Deep learning-based artificial intelligence model for classification of vertebral compression fractures: A multicenter diagnostic study

作者：Fan Xu, Yuchao Xiong, Guoxi Ye, Yingying Liang, Wei Guo, Qiuping Deng, Wu Li, Wuyi Jia, Dilang Wu, Song Chen, Zhi-ping Liang, Xuwen Zeng · 发表于：Frontiers in Endocrinology · 年份：2023 · DOI：10.3389/fendo.2023.1025749 · 被引用次数：36 · 研究领域：Medical Imaging and Analysis、Artificial Intelligence in Healthcare and Education、Spinal Fractures and Fixation Techniques

Objective: To develop and validate an artificial intelligence diagnostic system based on X-ray imaging data for diagnosing vertebral compression fractures (VCFs). Methods: In total, 1904 patients who underwent X-ray at four independent hospitals were retrospectively (n=1847) and prospectively (n=57) enrolled. The participants were separated into a development cohort, a prospective test cohort and three external test cohorts. The proposed model used a transfer learning method based on the ResNet-18 architecture. The diagnostic performance of the model was evaluated using receiver operating characteristic curve (ROC) analysis and validated using a prospective validation set and three external sets. The performance of the model was compared with three degrees of musculoskeletal expertise: expert, competent, and trainee. Results: The diagnostic accuracy for identifying compression fractures was 0.850 in the testing set, 0.829 in the prospective set, and ranged from 0.757 to 0.832 in the three external validation sets. In the human and deep learning (DL) collaboration dataset, the area under the ROC curves(AUCs) in acute, chronic, and pathological compression fractures were as follows: 0.780, 0.809, 0.734 for the DL model; 0.573, 0.618, 0.541 for the trainee radiologist; 0.701, 0.782, 0.665 for the competent radiologist; 0.707,0.732, 0.667 for the expert radiologist; 0.722, 0.744, 0.610 for the DL and trainee; 0.767, 0.779, 0.729 for the DL and competent; 0.801, 0.825, 0.751 for t...