Liver Fibrosis: Deep Convolutional Neural Network for Staging by Using Gadoxetic Acid–enhanced Hepatobiliary Phase MR Images

TLDR

The study investigates the performance of a deep convolutional neural network for staging liver fibrosis using gadoxetic acid–enhanced hepatobiliary phase MR images. A retrospective cohort of 634 patients (534 training, 100 test) provided hepatobiliary phase MR images, hepatitis B/C status, and biopsy‑based fibrosis stages; images were augmented 90‑fold and a DCNN was trained to predict fibrosis scores, then evaluated on the test set via ROC analysis. The DCNN’s fibrosis score correlated strongly with stage (Spearman 0.63, P < 0.001) and achieved AUCs of 0.84 for F4, 0.84 for F3, and 0.85 for F2, indicating high diagnostic performance. © RSNA, 2017; online supplemental material available.

Abstract

Purpose To investigate the performance of a deep convolutional neural network (DCNN) model in the staging of liver fibrosis using gadoxetic acid-enhanced hepatobiliary phase magnetic resonance (MR) imaging. Materials and Methods This retrospective study included patients for whom input data (hepatobiliary phase MR images, static magnetic field of the imaging unit, and hepatitis B and C virus testing results available, either positive or negative) and reference standard data (liver fibrosis stage evaluated from biopsy or surgical specimens obtained within 6 months of the MR examinations) were available were assigned to the training (534 patients) or the test (100 patients) group. For the training group (54, 53, 81, 113, and 233 patients with fibrosis stages F0, F1, F2, F3, and F4, respectively; mean patient age, 67.4 ± 9.7 years; 388 men and 146 women), MR images with three different section levels were augmented 90-fold (rotated, parallel-shifted, brightness-changed and contrast-changed images were generated; a total of 144 180 images). Supervised training was performed by using the DCNN model to minimize the difference between the output data (fibrosis score obtained through deep learning [FDL score]) and liver fibrosis stage. The performance of the DCNN model was evaluated in the test group (10, 10, 15, 20, and 45 patients with fibrosis stages F0, F1, F2, F3, and F4, respectively; mean patient age, 66.8 years ± 10.7; 71 male patients and 29 female patients) with receiver operating characteristic (ROC) analyses. Results The FDL score was correlated significantly with fibrosis stage (Spearman rank correlation coefficient: 0.63; P < .001). Fibrosis stages F4, F3, and F2 were diagnosed with areas under the ROC curve of 0.84, 0.84, and 0.85, respectively. Conclusion The DCNN model exhibited a high diagnostic performance in the staging of liver fibrosis. © RSNA, 2017 Online supplemental material is available for this article.