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DeepLiverNet: a deep transfer learning model for classifying liver stiffness using clinical and T2-weighted magnetic resonance imaging data in children and young adults

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Abstract

Background

Although MR elastography allows for quantitative evaluation of liver stiffness to assess chronic liver diseases, it has associated drawbacks related to additional scanning time, patient discomfort, and added costs.

Objective

To develop a machine learning model that can categorically classify the severity of liver stiffness using both anatomical T2-weighted MRI and clinical data for children and young adults with known or suspected pediatric chronic liver diseases.

Materials and methods

We included 273 subjects with known or suspected chronic liver disease. We extracted data including axial T2-weighted fast spin-echo fat-suppressed images, clinical data (e.g., demographic/anthropomorphic data, particular medical diagnoses, laboratory values) and MR elastography liver stiffness measurements. We propose DeepLiverNet (a deep transfer learning model) to classify patients into one of two groups: no/mild liver stiffening (<3 kPa) or moderate/severe liver stiffening (≥3 kPa). We conducted internal cross-validation using 178 subjects, and external validation using an independent cohort of 95 subjects. We assessed diagnostic performance using accuracy, sensitivity, specificity and area under the receiver operating characteristic curve (AuROC).

Results

In the internal cross-validation experiment, the combination of clinical and imaging data produced the best performance (AuROC=0.86) compared to clinical (AuROC=0.83) or imaging (AuROC=0.80) data alone. Using both clinical and imaging data, the DeepLiverNet correctly classified patients with accuracy of 88.0%, sensitivity of 74.3% and specificity of 94.6%. In our external validation experiment, this same deep learning model achieved an accuracy of 80.0%, sensitivity of 61.1%, specificity of 91.5% and AuROC of 0.79.

Conclusion

A deep learning model that incorporates clinical data and anatomical T2-weighted MR images might provide a means of risk-stratifying liver stiffness and directing the use of MR elastography.

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Acknowledgments

This study was supported by an internal grant from the Department of Radiology, Cincinnati Children’s Hospital Medical Center.

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Authors and Affiliations

  1. The Perinatal Institute and Section of Neonatology, Perinatal and Pulmonary Biology, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA

    Hailong Li, Lili He & Nehal A. Parikh

  2. Imaging Research Center, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA

    Hailong Li, Lili He, Jonathan A. Dudley, Thomas C. Maloney, Elanchezhian Somasundaram & Jonathan R. Dillman

  3. Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA

    Lili He & Nehal A. Parikh

  4. Department of Radiology, Cincinnati Children’s Hospital Medical Center, 3333 Burnet Ave., MLC 5031, Cincinnati, OH, 45229, USA

    Jonathan A. Dudley, Thomas C. Maloney, Elanchezhian Somasundaram, Samuel L. Brady & Jonathan R. Dillman

  5. Department of Radiology, University of Cincinnati College of Medicine, Cincinnati, OH, USA

    Elanchezhian Somasundaram, Samuel L. Brady & Jonathan R. Dillman

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  1. Hailong Li
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  2. Lili He
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Correspondence to Jonathan R. Dillman.

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Li, H., He, L., Dudley, J.A. et al. DeepLiverNet: a deep transfer learning model for classifying liver stiffness using clinical and T2-weighted magnetic resonance imaging data in children and young adults. Pediatr Radiol 51, 392–402 (2021). https://doi.org/10.1007/s00247-020-04854-3

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  • DOI: https://doi.org/10.1007/s00247-020-04854-3

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