DeePSC: A Deep Learning Model for Automated Diagnosis of Primary Sclerosing Cholangitis at Two-dimensional MR Cholangiopancreatography

Deep learning models in classifying primary bone tumors and bone infections based on radiographs

Primary bone tumors (PBTs) present significant diagnostic challenges due to their heterogeneous nature and similarities with bone infections. This study aimed to develop an ensemble deep learning framework that integrates multicenter radiographs and extensive clinical features to accurately differentiate between PBTs and bone infections. We compared the performance of the ensemble model with four imaging models based solely on radiographs utilizing EfficientNet B3, EfficientNet B4, Vision Transformer, and Swin Transformers. The patients were split into external dataset (N = 423) and internal dataset [including training (N = 1044), test (N = 354), and validation set (N = 171)]. The ensemble model outperformed imaging models, achieving areas under the curve (AUCs) of 0.948 and 0.963 on internal and external sets, respectively, with accuracies of 0.881 and 0.895. Its performance surpassed junior and mid-level radiologists and was comparable to senior radiologists (accuracy: 83.6%). These findings underscore the potential of deep learning in enhancing diagnostic precision for PBTs and bone infections (Research Registration Unique Identifying Number (UIN): researchregistry10483 and with details are available at https://www.researchregistry.com/register-now#home/registrationdetails/6693845995ba110026aeb754/ ).

Primary Sclerosing Cholangitis: Diagnostic Criteria

Primary sclerosing cholangitis is a chronic cholestatic liver disease characterized by inflammation and fibrosis of intra- and/or extrahepatic bile ducts leading to the formation of multifocal strictures alternated to bile duct dilatations. The diagnosis of the most common subtype of the disease, the large duct PSC, is based on the presence of elevation of cholestatic indices, the association of typical cholangiographic findings assessed by magnetic resonance cholangiography and the exclusion of causes of secondary sclerosing cholangitis. Liver biopsy is not routinely applied for the diagnosis of large duct PSC but is mandatory in the case of suspicion of small duct PSC or overlap with autoimmune hepatitis.