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arXiv 2507.08952eess.IVcs.CV

可解释人工智能在急性胸部CT扫描中检测急性心力衰竭的应用

Interpretable Artificial Intelligence for Detecting Acute Heart Failure on Acute Chest CT Scans

University of Copenhagen(哥本哈根大学);Copenhagen University Hospital – Herlev Gentofte(哥本哈根大学医院 – 赫尔莱夫根托夫特)

Silas Nyboe Ørting, Kristina Miger, Anne Sophie Overgaard Olesen, Mikael Ploug Boesen, Michael Brun Andersen, Jens Petersen, Olav W. Nielsen, Marleen de Bruijne

AI总结:

本研究开发了一种基于Boosted Trees的可解释AI模型,通过分析胸部CT中分割出的心肺结构来检测急性心力衰竭,其诊断准确率与放射科医师相当,且透明的预测过程能有效支持急诊决策。

摘要:

引言:胸部CT扫描越来越多地用于呼吸困难患者,其中急性心力衰竭(AHF)是关键的鉴别诊断。尽管为急诊医师标记此类信息具有治疗意义,但由于放射科医师短缺,影像解读仍具挑战性且报告经常延迟。人工智能(AI)可作为提高诊断精度的补充工具。我们旨在开发一个可解释的AI模型,以检测胸部CT中AHF的放射学征象,其准确度可与胸科放射科医师相媲美。方法:这是一项于2016-2021年间在丹麦哥本哈根大学医院Bispebjerg和Frederiksberg进行的单中心回顾性研究。训练了一个Boosted Trees模型,基于急性胸部CT扫描中分割出的心脏和肺部结构的测量值来预测AHF。训练和测试的诊断标签从放射学报告中提取。结构使用TotalSegmentator进行分割。使用Shapley Additive explanations值来解释每个测量值对最终预测的影响。结果:在4,672名受试者中,49%为女性。最终模型纳入了AHF的十二个关键特征,并在独立测试集上实现了0.87的ROC曲线下面积。放射科专家对模型误分类的审查发现,64个假阳性中的24个(38%)和61个假阴性中的24个(39%)实际上是正确的模型预测,错误源于初始放射学报告的不准确。结论:我们开发了一个具有强鉴别性能的可解释AI模型,与胸科放射科医师相当。该AI模型的逐步、透明预测可支持决策制定。

英文摘要:

Introduction: Chest CT scans are increasingly used in dyspneic patients where acute heart failure (AHF) is a key differential diagnosis. Interpretation remains challenging and radiology reports are frequently delayed due to a radiologist shortage, although flagging such information for emergency physicians would have therapeutic implication. Artificial intelligence (AI) can be a complementary tool to enhance the diagnostic precision. We aim to develop an explainable AI model to detect radiological signs of AHF in chest CT with an accuracy comparable to thoracic radiologists. Methods: A single-center, retrospective study during 2016-2021 at Copenhagen University Hospital - Bispebjerg and Frederiksberg, Denmark. A Boosted Trees model was trained to predict AHF based on measurements of segmented cardiac and pulmonary structures from acute thoracic CT scans. Diagnostic labels for training and testing were extracted from radiology reports. Structures were segmented with TotalSegmentator. Shapley Additive explanations values were used to explain the impact of each measurement on the final prediction. Results: Of the 4,672 subjects, 49% were female. The final model incorporated twelve key features of AHF and achieved an area under the ROC of 0.87 on the independent test set. Expert radiologist review of model misclassifications found that 24 out of 64 (38%) false positives and 24 out of 61 (39%) false negatives were actually correct model predictions, with the errors originating from inaccuracies in the initial radiology reports. Conclusion: We developed an explainable AI model with strong discriminatory performance, comparable to thoracic radiologists. The AI model's stepwise, transparent predictions may support decision-making.

机构、总结、中文摘要均由AI分析而来,可能存在错误,请以论文正文为准。

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