Development and multicenter validation of deep convolutional neural network-based detection of colorectal cancer on abdominal CT
- Authors
- Han, Yeo Eun; Cho, Yongwon; Park, Beom Jin; Kim, Min Ju; Sim, Ki Choon; Sung, Deuk Jae; Han, Na Yeon; Lee, Jongmee; Park, Yang Shin; Yeom, Suk Keu; Kim, Jin; An, Hyonggin; Oh, Kyuhyup
- Issue Date
- Feb-2024
- Publisher
- Springer Verlag
- Keywords
- Colorectal neoplasms; Tomography (X-ray computed); Radiographic image interpretation (Computer-assisted); Deep learning; Retrospective studies
- Citation
- European Radiology
- Indexed
- SCIE
SCOPUS
- Journal Title
- European Radiology
- URI
- https://scholarworks.korea.ac.kr/kumedicine/handle/2021.sw.kumedicine/65512
- DOI
- 10.1007/s00330-023-10452-2
- ISSN
- 0938-7994
1432-1084
- Abstract
- ObjectivesThis study aims to develop computer-aided detection (CAD) for colorectal cancer (CRC) using abdominal CT based on a deep convolutional neural network.MethodsThis 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.ResultsCUNET 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.ConclusionsCUNET can detect CRC on abdominal CT in patients with various clinical situations and from external institutions.Key Points center dot 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.center dot 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.center dot 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.Key Points center dot 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.center dot 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.center dot 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.Key Points center dot 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.center dot 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.center dot 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.
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Collections - 1. Basic Science > Department of Biostatistics > 1. Journal Articles
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