1. Multi-center application of a convolutional neural network for preoperative detection of cavernous sinus invasion in pituitary adenomas.
- Author
-
Fang, Yi, Wang, He, Cao, Demao, Cai, Shengyu, Qian, Chengxing, Feng, Ming, Zhang, Wentai, Cao, Lei, Chen, Hongjie, Wei, Liangfeng, Mu, Shuwen, Pei, Zhijie, Li, Jun, Wang, Renzhi, and Wang, Shousen
- Subjects
- *
PREOPERATIVE care , *DEEP learning , *CONFIDENCE intervals , *CAVERNOUS sinus , *CANCER invasiveness , *MAGNETIC resonance imaging , *RETROSPECTIVE studies , *PITUITARY tumors , *DESCRIPTIVE statistics , *RESEARCH funding , *ARTIFICIAL neural networks , *PREDICTION models , *SENSITIVITY & specificity (Statistics) , *RECEIVER operating characteristic curves - Abstract
Objective: Cavernous sinus invasion (CSI) plays a pivotal role in determining management in pituitary adenomas. The study aimed to develop a Convolutional Neural Network (CNN) model to diagnose CSI in multiple centers. Methods: A total of 729 cases were retrospectively obtained in five medical centers with (n = 543) or without CSI (n = 186) from January 2011 to December 2021. The CNN model was trained using T1-enhanced MRI from two pituitary centers of excellence (n = 647). The other three municipal centers (n = 82) as the external testing set were imported to evaluate the model performance. The area-under-the-receiver-operating-characteristic-curve values (AUC-ROC) analyses were employed to evaluate predicted performance. Gradient-weighted class activation mapping (Grad-CAM) was used to determine models' regions of interest. Results: The CNN model achieved high diagnostic accuracy (0.89) in identifying CSI in the external testing set, with an AUC-ROC value of 0.92 (95% CI, 0.88–0.97), better than CSI clinical predictor of diameter (AUC-ROC: 0.75), length (AUC-ROC: 0.80), and the three kinds of dichotomizations of the Knosp grading system (AUC-ROC: 0.70–0.82). In cases with Knosp grade 3A (n = 24, CSI rate, 0.35), the accuracy the model accounted for 0.78, with sensitivity and specificity values of 0.72 and 0.78, respectively. According to the Grad-CAM results, the views of the model were confirmed around the sellar region with CSI. Conclusions: The deep learning model is capable of accurately identifying CSI and satisfactorily able to localize CSI in multicenters. [ABSTRACT FROM AUTHOR]
- Published
- 2024
- Full Text
- View/download PDF