Accurate and generalizable quantitative scoring of liver steatosis from ultrasound images via scalable deep learning  

作　　者：Bowen Li Dar-In Tai Ke Yan Yi-Cheng Chen Cheng-Jen Chen Shiu-Feng Huang Tse-Hwa Hsu Wan-Ting Yu Jing Xiao Lu Le Adam P Harrison 

机构地区：[1]Research and Development,PAII Inc.,Bethesda,MD 20817,United States [2]Department of Gastroenterology and Hepatology,Chang Gung Memorial Hospital,Linkou Medical Center,Taoyuan 33305,Taiwan [3]Division of Molecular and Genomic Medicine,National Health Research Institute,Taoyuan 33305,Taiwan [4]Research and Development,Ping An Insurance Group,Shenzhen 518001,Guangdong,China

出　　处：《World Journal of Gastroenterology》2022年第22期2494-2508,共15页世界胃肠病学杂志（英文版）

基　　金：Supported by the Maintenance Project of the Center for Artificial Intelligence,No.CLRPG3H0012 and No.SMRPG3I0011.

摘　　要：BACKGROUND Hepatic steatosis is a major cause of chronic liver disease.Two-dimensional(2D)ultrasound is the most widely used non-invasive tool for screening and monitoring,but associated diagnoses are highly subjective.AIM To develop a scalable deep learning(DL)algorithm for quantitative scoring of liver steatosis from 2D ultrasound images.METHODS Using multi-view ultrasound data from 3310 patients,19513 studies,and 228075 images from a retrospective cohort of patients received elastography,we trained a DL algorithm to diagnose steatosis stages(healthy,mild,moderate,or severe)from clinical ultrasound diagnoses.Performance was validated on two multiscanner unblinded and blinded(initially to DL developer)histology-proven cohorts(147 and 112 patients)with histopathology fatty cell percentage diagnoses and a subset with FibroScan diagnoses.We also quantified reliability across scanners and viewpoints.Results were evaluated using Bland-Altman and receiver operating characteristic(ROC)analysis.RESULTS The DL algorithm demonstrated repeatable measurements with a moderate number of images(three for each viewpoint)and high agreement across three premium ultrasound scanners.High diagnostic performance was observed across all viewpoints:Areas under the curve of the ROC to classify mild,moderate,and severe steatosis grades were 0.85,0.91,and 0.93,respectively.The DL algorithm outperformed or performed at least comparably to FibroScan control attenuation parameter(CAP)with statistically significant improvements for all levels on the unblinded histology-proven cohort and for“=severe”steatosis on the blinded histology-proven cohort.CONCLUSION The DL algorithm provides a reliable quantitative steatosis assessment across view and scanners on two multi-scanner cohorts.Diagnostic performance was high with comparable or better performance than the CAP.

关 键 词：ULTRASOUND Liver steatosis Deep learning SCREENING Computer-aided diagnosis 

分 类 号：R575[医药卫生—消化系统]