Deep learning nomogram for preoperative distinction between Xanthogranulomatous cholecystitis and gallbladder carcinoma: A novel approach for surgical decision.

Journal: Computers in biology and medicine
Published Date:

Abstract

The distinction between Xanthogranulomatous Cholecystitis (XGC) and Gallbladder Carcinoma (GBC) is challenging due to their similar imaging features. This study aimed to differentiate between XGC and GBC using a deep learning nomogram model built from contrast enhanced computed tomography (CT) scans. 297 patients were included with confirmed XGC (94) and GBC (203) as the training and internal validation cohort from 2017 to 2021. The deep learning model Resnet-18 with Fourier transformation named FCovResnet18, shows most impressive potential in distinguishing XGC from GBC using 3-phase merged images. The accuracy, precision and area under the curve (AUC) of the model were then calculated. An additional cohort of 74 patients consisting of 22 XGC and 52 GBC patients was enrolled from two subsidiary hospitals as the external validation cohort. The accuracy, precision and AUC achieve 0.98, 0.99, 1.00 in the internal validation cohort and 0.89, 0.92, 0.92 in external validation cohort. A nomogram model combining clinical characteristics and deep learning prediction score showed improved predicting value. Altogether, FCovResnet18 nomogram has demonstrated its ability to effectively differentiate XGC from GBC preoperatively, which significantly aid surgeons in making informed and accurate surgical decisions for XGC and GBC patients.

Authors

  • Weichen Zhang
    Department of Hepatobiliary and Pancreatic Surgery, First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China.
  • Qing Wang
    School of Chemistry and Chemical Engineering, Southwest Petroleum University, Chengdu 610500, China. qwang@163.com.
  • Kewei Liang
    National Laboratory of Pattern Recognition, Institute of Automation, Chinese Academy of Sciences, Beijing 100190, China.
  • Haihao Lin
    School of Mathematical Sciences, Zhejiang University, Hangzhou, China.
  • Dongyan Wu
    School of Aviation Operations and Services, Aviation University of Air Force, No. 2222, Dongnanhu Rd., Changchun 130022, China.
  • Yuzhe Han
    School of Mathematical Sciences, Zhejiang University, Hangzhou, China.
  • Hanxi Yu
    International Institutes of Medicine, Fourth Affiliated Hospital, School of Medicine, Zhejiang University, Yiwu, China.
  • Keyi Du
    School of Medicine, Zhejiang University, Hangzhou, China.
  • Haitao Zhang
    Graduate School, Hebei North University, 075000 Zhangjiakou, Hebei, China.
  • Jiawei Hong
    School of Medicine, Zhejiang University, Hangzhou, China.
  • Xun Zhong
    Department of Hepatobiliary and Pancreatic Surgery, First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China.
  • Lingfeng Zhou
    Department of Hepatobiliary and Pancreatic Surgery, First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China.
  • Yuhong Shi
    Polytechnic Institute, Zhejiang University, Hangzhou, China.
  • Jian Wu
    Department of Medical Technology, Jiangxi Medical College, Shangrao, Jiangxi, China.
  • Tianxiao Pang
    School of Mathematical Sciences, Zhejiang University, Hangzhou, China.
  • Jun Yu
  • Linping Cao
    Department of Hepatobiliary and Pancreatic Surgery, First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China. Electronic address: caolinping510@zju.edu.cn.