Pan-mediastinal neoplasm diagnosis via nationwide federated learning: a multicentre cohort study

作者全名："Tang, Ruijie; Liang, Hengrui; Guo, Yuchen; Li, Zhigang; Liu, Zhichao; Lin, Xu; Yan, Zeping; Liu, Jun; Xu, Xin; Shao, Wenlong; Li, Shuben; Liang, Wenhua; Wang, Wei; Cui, Fei; He, Huanghe; Yang, Chao; Jiang, Long; Wang, Haixuan; Chen, Huai; Guo, Chenguang; Zhang, Haipeng; Gao, Zebin; He, Yuwei; Chen, Xiangru; Zhao, Lei; Yu, Hong; Hu, Jian; Zhao, Jiangang; Li, Bin; Yin, Ci; Mao, Wenjie; Lin, Wanli; Xie, Yujie; Liu, Jixian; Li, Xiaoqiang; Wu, Dingwang; Hou, Qinghua; Chen, Yongbing; Chen, Donglai; Xue, Yuhang; Liang, Yi; Tang, Wenfang; Wang, Qi; Li, Encheng; Liu, Hongxu; Wang, Guan; Yu, Pingwen; Chen, Chun; Zheng, Bin; Chen, Hao; Zhang, Zhe; Wang, Lunqing; Wang, Ailin; Li, Zongqi; Fu, Junke; Zhang, Guangjian; Zhang, Jia; Liu, Bohao; Zhao, Jian; Deng, Boyun; Han, Yongtao; Leng, Xuefeng; Li, Zhiyu; Zhang, Man; Liu, Changling; Wang, Tianhu; Luo, Zhilin; Yang, Chenglin; Guo, Xiaotong; Ma, Kai; Wang, Lixu; Jiang, Wenjun; Han, Xu; Wang, Qing; Qiao, Kun; Xia, Zhaohua; Zheng, Shuo; Xu, Chenyang; Peng, Jidong; Wu, Shilong; Zhang, Zhifeng; Huang, Haoda; Pang, Dazhi; Liu, Qiao; Li, Jinglong; Ding, Xueru; Liu, Xiang; Zhong, Liucheng; Lu, Yutong; Xu, Feng; Dai, Qionghai; He, Jianxing"

作者地址："[Liang, Hengrui; Yan, Zeping; Liu, Jun; Shao, Wenlong; Liang, Wenhua; Wang, Wei; Cui, Fei; He, Huanghe; Yang, Chao; Wang, Haixuan; Zhang, Man] Guangzhou Med Univ, Natl Clin Res Ctr Resp Dis, Dept Thorac Oncol & Surg, China State Key Lab Resp Dis,Affiliated Hosp 1, Guangzhou, Peoples R China; [Tang, Ruijie; Xu, Feng] Tsinghua Univ, Inst Brain & Cognit Sci, Beijing Natl Res Ctr Informat Sci & Technol, Sch Software, Beijing, Peoples R China; [Guo, Yuchen] Tsinghua Univ, Inst Brain & Cognit Sci, Beijing Natl Res Ctr Informat Sci & Technol, Beijing, Peoples R China; [Dai, Qionghai] Tsinghua Univ, Beijing Natl Res Ctr Informat Sci & Technol, Inst Brain & Cognit Sci, Dept Automat, Beijing 100084, Peoples R China; [Li, Zhigang; Liu, Zhichao] Shanghai Jiao Tong Univ, Sch Med, Dept Thorac Surg, Shanghai, Peoples R China; [Yu, Hong] Shanghai Jiao Tong Univ, Shanghai Chest Hosp, Sch Med, Dept Radiol, Shanghai, Peoples R China; [Lin, Xu; Hu, Jian; Zhao, Jiangang] Zhejiang Univ, Affiliated Hosp 1, Sch Med, Dept Thorac Surg, Hangzhou, Zhejiang, Peoples R China; [Yan, Zeping; Guo, Chenguang; Zhang, Haipeng] Guangdong Assoc Thorac Dis, Guangzhou, Peoples R China; [Chen, Huai] Guangzhou Med Univ, Affiliated Hosp 2, Dept Radiol, Guangzhou 510260, Peoples R China; [Gao, Zebin] Fudan Univ, Sch Informat Sci & Technol, Shanghai, Peoples R China; [Zhao, Lei] Guangzhou Med Univ, Sch Basic Med Sci, Dept Physiol, Guangzhou, Peoples R China; [Li, Bin; Yin, Ci; Mao, Wenjie] Lanzhou Univ Second Hosp, Lanzhou Univ Clin Med Coll 2, Dept Thorac Surg, Lanzhou, Peoples R China; [Lin, Wanli; Xie, Yujie] Gaozhou Peoples Hosp, Dept Thorac Surg, Gaozhou, Peoples R China; [Liu, Jixian; Li, Xiaoqiang; Wu, Dingwang; Hou, Qinghua] Peking Univ, Shenzhen Hosp, Dept Thorac Surg, Shenzhen, Peoples R China; [Chen, Yongbing; Xue, Yuhang] Soochow Univ, Affiliated Hosp 2, Dept Thorac Surg, Suzhou, Peoples R China; [Chen, Donglai] Fudan Univ, Zhongshan Hosp, Dept Thorac Surg, Shanghai, Peoples R China; [Liang, Yi; Tang, Wenfang] Zhongshan City Peoples Hosp, Dept Cardiothorac Surg, Zhongshan, Peoples R China; [Wang, Qi; Li, Encheng] Dalian Med Univ, Second Hosp, Dept Resp Med, Dalian, Peoples R China; [Liu, Hongxu; Wang, Guan; Yu, Pingwen] Dalian Univ Technol, Liaoning Canc Hosp & Inst, Dept Thorac Surg, Canc Hosp, Shenyang, Peoples R China; [Chen, Chun; Zheng, Bin; Chen, Hao] Fujian Med Univ, Union Hosp, Dept Thorac Surg, Fuzhou, Peoples R China; [Zhang, Zhe; Wang, Lunqing; Wang, Ailin; Li, Zongqi] Univ Hlth & Rehabil Sci, Qingdao Municipal Hosp, Dept Thorac Surg, Qingdao, Peoples R China; [Fu, Junke; Zhang, Guangjian; Zhang, Jia; Liu, Bohao] Xi An Jiao Tong Univ, Affiliated Hosp 1, Dept Hepatobil Surg, Xian, Peoples R China; [Zhao, Jian] Guangzhou Med Univ, Affiliated Canc Hosp & Inst, Dept Chest Surg, Guangzhou, Guangdong, Peoples R China; [Deng, Boyun] Cent Peoples Hosp Zhanjiang, Dept Thorac Surg, Zhanjiang, Peoples R China; [Han, Yongtao; Leng, Xuefeng; Li, Zhiyu] Univ Elect Sci & Technol China, Sichuan Canc Hosp & Inst, Sch Med, Div Thorac Surg, Chengdu, Peoples R China; [Zhang, Man; Liu, Changling] Inner Mongolia Med Univ, Dept Thorac Surg, Affiliated Hosp, Hohhot, Peoples R China; [Wang, Tianhu; Luo, Zhilin] Chongqing Med Univ, Affiliated Hosp 3, Dept Thorac Surg, Chongqing, Peoples R China; [Yang, Chenglin; Guo, Xiaotong; Ma, Kai; Wang, Lixu] Chinese Acad Med Sci & Peking Union Med Coll, Canc Hosp, Natl Canc Ctr, Natl Clin Res Ctr Canc, Shenzhen, Peoples R China; [Yang, Chenglin; Guo, Xiaotong; Ma, Kai; Wang, Lixu] Chinese Acad Med Sci & Peking Union Med Coll, Shenzhen Hosp, Shenzhen, Peoples R China; [Jiang, Wenjun; Han, Xu; Wang, Qing] China Med Univ, Affiliated Hosp 4, Dept Thorac Surg, Shenyang, Peoples R China; [Qiao, Kun; Xia, Zhaohua; Zheng, Shuo] Third Peoples Hosp Shenzhen, Dept Thorac Surg, Shenzhen, Peoples R China; [Xu, Chenyang; Wu, Shilong] Ganzhou Peoples Hosp, Dept Thorac Surg, Ganzhou, Peoples R China; [Peng, Jidong] Ganzhou Peoples Hosp, Dept Radiol, Ganzhou, Peoples R China; [Zhang, Zhifeng; Huang, Haoda] Jieyang Peoples Hosp, Dept Cardiothorac Surg, Jieyang, Peoples R China; [Pang, Dazhi; Liu, Qiao; Li, Jinglong; Ding, Xueru] Univ Hong Kong, Shenzhen Hosp, Dept Thorac Surg, Shenzhen, Peoples R China; [Liu, Xiang] Univ South China, Affiliated Hosp 2, Hengyang Med Sch, Dept Thorac Surg, Hengyang, Peoples R China; [Zhong, Liucheng] Huizhou First Peoples Hosp, Dept Radiol, Huizhou, Peoples R China; [Lu, Yutong] Sun Yat Sen Univ, Natl Supercomp Ctr Guangzhou, Sch Comp Sci & Engn, Guangzhou 510006, Peoples R China; [He, Yuwei; Chen, Xiangru] Hangzhou Zhuoxi Inst Brain & Intelligence, Hangzhou, Peoples R China; [Xu, Feng] Tsinghua Univ, Inst Brain & Cognit Sci, Beijing Natl Res Ctr Informat Sci & Technol, Sch Software, Beijing 100084, Peoples R China; [Dai, Qionghai] Tsinghua Univ, Inst Brain & Cognit Sci, Beijing Natl Res Ctr Informat Sci & Technol, Dept Automat, Beijing 100084, Peoples R China; [He, Jianxing] Guangzhou Med Univ, Dept Thorac Oncol & Surg, China State Key Lab Resp Dis, Guangzhou 510120, Peoples R China; [He, Jianxing] Guangzhou Med Univ, Affiliated Hosp 1, Natl Clin Res Ctr Resp Dis, Guangzhou 510120, Peoples R China"

通信作者："Xu, F (通讯作者)，Tsinghua Univ, Inst Brain & Cognit Sci, Beijing Natl Res Ctr Informat Sci & Technol, Sch Software, Beijing 100084, Peoples R China.; Dai, QH (通讯作者)，Tsinghua Univ, Inst Brain & Cognit Sci, Beijing Natl Res Ctr Informat Sci & Technol, Dept Automat, Beijing 100084, Peoples R China.; He, JX (通讯作者)，Guangzhou Med Univ, Dept Thorac Oncol & Surg, China State Key Lab Resp Dis, Guangzhou 510120, Peoples R China.; He, JX (通讯作者)，Guangzhou Med Univ, Affiliated Hosp 1, Natl Clin Res Ctr Resp Dis, Guangzhou 510120, Peoples R China."

来源：LANCET DIGITAL HEALTH

ESI学科分类：　

WOS号：WOS:001068832800001

JCR分区：Q1

影响因子：23.8

年份：2023

卷号：5

期号：9

开始页：E560

结束页：E570

文献类型：Article

关键词：　

摘要："Background Mediastinal neoplasms are typical thoracic diseases with increasing incidence in the general global population and can lead to poor prognosis. In clinical practice, the mediastinum's complex anatomic structures and intertype confusion among different mediastinal neoplasm pathologies severely hinder accurate diagnosis. To solve these difficulties, we organised a multicentre national collaboration on the basis of privacy-secured federated learning and developed CAIMEN, an efficient chest CT-based artificial intelligence (AI) mediastinal neoplasm diagnosis system. Methods In this multicentre cohort study, 7825 mediastinal neoplasm cases and 796 normal controls were collected from 24 centres in China to develop CAIMEN. We further enhanced CAIMEN with several novel algorithms in a multiview, knowledge-transferred, multilevel decision-making pattern. CAIMEN was tested by internal (929 cases at 15 centres), external (1216 cases at five centres and a real-world cohort of 11 162 cases), and human-AI (60 positive cases from four centres and radiologists from 15 institutions) test sets to evaluate its detection, segmentation, and classification performance. Findings In the external test experiments, the area under the receiver operating characteristic curve for detecting mediastinal neoplasms of CAIMEN was 0 & BULL;973 (95% CI 0 & BULL;969-0 & BULL;977). In the real-world cohort, CAIMEN detected 13 false-negative cases confirmed by radiologists. The dice score for segmenting mediastinal neoplasms of CAIMEN was 0 & BULL;765 (0 & BULL;738-0 & BULL;792). The mediastinal neoplasm classification top-1 and top-3 accuracy of CAIMEN were 0 & BULL;523 (0 & BULL;497-0 & BULL;554) and 0 & BULL;799 (0 & BULL;778-0 & BULL;822), respectively. In the human-AI test experiments, CAIMEN outperformed clinicians with top-1 and top-3 accuracy of 0 & BULL;500 (0 & BULL;383-0 & BULL;633) and 0 & BULL;800 (0 & BULL;700-0 & BULL;900), respectively. Meanwhile, with assistance from the computer aided diagnosis software based on CAIMEN, the 46 clinicians improved their average top-1 accuracy by 19 & BULL;1% (0 & BULL;345-0 & BULL;411) and top-3 accuracy by 13 & BULL;0% (0 & BULL;545-0 & BULL;616). Interpretation For mediastinal neoplasms, CAIMEN can produce high diagnostic accuracy and assist the diagnosis of human experts, showing its potential for clinical practice. Funding National Key R & D Program of China, National Natural Science Foundation of China, and Beijing Natural Science Foundation. Copyright & COPY; 2023 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY-NC-ND 4.0 license."

基金机构：National Key Ramp;D Program of China; National Natural Science Foundation of China; Beijing Natural Science Foundation

基金资助正文："National Key R & amp;D Program of China, National Natural Science Foundation of China, and Beijing Natural Science Foundation."