Journal
UROLOGY
Volume 142, Issue -, Pages 183-189Publisher
ELSEVIER SCIENCE INC
DOI: 10.1016/j.urology.2020.05.019
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Funding
- National Institutes of Health [R21DK117297, P50DK114786, K23DK106428]
- National Center for Advancing Translational Sciences of the National Institutes of Health [UL1TR001878]
- National Natural Science Foundation of China [61772220, 61473296]
- Key Program for International S&T Cooperation Projects of China [2016YFE0121200]
- Hubei Province Technological Innovation Major Project [2017AAA017, 2018ACA135]
- Institute for Translational Medicine and Therapeutics' (ITMAT) Transdisciplinary Program in Translational Medicine and Therapeutics
- China Scholarship Council
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OBJECTIVE To reliably and quickly diagnose children with posterior urethral valves (PUV), we developed a multi-instance deep learning method to automate image analysis. METHODS We built a robust pattern classifier to distinguish 86 children with PUV from 71 children with mild unilateral hydronephrosis based on ultrasound images (3504 in sagittal view and 2558 in transverse view) obtained during routine clinical care. RESULTS The multi-instance deep learning classifier performed better than classifiers built on either single sagittal images or single transverse images. Particularly, the deep learning classifiers built on single images in the sagittal view and single images in the transverse view obtained area under the receiver operating characteristic curve (AUC) values of 0.796 +/- 0.064 and 0.815 +/- 0.071, respectively. AUC values of the multi-instance deep learning classifiers built on images in the sagittal and transverse views with mean pooling operation were 0.949 +/- 0.035 and 0.954 +/- 0.033, respectively. The multi-instance deep learning classifiers built on images in both the sagittal and transverse views with a mean pooling operation obtained an AUC of 0.961 +/- 0.026 with a classification rate of 0.925 +/- 0.060, specificity of 0.986 +/- 0.032, and sensitivity of 0.873 +/- 0.120, respectively. Discriminative regions of the kidney located using classification activation mapping demonstrated that the deep learning techniques could identify meaningful anatomical features from ultrasound images. CONCLUSION The multi-instance deep learning method provides an automatic and accurate means to extract informative features from ultrasound images and discriminate infants with PUV from male children with unilateral hydronephrosis. (C) 2020 Elsevier Inc.
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