Simulating Dual-Energy X-Ray Absorptiometry in CT Using Deep-Learning Segmentation Cascade
| Autor: | Spencer K. Barrett, Eldad Elnekave, Amir Bar, Michael Cohen-Sfady, Orna Bregman-Amitai, Arun Krishnaraj, David Chettrit, Mila Orlovsky |
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| Rok vydání: | 2019 |
| Předmět: |
Male
musculoskeletal diseases medicine.medical_specialty Osteoporosis Standard score Sensitivity and Specificity 030218 nuclear medicine & medical imaging 03 medical and health sciences Absorptiometry Photon Deep Learning 0302 clinical medicine Lumbar Bone Density False positive paradox Humans Medicine Computer Simulation Radiology Nuclear Medicine and imaging Dual-energy X-ray absorptiometry Aged Aged 80 and over Lumbar Vertebrae medicine.diagnostic_test business.industry Middle Aged medicine.disease Spinal column Confidence interval Osteopenia 030220 oncology & carcinogenesis Female Radiology Tomography X-Ray Computed business |
| Zdroj: | Journal of the American College of Radiology. 16:1473-1479 |
| ISSN: | 1546-1440 |
| DOI: | 10.1016/j.jacr.2019.02.033 |
| Popis: | Purpose Osteoporosis is an underdiagnosed condition despite effective screening modalities. Dual-energy x-ray absorptiometry (DEXA) screening, although recommended in clinical guidelines, remains markedly underutilized. In contrast to DEXA, CT utilization is high and presents a valuable data source for opportunistic osteoporosis screening. The purpose of this study was to describe a method to simulate lumbar DEXA scores from routinely acquired CT studies using a machine-learning algorithm. Methods Between January 2010 and September 2014, 610 CT studies of the abdomen and pelvis were used to develop spinal column and L1 to L4 multiclass segmentation. DEXA simulation training and validation used 1,843 pairs of CT studies accompanied by DEXA results obtained within a 6-month interval from the same individual. Machine learning–based regression was used to determine correlation between calculated grade (on the basis of vertebrae L1-L4) and DEXA t score. Results Analysis of the t score equivalent, generated by the algorithm, revealed true positives in 1,144 patients, false positives in 92 patients, true negatives in 245 patients, and false negatives in 212 patients, resulting in an accuracy of 82%. Sensitivity for the detection of osteoporosis or osteopenia was 84.4% (95% confidence interval, 82.3%-86.2%), and specificity was 72.7% (95% confidence interval, 67.7%-77.2%). Conclusions The presented algorithm can identify osteoporosis and osteopenia with a high degree of accuracy (82%) and a small proportion of false positives. Efforts to cull greater information using machine-learning algorithms from pre-existing data have the potential to have a marked impact on population health efforts such as bone mineral density screening for osteoporosis, in which gaps in screening currently exist. |
| Databáze: | OpenAIRE |
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