1. Development and multicenter validation of deep convolutional neural network-based detection of colorectal cancer on abdominal CT.
- Author
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Han YE, Cho Y, Park BJ, Kim MJ, Sim KC, Sung DJ, Han NY, Lee J, Park YS, Yeom SK, Kim J, An H, and Oh K
- Subjects
- Humans, Male, Retrospective Studies, Female, Middle Aged, Aged, Sensitivity and Specificity, Adult, Radiography, Abdominal methods, Radiographic Image Interpretation, Computer-Assisted methods, Adenocarcinoma diagnostic imaging, Aged, 80 and over, Reproducibility of Results, Colorectal Neoplasms diagnostic imaging, Tomography, X-Ray Computed methods, Neural Networks, Computer
- Abstract
Objectives: This study aims to develop computer-aided detection (CAD) for colorectal cancer (CRC) using abdominal CT based on a deep convolutional neural network., Methods: This retrospective study included consecutive patients with colorectal adenocarcinoma who underwent abdominal CT before CRC resection surgery (training set = 379, test set = 103). We customized the 3D U-Net of nnU-Net (CUNET) for CRC detection, which was trained with fivefold cross-validation using annotated CT images. CUNET was validated using datasets covering various clinical situations and institutions: an internal test set (n = 103), internal patients with CRC first determined by CT (n = 54) and asymptomatic CRC (n = 51), and an external validation set from two institutions (n = 60). During each validation, data from the healthy population were added (internal = 60; external = 130). CUNET was compared with other deep CNNs: residual U-Net and EfficientDet. The CAD performances were evaluated using per-CRC sensitivity (true positive/all CRCs), free-response receiver operating characteristic (FROC), and jackknife alternative FROC (JAFROC) curves., Results: CUNET showed a higher maximum per-CRC sensitivity than residual U-Net and EfficientDet (internal test set 91.3% vs. 61.2%, and 64.1%). The per-CRC sensitivity of CUNET at false-positive rates of 3.0 was as follows: internal CRC determined by CT, 89.3%; internal asymptomatic CRC, 87.3%; and external validation, 89.6%. CUNET detected 69.2% (9/13) of CRCs missed by radiologists and 89.7% (252/281) of CRCs from all validation sets., Conclusions: CUNET can detect CRC on abdominal CT in patients with various clinical situations and from external institutions., Key Points: • Customized 3D U-Net of nnU-Net (CUNET) can be applied to the opportunistic detection of colorectal cancer (CRC) in abdominal CT, helping radiologists detect unexpected CRC. • CUNET showed the best performance at false-positive rates ≥ 3.0, and 30.1% of false-positives were in the colorectum. CUNET detected 69.2% (9/13) of CRCs missed by radiologists and 87.3% (48/55) of asymptomatic CRCs. • CUNET detected CRCs in multiple validation sets composed of varying clinical situations and from different institutions, and CUNET detected 89.7% (252/281) of CRCs from all validation sets., (© 2023. The Author(s), under exclusive licence to European Society of Radiology.)
- Published
- 2024
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