Differentiation of eosinophilic and non-eosinophilic chronic
rhinosinusitis on preoperative computed tomography using deep learning
Abstract
Objective: This study aimed to develop deep learning (DL) models for
differentiating between eosinophilic chronic rhinosinusitis (ECRS) and
non-eosinophilic chronic rhinosinusitis (NECRS) on preoperative computed
tomography (CT). Methods: A total of 878 chronic rhinosinusitis (CRS)
patients undergoing nasal endoscopic surgery were included. Axial spiral
CT images were pre-processed and used to build the dataset. Two semantic
segmentation models based on U-net and Deeplabv3 were trained to segment
sinus area in CT images. All patient images were segmented using the
better-performing segmentation model and used for training and
validation of the transferred efficientnet_b0, resnet50,
inception_resnet_v2, and Xception neural networks. Additionally, we
evaluated the performances of the models trained using each image and
each patient as a unit. The precision of each model was assessed based
on the receiver operating characteristic curve. Further, we analyzed the
confusion matrix, accuracy, and interpretability of each model. Results:
The Dice coefficients of U-net and Deeplabv3 were 0.953 and 0.961,
respectively. The average area under the curve and mean accuracy values
of the four networks were 0.848 and 0.762 for models trained using a
single image as a unit, while the corresponding values for models
trained using each patient as a unit were 0.853 and 0.893, respectively.
The generated Grad-Cams showed good interpretability. Conclusion:
Combining semantic segmentation with classification networks could
effectively distinguish between patients with ECRS and NECRS based on
preoperative sinus CT images. Furthermore, labeling each patient to
build a dataset for classification may be more reliable than labeling
each medical image.