Progress in the application of machine learning in CT diagnosis of acute appendicitis.

Journal: Abdominal radiology (New York)
Published Date:

Abstract

Acute appendicitis represents a prevalent condition within the spectrum of acute abdominal pathologies, exhibiting a diverse clinical presentation. Computed tomography (CT) imaging has emerged as a prospective diagnostic modality for the identification and differentiation of appendicitis. This review aims to synthesize current applications, progress, and challenges in integrating machine learning (ML) with CT for diagnosing acute appendicitis while exploring prospects. ML-driven advancements include automated detection, differential diagnosis, and severity stratification. For instance, deep learning models such as AppendiXNet achieved an AUC of 0.81 for appendicitis detection, while 3D convolutional neural networks (CNNs) demonstrated superior performance, with AUCs up to 0.95 and an accuracy of 91.5%. ML algorithms effectively differentiate appendicitis from similar conditions like diverticulitis, achieving AUCs between 0.951 and 0.972. They demonstrate remarkable proficiency in distinguishing between complex and straightforward cases through the innovative use of radiomics and hybrid models, achieving AUCs ranging from 0.80 to 0.96. Even with these advancements, challenges remain, such as the "black-box" nature of artificial intelligence, its integration into clinical workflows, and the significant resources required. Future directions emphasize interpretable models, multimodal data fusion, and cost-effective decision-support systems. By addressing these barriers, ML holds promise for refining diagnostic precision, optimizing treatment pathways, and reducing healthcare costs.

Authors

  • Jiaxin Li
    Department of Gastroenterology, West China Hospital, Sichuan University, Chengdu, China.
  • Jiayin Ye
    Shanghai Jiao Tong University, Shanghai, China.
  • Yiyun Luo
    Shanghai Jiao Tong University, Shanghai, China.
  • Tianyang Xu
    School of Artificial Intelligence and Computer Science, Jiangnan University, Wuxi 214122, China; Jiangsu Provincial Engineering Laboratory of Pattern Recognition and Computational Intelligence, Jiangnan University, Wuxi 214122, China.
  • Zhenyi Jia
    School of Geographic and Oceanographic Sciences, Nanjing University, Nanjing 210023, China. zhenyijay@smail.nju.edu.cn.