Automatic Segmentation and Quantification of Abdominal Aortic Calcification in Lateral Lumbar Radiographs Based on Deep-Learning-Based Algorithms
Abstract
:1. Introduction
2. Materials and Methods
2.1. Data Enrollment
2.2. Image Annotation
2.3. AAC Scoring
2.4. Model Development
2.5. Evaluation of the U-Net Model Performance
2.6. Statistical Analysis
3. Results
3.1. Clinical Characteristics
3.2. Performance of U-Net Models in Model Development
3.3. Performance of the U-Net Model in AAC Score Quantification
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Training (n = 965) | Validation (n = 122) | Internal Test (n = 122) | Hold-Out Test (n = 150) | Overall (n = 1359) | |
---|---|---|---|---|---|
Vendor | |||||
Carestream health, n (%) | 322 (33.4%) | 41 (33.6%) | 38 (31.1%) | 126 (84.0%) | 527 (38.8%) |
GE healthcare, n (%) | 383 (39.7%) | 53 (43.4%) | 47 (38.5%) | 23 (15.3%) | 506 (37.2%) |
Kodak, n (%) | 190 (19.7%) | 19 (15.6%) | 25 (20.5%) | 0 (0%) | 234 (17.2%) |
Siemens, n (%) | 70 (7.3%) | 9 (7.4%) | 12 (9.8%) | 1 (0.7%) | 92 (6.8%) |
FOV, mm2 | 424 [424, 424] | 424 [404, 424] | 424 [404, 424] | 410 [404, 424] | 424 [404, 424] |
Tube current, mA | 250 [250, 250] | 500 [250, 789] | 499 [250, 766] | 499 [250, 510] | 498 [250, 630] |
Tube voltage, kV | 40.0 [26.0, 58.0] | 32.0 [19.0, 45.5] | 35.0 [22.0, 52.0] | 35.5 [22.0, 55.3] | 35.0 [22.0, 54.0] |
Pixel spacing, mm | 0.14 [0.14, 0.14] | 0.14 [0.14, 0.19] | 0.14 [0.14, 0.19] | 0.15 [0.14, 0.19] | 0.14 [0.14, 0.19] |
Overall (n = 1209) | Training (n = 965) | Validation (n = 122) | Internal Test (n = 122) | p Value | |
---|---|---|---|---|---|
Sex | 0.94 | ||||
Men, n (%) | 646 (53.4%) | 514 (53.3%) | 67 (54.9%) | 65 (53.3%) | |
Women, n (%) | 563 (46.6%) | 451 (46.7%) | 55 (45.1%) | 57 (46.7%) | |
Age, years | 55.7(13.5) | 55.7 (13.3) | 54.8 (13.0) | 56.1 (15.3) | 0.86 |
Peritoneal dialysis catheter | 0.41 | ||||
Yes, n (%) | 355 (29.4%) | 286 (29.6%) | 30 (24.6%) | 39 (32.0%) | |
No, n (%) | 854 (70.6%) | 679 (70.4%) | 92 (75.4%) | 83 (68.0%) | |
AAC score | |||||
L1 anterior score | 0 [0, 1] | 0 [0, 1] | 0 [0, 1] | 0 [0, 0] | 0.47 |
L1 posterior score | 0 [0, 1] | 0 [0, 1] | 0 [0, 1] | 0 [0, 1] | 0.56 |
L2 anterior score | 0 [0, 2] | 0 [0, 2] | 0 [0, 2] | 0 [0, 2] | 0.75 |
L2 posterior score | 0 [0, 2] | 0 [0, 2] | 0 [0, 2] | 0 [0, 2] | 0.86 |
L3 anterior score | 1 [0, 3] | 1 [0, 3] | 1 [0, 3] | 0 [0, 3] | 0.32 |
L3 posterior score | 0 [0, 2] | 0 [0, 2] | 0 [0, 2] | 0 [0, 2] | 0.25 |
L4 anterior score | 0 [0, 3] | 1 [0, 3] | 1 [0, 3] | 0 [0, 3] | 0.22 |
L4 posterior score | 1 [0, 3] | 1 [0, 3] | 1 [0, 3] | 0 [0, 2] | 0.06 |
Total AAC score | 6 [0, 15] | 6 [0, 15] | 8 [0, 15] | 3 [0, 14] | 0.20 |
AAC severity | 0.33 | ||||
Mild: 0–4, n (%) | 559 (46.2%) | 439 (45.5%) | 53 (43.4%) | 67 (54.9%) | |
Moderate: 5–15, n (%) | 376 (31.1%) | 302 (31.3%) | 42 (34.4%) | 32 (26.2%) | |
Severe: 16–24, n (%) | 274 (22.7%) | 224 (23.2%) | 27 (22.1%) | 23 (18.9%) |
Overall | Training | Validation | Internal Test | |
---|---|---|---|---|
DSC | ||||
Vertebrae T12–L5 | 0.98 [0.97, 0.98] | 0.98 [0.98, 0.99] | 0.96 [0.92, 0.97] | 0.95 [0.91, 0.97] |
Aorta | 0.98 [0.96, 0.98] | 0.98 [0.97, 0.98] | 0.94 [0.90, 0.95] | 0.93 [0.89, 0.95] |
Posterior wall calcification | 0.74 [0.58, 0.82] | 0.77 [0.66, 0.84] | 0.44 [0.14, 0.60] | 0.56 [0.03, 0.65] |
Anterior wall calcification | 0.72 [0.59, 0.80] | 0.75 [0.66, 0.81] | 0.52 [0.29, 0.64] | 0.53 [0.18, 0.65] |
VS | ||||
Vertebrae T12–L5 | 0.99 [0.99, 1.00] | 0.99 [0.99, 1.00] | 0.98 [0.95, 0.99] | 0.98 [0.94, 0.99] |
Aorta | 0.99 [0.98, 1.00] | 0.99 [0.99, 1.00] | 0.97 [0.95, 0.99] | 0.97 [0.94, 0.99] |
Posterior wall calcification | 0.89 [0.79, 0.95] | 0.91 [0.82, 0.95] | 0.81 [0.52, 0.92] | 0.74 [0.52, 0.92] |
Anterior wall calcification | 0.89 [0.81, 0.95] | 0.90 [0.82, 0.95] | 0.84 [0.66, 0.94] | 0.82 [0.65, 0.91] |
HD (mm) | ||||
Vertebrae T12–L5 | 2.76 [2.04, 6.97] | 2.48 [2.00, 3.35] | 15.7 [5.40, 36.2] | 22.2 [6.23, 34.4] |
Aorta | 3.64 [2.79, 8.21] | 3.31 [2.68, 4.08] | 16.1 [8.95, 35.4] | 17.4 [8.96, 36.7] |
Posterior wall calcification | 23.5 [9.20, 49.0] | 19.6 [6.76, 38.6] | 48.2 [26.2, 72.8] | 35.7 [16.3, 74.2] |
Anterior wall calcification | 20.9 [8.96, 45.8] | 17.5 [7.49, 42.9] | 35.7 [22.5, 51.9] | 33.3 [17.1, 54.8] |
Reference Score | Structured Clinical Report | Model Prediction | |||
---|---|---|---|---|---|
Score | Correlation Coefficient | Score | Correlation Coefficient | ||
L1 anterior wall | 0.98 | 0.81 | |||
0 | 80 (53.3%) | 82 (54.7%) | 88 (58.7%) | ||
1 | 28 (18.7%) | 42 (28.0%) | 20 (13.3%) | ||
2 | 32 (21.3%) | 20 (13.3%) | 21 (14.0%) | ||
3 | 10 (6.7%) | 6 (4.0%) | 21 (14.0%) | ||
L1 posterior wall | 0.97 | 0.83 | |||
0 | 74 (49.3%) | 75 (50.0%) | 81 (54.0%) | ||
1 | 29 (19.3%) | 41 (27.3%) | 17 (11.3%) | ||
2 | 26 (17.3%) | 20 (13.3%) | 27 (18.0%) | ||
3 | 21 (14.0%) | 14 (9.3%) | 25 (16.7%) | ||
L2 anterior wall | 0.96 | 0.82 | |||
0 | 58 (38.7%) | 61 (40.7%) | 40 (26.7%) | ||
1 | 32 (21.3%) | 50 (33.3%) | 28 (18.7%) | ||
2 | 36 (24.0%) | 24 (16.0%) | 37 (24.7%) | ||
3 | 24 (16.0%) | 15 (10.0%) | 45 (30.0%) | ||
L2 posterior wall | 0.97 | 0.84 | |||
0 | 65 (43.3%) | 70 (46.7%) | 60 (40.0%) | ||
1 | 26 (17.3%) | 40 (26.7%) | 24 (16.0%) | ||
2 | 37 (24.7%) | 25 (16.7%) | 27 (18.0%) | ||
3 | 22 (14.7%) | 15 (10.0%) | 39 (26.0%) | ||
L3 anterior wall | 0.96 | 0.85 | |||
0 | 46 (30.7%) | 54 (36.0%) | 43 (28.7%) | ||
1 | 35 (23.3%) | 49 (32.7%) | 20 (13.3%) | ||
2 | 27 (18.0%) | 17 (11.3%) | 25 (16.7%) | ||
3 | 42 (28.0%) | 30 (20.0%) | 62 (41.3%) | ||
L3 posterior wall | 0.96 | 0.84 | |||
0 | 50 (33.3%) | 56 (37.3%) | 51 (34.0%) | ||
1 | 30 (20.0%) | 52 (34.7%) | 20 (13.3%) | ||
2 | 40 (26.7%) | 25 (16.7%) | 37 (24.7%) | ||
3 | 30 (20.0%) | 17 (11.3%) | 42 (28.0%) | ||
L4 anterior wall | 0.94 | 0.87 | |||
0 | 49 (32.7%) | 60 (40.0%) | 34 (22.7%) | ||
1 | 25 (16.7%) | 50 (33.3%) | 21 (14.0%) | ||
2 | 33 (22.0%) | 15 (10.0%) | 29 (19.3%) | ||
3 | 43 (28.7%) | 25 (16.7%) | 66 (44.0%) | ||
L4 posterior wall | 0.95 | 0.9 | |||
0 | 37 (24.7%) | 43 (28.7%) | 50 (33.3%) | ||
1 | 21 (14.0%) | 49 (32.7%) | 19 (12.7%) | ||
2 | 40 (26.7%) | 26 (17.3%) | 23 (15.3%) | ||
3 | 52 (34.7%) | 32 (21.3%) | 58 (38.7%) | ||
AAC severity | 0.89 | 0.88 | |||
1 | 36 (24.0%) | 58 (38.7%) | 20 (13.3%) | ||
2 | 79 (52.7%) | 74 (49.3%) | 90 (60.0%) | ||
3 | 35 (23.3%) | 18 (12.0%) | 40 (26.7%) | ||
Total AAC score | 9 [5, 15] | 6 [3, 12] | 0.97 | 10 [6, 16] | 0.91 |
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Wang, K.; Wang, X.; Xi, Z.; Li, J.; Zhang, X.; Wang, R. Automatic Segmentation and Quantification of Abdominal Aortic Calcification in Lateral Lumbar Radiographs Based on Deep-Learning-Based Algorithms. Bioengineering 2023, 10, 1164. https://doi.org/10.3390/bioengineering10101164
Wang K, Wang X, Xi Z, Li J, Zhang X, Wang R. Automatic Segmentation and Quantification of Abdominal Aortic Calcification in Lateral Lumbar Radiographs Based on Deep-Learning-Based Algorithms. Bioengineering. 2023; 10(10):1164. https://doi.org/10.3390/bioengineering10101164
Chicago/Turabian StyleWang, Kexin, Xiaoying Wang, Zuqiang Xi, Jialun Li, Xiaodong Zhang, and Rui Wang. 2023. "Automatic Segmentation and Quantification of Abdominal Aortic Calcification in Lateral Lumbar Radiographs Based on Deep-Learning-Based Algorithms" Bioengineering 10, no. 10: 1164. https://doi.org/10.3390/bioengineering10101164