Development and Validation of a Deep Learning Algorithm to Automatic Detection of Pituitary Microadenoma From MRI

Abstract

Background: It is often difficult to diagnose pituitary microadenoma (PM) by MRI alone, due to its relatively small size, variable anatomical structure, complex clinical symptoms, and signs among individuals. We develop and validate a deep learning -based system to diagnose PM from MRI.Methods: A total of 11,935 infertility participants were initially recruited for this project. After applying the exclusion criteria, 1,520 participants (556 PM patients and 964 controls subjects) were included for further stratified into 3 non-overlapping cohorts. The data used for the training set were derived from a retrospective study, and in the validation dataset, prospective temporal and geographical validation set were adopted. A total of 780 participants were used for training, 195 participants for testing, and 545 participants were used to validate the diagnosis performance. The PM-computer-aided diagnosis (PM-CAD) system consists of two parts: pituitary region detection and PM diagnosis. The diagnosis performance of the PM-CAD system was measured using the receiver operating characteristics (ROC) curve and area under the ROC curve (AUC), calibration curve, accuracy, sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and F1-score.Results: Pituitary microadenoma-computer-aided diagnosis system showed 94.36% diagnostic accuracy and 98.13% AUC score in the testing dataset. We confirm the robustness and generalization of our PM-CAD system, the diagnostic accuracy in the internal dataset was 96.50% and in the external dataset was 92.26 and 92.36%, the AUC was 95.5, 94.7, and 93.7%, respectively. In human-computer competition, the diagnosis performance of our PM-CAD system was comparable to radiologists with >10 years of professional expertise (diagnosis accuracy of 94.0% vs. 95.0%, AUC of 95.6% vs. 95.0%). For the misdiagnosis cases from radiologists, our system showed a 100% accurate diagnosis. A browser-based software was designed to assist the PM diagnosis.Conclusions: This is the first report showing that the PM-CAD system is a viable tool for detecting PM. Our results suggest that the PM-CAD system is applicable to radiology departments, especially in primary health care institutions.

Pituitary MRI in Cushing's disease ‐ an update

“…14 Lastly, the future will tell us if a machine learning model could help for demonstration and characterization of corticotropinomas and replace expert neuroradiologists. 15 If after performing all the sequences mentioned previously the responsible pituitary adenoma is still not identified, or if the MRI remains inconclusive, the examination has to be renewed under optimal conditions. In a personal Cushing's disease series from 20 years ago, the pituitary origin of the hypercorticism was only proven after one to five pituitary MRIs, with a mean of 2.9 examinations.…”

“…As 3.0 Tesla‐scanner has demonstrated its superiority over 1.5 Tesla‐ scanner, 7.0 Tesla MRI has not yet dramatically demonstrated its superiority over 3.0 T MRI 14 . Lastly, the future will tell us if a machine learning model could help for demonstration and characterization of corticotropinomas and replace expert neuroradiologists 15 …”

Clinical features of hyperprolactinemia in children: modern methods of diagnosis and treatment

“…Для якісної МРТ-діагностики мікроаденом гіпофіза сьогодні використовується система комп'ютерної діагностики мікроаденом гіпофіза (Pituitary microadenoma computer-aided diagnosis (PM-CAD) system). PM-CAD показала діагностичну точність 94,36 % та показник AUC 98,13 % у наборі даних тестування [19].…”