A deep learning model enables accurate prediction and quantification of pulmonary edema from chest X-rays.


Journal

Critical care (London, England)
ISSN: 1466-609X
Titre abrégé: Crit Care
Pays: England
ID NLM: 9801902

Informations de publication

Date de publication:
26 05 2023
Historique:
received: 24 01 2023
accepted: 02 04 2023
medline: 29 5 2023
pubmed: 27 5 2023
entrez: 26 5 2023
Statut: epublish

Résumé

A quantitative assessment of pulmonary edema is important because the clinical severity can range from mild impairment to life threatening. A quantitative surrogate measure, although invasive, for pulmonary edema is the extravascular lung water index (EVLWI) extracted from the transpulmonary thermodilution (TPTD). Severity of edema from chest X-rays, to date is based on the subjective classification of radiologists. In this work, we use machine learning to quantitatively predict the severity of pulmonary edema from chest radiography. We retrospectively included 471 X-rays from 431 patients who underwent chest radiography and TPTD measurement within 24 h at our intensive care unit. The EVLWI extracted from the TPTD was used as a quantitative measure for pulmonary edema. We used a deep learning approach and binned the data into two, three, four and five classes increasing the resolution of the EVLWI prediction from the X-rays. The accuracy, area under the receiver operating characteristic curve (AUROC) and Mathews correlation coefficient (MCC) in the binary classification models (EVLWI < 15, ≥ 15) were 0.93 (accuracy), 0.98 (AUROC) and 0.86(MCC). In the three multiclass models, the accuracy ranged between 0.90 and 0.95, the AUROC between 0.97 and 0.99 and the MCC between 0.86 and 0.92. Deep learning can quantify pulmonary edema as measured by EVLWI with high accuracy.

Sections du résumé

BACKGROUND
A quantitative assessment of pulmonary edema is important because the clinical severity can range from mild impairment to life threatening. A quantitative surrogate measure, although invasive, for pulmonary edema is the extravascular lung water index (EVLWI) extracted from the transpulmonary thermodilution (TPTD). Severity of edema from chest X-rays, to date is based on the subjective classification of radiologists. In this work, we use machine learning to quantitatively predict the severity of pulmonary edema from chest radiography.
METHODS
We retrospectively included 471 X-rays from 431 patients who underwent chest radiography and TPTD measurement within 24 h at our intensive care unit. The EVLWI extracted from the TPTD was used as a quantitative measure for pulmonary edema. We used a deep learning approach and binned the data into two, three, four and five classes increasing the resolution of the EVLWI prediction from the X-rays.
RESULTS
The accuracy, area under the receiver operating characteristic curve (AUROC) and Mathews correlation coefficient (MCC) in the binary classification models (EVLWI < 15, ≥ 15) were 0.93 (accuracy), 0.98 (AUROC) and 0.86(MCC). In the three multiclass models, the accuracy ranged between 0.90 and 0.95, the AUROC between 0.97 and 0.99 and the MCC between 0.86 and 0.92.
CONCLUSION
Deep learning can quantify pulmonary edema as measured by EVLWI with high accuracy.

Identifiants

pubmed: 37237287
doi: 10.1186/s13054-023-04426-5
pii: 10.1186/s13054-023-04426-5
pmc: PMC10214619
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

201

Informations de copyright

© 2023. The Author(s).

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Auteurs

Dominik Schulz (D)

Klinik und Poliklinik für Innere Medizin II, Klinikum rechts der Isar, Munich, Germany. Dominik.Schulz@uk-augsburg.de.
III. Medizinische Klinik, Universitätsklinikum Augsburg, Augsburg, Germany. Dominik.Schulz@uk-augsburg.de.

Sebastian Rasch (S)

Klinik und Poliklinik für Innere Medizin II, Klinikum rechts der Isar, Munich, Germany.

Markus Heilmaier (M)

Klinik und Poliklinik für Innere Medizin II, Klinikum rechts der Isar, Munich, Germany.

Rami Abbassi (R)

Klinik und Poliklinik für Innere Medizin II, Klinikum rechts der Isar, Munich, Germany.

Alexander Poszler (A)

Innere Medizin - Gastroenterologie, Krankenhaus Agatharied, Hausham, Germany.

Jörg Ulrich (J)

Klinik und Poliklinik für Innere Medizin II, Klinikum rechts der Isar, Munich, Germany.

Manuel Steinhardt (M)

Institute for Diagnostic and Interventional Radiology, Klinikum rechts der Isar, School of Medicine, Technical University of Munich, Munich, Germany.

Georgios A Kaissis (GA)

Institute for Diagnostic and Interventional Radiology, Klinikum rechts der Isar, School of Medicine, Technical University of Munich, Munich, Germany.

Roland M Schmid (RM)

Klinik und Poliklinik für Innere Medizin II, Klinikum rechts der Isar, Munich, Germany.

Rickmer Braren (R)

Institute for Diagnostic and Interventional Radiology, Klinikum rechts der Isar, School of Medicine, Technical University of Munich, Munich, Germany.

Tobias Lahmer (T)

Klinik und Poliklinik für Innere Medizin II, Klinikum rechts der Isar, Munich, Germany.

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Classifications MeSH