Deep learning for detection of radiographic sacroiliitis: achieving expert-level performance

Keno K. Bressem, Janis L. Vahldiek, Lisa Adams, Stefan Markus Niehues, Hildrun Haibel, Valeria Rios Rodriguez, Murat Torgutalp, Mikhail Protopopov, Fabian Proft, Judith Rademacher, Joachim Sieper, Martin Rudwaleit, Bernd Hamm, Marcus R. Makowski, Kay Geert Hermann, Denis Poddubnyy

Research output: Contribution to journalArticlepeer-review

48 Scopus citations

Abstract

Background: Radiographs of the sacroiliac joints are commonly used for the diagnosis and classification of axial spondyloarthritis. The aim of this study was to develop and validate an artificial neural network for the detection of definite radiographic sacroiliitis as a manifestation of axial spondyloarthritis (axSpA). Methods: Conventional radiographs of the sacroiliac joints obtained in two independent studies of patients with axSpA were used. The first cohort comprised 1553 radiographs and was split into training (n = 1324) and validation (n = 229) sets. The second cohort comprised 458 radiographs and was used as an independent test dataset. All radiographs were assessed in a central reading session, and the final decision on the presence or absence of definite radiographic sacroiliitis was used as a reference. The performance of the neural network was evaluated by calculating areas under the receiver operating characteristic curves (AUCs) as well as sensitivity and specificity. Cohen’s kappa and the absolute agreement were used to assess the agreement between the neural network and the human readers. Results: The neural network achieved an excellent performance in the detection of definite radiographic sacroiliitis with an AUC of 0.97 and 0.94 for the validation and test datasets, respectively. Sensitivity and specificity for the cut-off weighting both measurements equally were 88% and 95% for the validation and 92% and 81% for the test set. The Cohen’s kappa between the neural network and the reference judgements were 0.79 and 0.72 for the validation and test sets with an absolute agreement of 90% and 88%, respectively. Conclusion: Deep artificial neural networks enable the accurate detection of definite radiographic sacroiliitis relevant for the diagnosis and classification of axSpA.

Original languageEnglish
Article number106
JournalArthritis Research and Therapy
Volume23
Issue number1
DOIs
StatePublished - Dec 2021

Keywords

  • Artificial intelligence
  • Axial spondyloarthritis
  • Deep learning
  • Machine learning
  • Sacroiliitis

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