Y.H.C.); University Spine Centre, Department of Orthopaedic Surgery, National University Health System, Singapore (J.H.T., N.K.); and Department of Radiological Sciences, University of California, Irvine, Orange, Calif (H.Y.)., Lau S; From the Department of Diagnostic Imaging, National University Hospital, 5 Lower Kent Ridge Rd, Singapore 119074 (J.T.P.D.H., A.M., Y.L.T., S.L., Y.S.C., S.E.E., S.T.Q.); Department of Diagnostic Radiology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore (J.T.P.D.H., A.M., Y.L.T., S.L., Y.S.C., S.E.E., S.T.Q.); NUS Graduate School, Integrative Sciences and Engineering Programme, National University of Singapore, Singapore (L.Z.); Department of Computer Science, School of Computing, National University of Singapore, Singapore (K.Y., B.C.O.); Department of Radiology, Dammam Medical Complex, Dammam, Saudi Arabia (D.A.R.A.); Biostatistics Unit, Yong Loo Lin School of Medicine, Singapore (Q.V.Y., Y.H.C.); University Spine Centre, Department of Orthopaedic Surgery, National University Health System, Singapore (J.H.T., N.K.); and Department of Radiological Sciences, University of California, Irvine, Orange, Calif (H.Y.)., Choo YS; From the Department of Diagnostic Imaging, National University Hospital, 5 Lower Kent Ridge Rd, Singapore 119074 (J.T.P.D.H., A.M., Y.L.T., S.L., Y.S.C., S.E.E., S.T.Q.); Department of Diagnostic Radiology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore (J.T.P.D.H., A.M., Y.L.T., S.L., Y.S.C., S.E.E., S.T.Q.); NUS Graduate School, Integrative Sciences and Engineering Programme, National University of Singapore, Singapore (L.Z.); Department of Computer Science, School of Computing, National University of Singapore, Singapore (K.Y., B.C.O.); Department of Radiology, Dammam Medical Complex, Dammam, Saudi Arabia (D.A.R.A.); Biostatistics Unit, Yong Loo Lin School of Medicine, Singapore (Q.V.Y., Y.H.C.); University Spine Centre, Department of Orthopaedic Surgery, National University Health System, Singapore (J.H.T., N.K.); and Department of Radiological Sciences, University of California, Irvine, Orange, Calif (H.Y.)., Eide SE; From the Department of Diagnostic Imaging, National University Hospital, 5 Lower Kent Ridge Rd, Singapore 119074 (J.T.P.D.H., A.M., Y.L.T., S.L., Y.S.C., S.E.E., S.T.Q.); Department of Diagnostic Radiology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore (J.T.P.D.H., A.M., Y.L.T., S.L., Y.S.C., S.E.E., S.T.Q.); NUS Graduate School, Integrative Sciences and Engineering Programme, National University of Singapore, Singapore (L.Z.); Department of Computer Science, School of Computing, National University of Singapore, Singapore (K.Y., B.C.O.); Department of Radiology, Dammam Medical Complex, Dammam, Saudi Arabia (D.A.R.A.); Biostatistics Unit, Yong Loo Lin School of Medicine, Singapore (Q.V.Y., Y.H.C.); University Spine Centre, Department of Orthopaedic Surgery, National University Health System, Singapore (J.H.T., N.K.); and Department of Radiological Sciences, University of California, Irvine, Orange, Calif (H.Y.)., Yap QV; From the Department of Diagnostic Imaging, National University Hospital, 5 Lower Kent Ridge Rd, Singapore 119074 (J.T.P.D.H., A.M., Y.L.T., S.L., Y.S.C., S.E.E., S.T.Q.); Department of Diagnostic Radiology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore (J.T.P.D.H., A.M., Y.L.T., S.L., Y.S.C., S.E.E., S.T.Q.); NUS Graduate School, Integrative Sciences and Engineering Programme, National University of Singapore, Singapore (L.Z.); Department of Computer Science, School of Computing, National University of Singapore, Singapore (K.Y., B.C.O.); Department of Radiology, Dammam Medical Complex, Dammam, Saudi Arabia (D.A.R.A.); Biostatistics Unit, Yong Loo Lin School of Medicine, Singapore (Q.V.Y., Y.H.C.); University Spine Centre, Department of Orthopaedic Surgery, National University Health System, Singapore (J.H.T., N.K.); and Department of Radiological Sciences, University of California, Irvine, Orange, Calif (H.Y.)., Chan YH; From the Department of Diagnostic Imaging, National University Hospital, 5 Lower Kent Ridge Rd, Singapore 119074 (J.T.P.D.H., A.M., Y.L.T., S.L., Y.S.C., S.E.E., S.T.Q.); Department of Diagnostic Radiology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore (J.T.P.D.H., A.M., Y.L.T., S.L., Y.S.C., S.E.E., S.T.Q.); NUS Graduate School, Integrative Sciences and Engineering Programme, National University of Singapore, Singapore (L.Z.); Department of Computer Science, School of Computing, National University of Singapore, Singapore (K.Y., B.C.O.); Department of Radiology, Dammam Medical Complex, Dammam, Saudi Arabia (D.A.R.A.); Biostatistics Unit, Yong Loo Lin School of Medicine, Singapore (Q.V.Y., Y.H.C.); University Spine Centre, Department of Orthopaedic Surgery, National University Health System, Singapore (J.H.T., N.K.); and Department of Radiological Sciences, University of California, Irvine, Orange, Calif (H.Y.)., Tan JH; From the Department of Diagnostic Imaging, National University Hospital, 5 Lower Kent Ridge Rd, Singapore 119074 (J.T.P.D.H., A.M., Y.L.T., S.L., Y.S.C., S.E.E., S.T.Q.); Department of Diagnostic Radiology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore (J.T.P.D.H., A.M., Y.L.T., S.L., Y.S.C., S.E.E., S.T.Q.); NUS Graduate School, Integrative Sciences and Engineering Programme, National University of Singapore, Singapore (L.Z.); Department of Computer Science, School of Computing, National University of Singapore, Singapore (K.Y., B.C.O.); Department of Radiology, Dammam Medical Complex, Dammam, Saudi Arabia (D.A.R.A.); Biostatistics Unit, Yong Loo Lin School of Medicine, Singapore (Q.V.Y., Y.H.C.); University Spine Centre, Department of Orthopaedic Surgery, National University Health System, Singapore (J.H.T., N.K.); and Department of Radiological Sciences, University of California, Irvine, Orange, Calif (H.Y.)., Kumar N; From the Department of Diagnostic Imaging, National University Hospital, 5 Lower Kent Ridge Rd, Singapore 119074 (J.T.P.D.H., A.M., Y.L.T., S.L., Y.S.C., S.E.E., S.T.Q.); Department of Diagnostic Radiology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore (J.T.P.D.H., A.M., Y.L.T., S.L., Y.S.C., S.E.E., S.T.Q.); NUS Graduate School, Integrative Sciences and Engineering Programme, National University of Singapore, Singapore (L.Z.); Department of Computer Science, School of Computing, National University of Singapore, Singapore (K.Y., B.C.O.); Department of Radiology, Dammam Medical Complex, Dammam, Saudi Arabia (D.A.R.A.); Biostatistics Unit, Yong Loo Lin School of Medicine, Singapore (Q.V.Y., Y.H.C.); University Spine Centre, Department of Orthopaedic Surgery, National University Health System, Singapore (J.H.T., N.K.); and Department of Radiological Sciences, University of California, Irvine, Orange, Calif (H.Y.)., Ooi BC; From the Department of Diagnostic Imaging, National University Hospital, 5 Lower Kent Ridge Rd, Singapore 119074 (J.T.P.D.H., A.M., Y.L.T., S.L., Y.S.C., S.E.E., S.T.Q.); Department of Diagnostic Radiology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore (J.T.P.D.H., A.M., Y.L.T., S.L., Y.S.C., S.E.E., S.T.Q.); NUS Graduate School, Integrative Sciences and Engineering Programme, National University of Singapore, Singapore (L.Z.); Department of Computer Science, School of Computing, National University of Singapore, Singapore (K.Y., B.C.O.); Department of Radiology, Dammam Medical Complex, Dammam, Saudi Arabia (D.A.R.A.); Biostatistics Unit, Yong Loo Lin School of Medicine, Singapore (Q.V.Y., Y.H.C.); University Spine Centre, Department of Orthopaedic Surgery, National University Health System, Singapore (J.H.T., N.K.); and Department of Radiological Sciences, University of California, Irvine, Orange, Calif (H.Y.)., Yoshioka H; From the Department of Diagnostic Imaging, National University Hospital, 5 Lower Kent Ridge Rd, Singapore 119074 (J.T.P.D.H., A.M., Y.L.T., S.L., Y.S.C., S.E.E., S.T.Q.); Department of Diagnostic Radiology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore (J.T.P.D.H., A.M., Y.L.T., S.L., Y.S.C., S.E.E., S.T.Q.); NUS Graduate School, Integrative Sciences and Engineering Programme, National University of Singapore, Singapore (L.Z.); Department of Computer Science, School of Computing, National University of Singapore, Singapore (K.Y., B.C.O.); Department of Radiology, Dammam Medical Complex, Dammam, Saudi Arabia (D.A.R.A.); Biostatistics Unit, Yong Loo Lin School of Medicine, Singapore (Q.V.Y., Y.H.C.); University Spine Centre, Department of Orthopaedic Surgery, National University Health System, Singapore (J.H.T., N.K.); and Department of Radiological Sciences, University of California, Irvine, Orange, Calif (H.Y.)., Quek ST; From the Department of Diagnostic Imaging, National University Hospital, 5 Lower Kent Ridge Rd, Singapore 119074 (J.T.P.D.H., A.M., Y.L.T., S.L., Y.S.C., S.E.E., S.T.Q.); Department of Diagnostic Radiology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore (J.T.P.D.H., A.M., Y.L.T., S.L., Y.S.C., S.E.E., S.T.Q.); NUS Graduate School, Integrative Sciences and Engineering Programme, National University of Singapore, Singapore (L.Z.); Department of Computer Science, School of Computing, National University of Singapore, Singapore (K.Y., B.C.O.); Department of Radiology, Dammam Medical Complex, Dammam, Saudi Arabia (D.A.R.A.); Biostatistics Unit, Yong Loo Lin School of Medicine, Singapore (Q.V.Y., Y.H.C.); University Spine Centre, Department of Orthopaedic Surgery, National University Health System, Singapore (J.H.T., N.K.); and Department of Radiological Sciences, University of California, Irvine, Orange, Calif (H.Y.).
Jazyk:	angličtina
Zdroj:	Radiology [Radiology] 2021 Jul; Vol. 300 (1), pp. 130-138. Date of Electronic Publication: 2021 May 11.
DOI:	10.1148/radiol.2021204289
Abstrakt:	Background Assessment of lumbar spinal stenosis at MRI is repetitive and time consuming. Deep learning (DL) could improve -productivity and the consistency of reporting. Purpose To develop a DL model for automated detection and classification of lumbar central canal, lateral recess, and neural -foraminal stenosis. Materials and Methods In this retrospective study, lumbar spine MRI scans obtained from September 2015 to September 2018 were included. Studies of patients with spinal instrumentation or studies with suboptimal image quality, as well as postgadolinium studies and studies of patients with scoliosis, were excluded. Axial T2-weighted and sagittal T1-weighted images were used. Studies were split into an internal training set (80%), validation set (9%), and test set (11%). Training data were labeled by four radiologists using predefined gradings (normal, mild, moderate, and severe). A two-component DL model was developed. First, a convolutional neural network (CNN) was trained to detect the region of interest (ROI), with a second CNN for classification. An internal test set was labeled by a musculoskeletal radiologist with 31 years of experience (reference standard) and two subspecialist radiologists (radiologist 1: A.M., 5 years of experience; radiologist 2: J.T.P.D.H., 9 years of experience). DL model performance on an external test set was evaluated. Detection recall (in percentage), interrater agreement (Gwet κ), sensitivity, and specificity were calculated. Results Overall, 446 MRI lumbar spine studies were analyzed (446 patients; mean age ± standard deviation, 52 years ± 19; 240 women), with 396 patients in the training (80%) and validation (9%) sets and 50 (11%) in the internal test set. For internal testing, DL model and radiologist central canal recall were greater than 99%, with reduced neural foramina recall for the DL model (84.5%) and radiologist 1 (83.9%) compared with radiologist 2 (97.1%) ( P < .001). For internal testing, dichotomous classification (normal or mild vs moderate or severe) showed almost-perfect agreement for both radiologists and the DL model, with respective κ values of 0.98, 0.98, and 0.96 for the central canal; 0.92, 0.95, and 0.92 for lateral recesses; and 0.94, 0.95, and 0.89 for neural foramina ( P < .001). External testing with 100 MRI scans of lumbar spines showed almost perfect agreement for the DL model for dichotomous classification of all ROIs (κ, 0.95-0.96; P < .001). Conclusion A deep learning model showed comparable agreement with subspecialist radiologists for detection and classification of central canal and lateral recess stenosis, with slightly lower agreement for neural foraminal stenosis at lumbar spine MRI. © RSNA, 2021 Online supplemental material is available for this article. See also the editorial by Hayashi in this issue.
Databáze:	MEDLINE
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