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Gao Y, Zhang Y, Hu C, He P, Fu J, Lin F, Liu K, Fu X, Liu R, Sun J, Chen F, Yang W, Zhou Y. Distinguishing infectivity in patients with pulmonary tuberculosis using deep learning. Front Public Health 2023; 11:1247141. [PMID: 38089031 PMCID: PMC10711219 DOI: 10.3389/fpubh.2023.1247141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2023] [Accepted: 11/07/2023] [Indexed: 12/18/2023] Open
Abstract
Introduction This study aimed to develop and assess a deep-learning model based on CT images for distinguishing infectivity in patients with pulmonary tuberculosis (PTB). Methods We labeled all 925 patients from four centers with weak and strong infectivity based on multiple sputum smears within a month for our deep-learning model named TBINet's training. We compared TBINet's performance in identifying infectious patients to that of the conventional 3D ResNet model. For model explainability, we used gradient-weighted class activation mapping (Grad-CAM) technology to identify the site of lesion activation in the CT images. Results The TBINet model demonstrated superior performance with an area under the curve (AUC) of 0.819 and 0.753 on the validation and external test sets, respectively, compared to existing deep learning methods. Furthermore, using Grad-CAM, we observed that CT images with higher levels of consolidation, voids, upper lobe involvement, and enlarged lymph nodes were more likely to come from patients with highly infectious forms of PTB. Conclusion Our study proves the feasibility of using CT images to identify the infectivity of PTB patients based on the deep learning method.
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Affiliation(s)
- Yi Gao
- Department of Infectious Disease and Hepatology Unit, Nanfang Hospital, Southern Medical University, Guangzhou, China
- Department of Infectious Disease, Hainan General Hospital, Hainan Medical University, Haikou, China
- Department of Gastroenterology, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Yiwen Zhang
- School of Biomedical Engineering, Southern Medical University, Guangzhou, China
| | - Chengguang Hu
- Department of Gastroenterology, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Pengyuan He
- Department of Infectious Disease, The Fifth Affiliated Hospital, Sun Yat-sen University, Zhuhai, China
| | - Jian Fu
- Department of Infectious Disease, Hainan General Hospital, Hainan Medical University, Haikou, China
| | - Feng Lin
- Department of Infectious Disease, Hainan General Hospital, Hainan Medical University, Haikou, China
| | - Kehui Liu
- Department of Radiology, Haikou Municipal People's Hospital and Central South University Xiangya Medical College Affiliated Hospital, Haikou, China
| | - Xianxian Fu
- Clinical Lab, Haikou Municipal People's Hospital and Central South University Xiangya Medical College Affiliated Hospital, Haikou, China
| | - Rui Liu
- Department of Infectious Disease, The Second Affiliated Hospital, Hainan Medical University, Haikou, China
| | - Jiarun Sun
- Department of Infectious Disease and Hepatology Unit, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Feng Chen
- Department of Radiology, Hainan General Hospital, Hainan Medical University, Haikou, China
| | - Wei Yang
- School of Biomedical Engineering, Southern Medical University, Guangzhou, China
| | - Yuanping Zhou
- Department of Infectious Disease and Hepatology Unit, Nanfang Hospital, Southern Medical University, Guangzhou, China
- Department of Gastroenterology, Nanfang Hospital, Southern Medical University, Guangzhou, China
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Somoskovi A, Salfinger M. How Can the Tuberculosis Laboratory Aid in the Patient-Centered Diagnosis and Management of Tuberculosis? Clin Chest Med 2019; 40:741-753. [PMID: 31731981 DOI: 10.1016/j.ccm.2019.07.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
In 2019, tuberculosis is still a global source of morbidity and mortality. To determine and provide the most effective treatment regimen to patients, the tuberculosis laboratory needs to rapidly but reliably answer 2 main questions: (1) Is Mycobacterium tuberculosis detectable in the patient specimen? and (2) If so, is the strain detected drug susceptible or does it show any form of drug resistance? In cases of drug resistance, health care providers need to have access to minimal inhibitory concentration results and to the type of mutation conferring drug resistance to tailor the most appropriate drug regimen.
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Affiliation(s)
- Akos Somoskovi
- Global Health Technologies, Global Good Fund, Intellectual Ventures Laboratory, 3150 139th Avenue Southeast, Building 4, Bellevue, WA 98005, USA
| | - Max Salfinger
- University of South Florida, College of Public Health, 13201 Bruce B. Down Boulevard, MDC56, Tampa, FL 33612-3805, USA.
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