首页|基于深度学习算法联合Grad-CAM的宫腔镜子宫内膜病变诊断模型研究

基于深度学习算法联合Grad-CAM的宫腔镜子宫内膜病变诊断模型研究

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目的:探讨基于深度学习(DL)算法联合可视化技术梯度加权类激活热图(Grad-CAM)开发的宫腔镜子宫内膜病变诊断模型的有效性。方法:选择2021年6月1日至2022年12月31日在武汉大学人民医院妇科行宫腔镜检查的291例患者的303段宫腔镜视频(4781张图像),采用权重采样的方法,将数据集划分为训练集(3703张)和测试集(1078张)。在对训练集用于模型学习与训练后,选择残差神经网络(ResNet18)和高效神经网络(EfficientNet-B0)两种模型架构对测试集分别采用五类和二类分类任务进行模型验证。以病理组织学为金标准,评估其诊断效能,从而选出最优模型,并将Grad-CAM层嵌入最优模型中,输出宫腔镜图像Grad-CAM。结果:①在五类分类任务中,EfficientNet-B0 模型的准确度(93。23%)高于 ResNet18 模型(84。23%);EfficientNet-B0 模型在诊断无不典型性子宫内膜增生、子宫内膜息肉、子宫内膜癌、子宫内膜非典型增生、黏膜下肌瘤5种疾病的曲线下面积(AUC)均稍高于ResNet18模型,两者的AUC几乎都在0。980以上。②在准确度的二类分类任务中和对特异度的评估中,两种模型相似,均在93。00%以上,而EfficientNet-B0模型敏感度(91。14%)明显优于ResNet18模型(77。22%)。③EfficientNet-B0模型联合Grad-CAM算法可识别出图像中异常区域,取活检经病理检查证实,模型输出热力图中标记区域约95%为病灶区域。结论:EfficientNet-B0模型联合Grad-CAM研发的宫腔镜诊断模型具有较高的诊断准确度、敏感度和特异度,在诊断子宫内膜病变方面具有应用价值。
Research on Diagnosis Model of Endometrial Lesions by Hysteroscopy Based on Deep Learning Algorithm Combined with Grad-CAM
Objective:To explore the effectiveness of a hysteroscopic endometrial lesion diagnosis model de-veloped based on deep learning(DL)algorithm combined with gradient-weighted class activation mapping(Grad-CAM)visualization technology.Methods:303 hysteroscopy videos(4781 images)of 291 patients who un-derwent hysteroscopy examination in the Department of Gynecology,Renmin Hospital of Wuhan University from June 1,2021 to December 31,2022 were selected.The dataset was divided into a training set(3703 images)and a test set(1078 images)by weight sampling method.After the training set was used for model learning and train-ing,two model architectures,residual neural network(ResNet18)and efficient neural network(EfficientNet-B0),were selected to verify the model in the test set by five-class and two-class classification tasks,respectively.Tak-ing histopathology as the gold standard,the diagnostic efficacy was evaluated to select the optimal model,and the Grad-CAM layer was embedded in the optimal model to output hysteroscopy images of Grad-CAM.Results:①In the five-class classification tasks,the accuracy of EfficientNet-B0 model(93.23%)was higher than that of Res-Net18 model(84.23%);the area under the curve(AUC)of EfficientNet-B0 model in the diagnosis of five disea-ses,including atypical endometrial hyperplasia,endometrial polyps,endometrial cancer,endometrial atypical hy-perplasia,and submucous myoma,was slightly higher than that of ResNet18 model,and the AUC of both models was almost above 0.980.②In the binary classification task of accuracy and the evaluation of specificity,the two models were similar,both above 93.00%,and the sensitivity of EfficientNet-B0 model(91.14%)was significantly better than that of ResNet18 model(77.22%).③EfficientNet-B0 model combined with Grad-CAM algorithm could identify the abnormal areas in the image.After biopsy and pathological examination,it was confirmed that about 95%of the marked areas in the model's output heatmap were lesion areas.Conclusions:The hysteroscopy di-agnostic model developed by EfficientNet-B0 model combined with Grad-CAM has high diagnostic accuracy,sen-sitivity,and specificity,and has application value in the diagnosis of endometrial lesions.

HysteroscopyEndometrial cancerConvolutional neural networkGradient class activation mapDeep learning

曹明亮、尹蜜、王庆彬、朱汉峰、李星、张珺、毛林、穆雪峰、曹敏、马于涛、王健、张燕

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武汉大学人民医院妇产科,湖北武汉 430060

华中师范大学计算机学院,湖北武汉 430079

武汉大学计算机学院,湖北武汉 430064

宫腔镜 子宫内膜癌 卷积神经网络 梯度加权类激活热图 深度学习

武汉大学人民医院交叉创新人才项目(2022)

JCRCZN-2022-009

2024

实用妇产科杂志
四川省医学会

实用妇产科杂志

CSTPCD北大核心
影响因子:2.564
ISSN:1003-6946
年,卷(期):2024.40(5)