Jong Hyuk Lee1, Sunggyun Park2, Eui Jin Hwang3, Jin Mo Goo3, Woo Young Lee1,4, Sangho Lee1,5, Hyungjin Kim3, Jason R Andrews6, Chang Min Park7. 1. Armed Forces Seoul District Hospital, Seoul, South Korea. 2. Lunit Inc., Seoul, South Korea. 3. Department of Radiology, Seoul National University College of Medicine, Seoul, South Korea. 4. Airforce Surgeon General Office, Gyeryong-si, Chungcheongnam-do, South Korea. 5. Armed Forces Capital Hospital, Seongnam-si, Gyeonggi-do, South Korea. 6. Division of Infectious Diseases and Geographic Medicine, Stanford University School of Medicine, Stanford, CA, USA. 7. Department of Radiology, Seoul National University College of Medicine, Seoul, South Korea. cmpark.morphius@gmail.com.
Abstract
OBJECTIVES: Performance of deep learning-based automated detection (DLAD) algorithms in systematic screening for active pulmonary tuberculosis is unknown. We aimed to validate DLAD algorithm for detection of active pulmonary tuberculosis and any radiologically identifiable relevant abnormality on chest radiographs (CRs) in this setting. METHODS: We performed out-of-sample testing of a pre-trained DLAD algorithm, using CRs from 19.686 asymptomatic individuals (ages, 21.3 ± 1.9 years) as part of systematic screening for tuberculosis between January 2013 and July 2018. Area under the receiver operating characteristic curves (AUC) for diagnosis of tuberculosis and any relevant abnormalities were measured. Accuracy measures including sensitivities, specificities, positive predictive values (PPVs), and negative predictive values (NPVs) were calculated at pre-defined operating thresholds (high sensitivity threshold, 0.16; high specificity threshold, 0.46). RESULTS: All five CRs from four individuals with active pulmonary tuberculosis were correctly classified as having abnormal findings by DLAD with specificities of 0.959 and 0.997, PPVs of 0.006 and 0.068, and NPVs of both 1.000 at high sensitivity and high specificity thresholds, respectively. With high specificity thresholds, DLAD showed comparable diagnostic measures with the pooled radiologists (p values > 0.05). For the radiologically identifiable relevant abnormality (n = 28), DLAD showed an AUC value of 0.967 (95% confidence interval, 0.938-0.996) with sensitivities of 0.821 and 0.679, specificities of 0.960 and 0.997, PPVs of 0.028 and 0.257, and NPVs of both 0.999 at high sensitivity and high specificity thresholds, respectively. CONCLUSIONS: In systematic screening for tuberculosis in a low-prevalence setting, DLAD algorithm demonstrated excellent diagnostic performance, comparable with the radiologists in the detection of active pulmonary tuberculosis. KEY POINTS: • Deep learning-based automated detection algorithm detected all chest radiographs with active pulmonary tuberculosis with high specificities and negative predictive values in systematic screening. • Deep learning-based automated detection algorithm had comparable diagnostic measures with the radiologists for detection of active pulmonary tuberculosis on chest radiographs. • For the detection of radiologically identifiable relevant abnormalities on chest radiographs, deep learning-based automated detection algorithm showed excellent diagnostic performance in systematic screening.
OBJECTIVES: Performance of deep learning-based automated detection (DLAD) algorithms in systematic screening for active pulmonary tuberculosis is unknown. We aimed to validate DLAD algorithm for detection of active pulmonary tuberculosis and any radiologically identifiable relevant abnormality on chest radiographs (CRs) in this setting. METHODS: We performed out-of-sample testing of a pre-trained DLAD algorithm, using CRs from 19.686 asymptomatic individuals (ages, 21.3 ± 1.9 years) as part of systematic screening for tuberculosis between January 2013 and July 2018. Area under the receiver operating characteristic curves (AUC) for diagnosis of tuberculosis and any relevant abnormalities were measured. Accuracy measures including sensitivities, specificities, positive predictive values (PPVs), and negative predictive values (NPVs) were calculated at pre-defined operating thresholds (high sensitivity threshold, 0.16; high specificity threshold, 0.46). RESULTS: All five CRs from four individuals with active pulmonary tuberculosis were correctly classified as having abnormal findings by DLAD with specificities of 0.959 and 0.997, PPVs of 0.006 and 0.068, and NPVs of both 1.000 at high sensitivity and high specificity thresholds, respectively. With high specificity thresholds, DLAD showed comparable diagnostic measures with the pooled radiologists (p values > 0.05). For the radiologically identifiable relevant abnormality (n = 28), DLAD showed an AUC value of 0.967 (95% confidence interval, 0.938-0.996) with sensitivities of 0.821 and 0.679, specificities of 0.960 and 0.997, PPVs of 0.028 and 0.257, and NPVs of both 0.999 at high sensitivity and high specificity thresholds, respectively. CONCLUSIONS: In systematic screening for tuberculosis in a low-prevalence setting, DLAD algorithm demonstrated excellent diagnostic performance, comparable with the radiologists in the detection of active pulmonary tuberculosis. KEY POINTS: • Deep learning-based automated detection algorithm detected all chest radiographs with active pulmonary tuberculosis with high specificities and negative predictive values in systematic screening. • Deep learning-based automated detection algorithm had comparable diagnostic measures with the radiologists for detection of active pulmonary tuberculosis on chest radiographs. • For the detection of radiologically identifiable relevant abnormalities on chest radiographs, deep learning-based automated detection algorithm showed excellent diagnostic performance in systematic screening.
Entities:
Keywords:
Deep learning; Diagnosis, computer-assisted; Mass screening; Radiography; Tuberculosis
Authors: Laurens Hogeweg; Christian Mol; Pim A de Jong; Rodney Dawson; Helen Ayles; Bramin van Ginneken Journal: Med Image Comput Comput Assist Interv Date: 2010
Authors: T Santha; Garg Renu; T R Frieden; R Subramani; P G Gopi; V Chandrasekaran; N Selvakumar; A Thomas; R Rajeswari; R Balasubramanian; C Kolappan; P R Narayanan Journal: Int J Tuberc Lung Dis Date: 2003-03 Impact factor: 2.373
Authors: Hyunsuk Yoo; Eun Young Kim; Hyungjin Kim; Ye Ra Choi; Moon Young Kim; Sung Ho Hwang; Young Joong Kim; Young Jun Cho; Kwang Nam Jin Journal: Korean J Radiol Date: 2022-10 Impact factor: 7.109