Published in

British Institute of Radiology, British Journal of Radiology, 2023

DOI: 10.1259/bjr.20220685

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Effects of deep learning on radiologists’ and radiology residents’ performance in identifying esophageal cancer on CT

Distributing this paper is prohibited by the publisher
Distributing this paper is prohibited by the publisher

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Abstract

Objective: To investigate the effectiveness of a deep learning model in helping radiologists or radiology residents detect esophageal cancer on contrast-enhanced CT images. Methods: This retrospective study included 250 and 25 patients with and without esophageal cancer, respectively, who underwent contrast-enhanced CT between December 2014 and May 2021 (mean age, 67.9 ± 10.3 years; 233 men). A deep learning model was developed using data from 200 and 25 patients with esophageal cancer as training and validation datasets, respectively. The model was then applied to the test dataset, consisting of additional 25 and 25 patients with and without esophageal cancer, respectively. Four readers (one radiologist and three radiology residents) independently registered the likelihood of malignant lesions using a 3-point scale in the test dataset. After the scorings were completed, the readers were allowed to reference to the deep learning model results and modify their scores, when necessary. Results: The AUC of the deep learning model was 0.95 and 0.98 in the image- and patient-based analyses, respectively. By referencing to the deep learning model results, the AUCs for the readers were improved from 0.96/0.93/0.96/0.93 to 0.97/0.95/0.99/0.96 (p = 0.100/0.006/<0.001/<0.001, DeLong’s test) in the image-based analysis, with statistically significant differences noted for the three less experienced readers. Furthermore, the AUCs for the readers tended to improve from 0.98/0.96/0.98/0.94 to 1.00/1.00/1.00/1.00 (p = 0.317/0.149/0.317/0.073, DeLong’s test) in the patient-based analysis. Conclusion: The deep learning model mainly helped less experienced readers improve their performance in detecting esophageal cancer on contrast-enhanced CT. Advances in knowledge: A deep learning model could mainly help less experienced readers to detect esophageal cancer by improving their diagnostic confidence and diagnostic performance.