In Radiology. Artificial intelligence
Purpose : To develop, test, and validate a deep learning (DL) tool that improves upon a previous feature-based CT image processing bone mineral density (BMD) algorithm and compare it against the manual reference standard.
Materials and Methods : This single-center, retrospective, Health Insurance Portability and Accountability Act-compliant study included manual L1 trabecular Hounsfield unit measurements from abdominal CT scans in 11 035 patients (mean age, 58 years ± 12 [SD]; 6311 women) as the reference standard. Automated level selection and L1 trabecular region of interest (ROI) placement were then performed in this CT cohort with both a previously validated feature-based image processing tool and a new DL tool. Overall technical success rates and agreement with the manual reference standard were assessed.
Results : The overall success rate of the DL tool in this heterogeneous patient cohort was significantly higher than that of the older image processing BMD algorithm (99.3% vs 89.4%, P < .001). Using this DL tool, the closest median Hounsfield unit values for single-, three-, and seven-slice vertebral ROIs were within 5% of the manual reference standard Hounsfield unit values in 35.1%, 56.9%, and 85.8% of scans; within 10% in 56.6%, 75.6%, and 92.9% of scans; and within 25% in 76.5%, 89.3%, and 97.1% of scans, respectively. Trade-offs in sensitivity and specificity for osteoporosis assessment were observed from the single-slice approach (sensitivity, 39.4%; specificity, 98.3%) to the minimum value of the multislice approach (for seven contiguous slices; sensitivity, 71.3% and specificity, 94.6%).
Conclusion : The new DL BMD tool demonstrated a higher success rate than the older feature-based image processing tool, and its outputs can be targeted for higher specificity or sensitivity for osteoporosis assessment.Keywords: CT, CT-Quantitative, Abdomen/GI, Skeletal-Axial, Spine, Deep Learning, Machine Learning Supplemental material is available for this article. © RSNA, 2022.
Pickhardt Perry J, Nguyen Thang, Perez Alberto A, Graffy Peter M, Jang Samuel, Summers Ronald M, Garrett John W
Abdomen/GI, CT, CT-Quantitative, Deep Learning, Machine Learning, Skeletal-Axial, Spine