用CT影像结合深度学习与XGBoost,精准预测肺栓塞患者30天死亡率。
Mortality Prediction of Pulmonary Embolism Patients with Deep Learning and XGBoost
- 融合3D残差网络与XGBoost,利用初始CT图像进行联合预测。
- 在193例患者上达到94.5%准确率,显著优于传统模型(76-78%)。
- 适合缺乏大量标注数据的临床场景,提升预测稳定性与泛化能力。
肺栓塞(PE)是一种严重的心血管疾病,仍是导致死亡和重症的重要原因,亟需更优的诊断策略。传统临床方法在预测急性肺栓塞患者30天院内死亡率方面表现有限。本研究提出一种名为PEP-Net的新算法,基于初始影像数据(CT)实现30天死亡率预测,通过将3D残差网络(3DResNet)与极端梯度提升(XGBoost)结合,在无栓子及其范围标注的患者级二分类标签下完成建模。该系统通过处理类别不平衡、正则化降低过拟合、减少预测方差以实现更稳定的结果。在193例确诊为急性肺栓塞的体积化CT扫描数据上验证,当输入为肺区域(Lung-ROI)或心脏区域(Cardiac-ROI)时,准确率分别达94.5%(±0.3)和94.0%(±0.7),显著优于基线模型(76-78%)。结果表明,仅使用初始影像即可实现高精度预后评估,为该领域树立新基准。尽管纯深度学习模型广泛用于医学分类任务,但本文中结合ResNet与XGBoost的模型因数据量不足问题反而表现更优。
原文摘要 · Abstract (English)
Pulmonary Embolism (PE) is a serious cardiovascular condition that remains a leading cause of mortality and critical illness, underscoring the need for enhanced diagnostic strategies. Conventional clinical methods have limited success in predicting 30-day in-hospital mortality of PE patients. In this study, we present a new algorithm, called PEP-Net, for 30-day mortality prediction of PE patients based on the initial imaging data (CT) that opportunistically integrates a 3D Residual Network (3DResNet) with Extreme Gradient Boosting (XGBoost) algorithm with patient level binary labels without annotations of the emboli and its extent. Our proposed system offers a comprehensive prediction strategy by handling class imbalance problems, reducing overfitting via regularization, and reducing the prediction variance for more stable predictions. PEP-Net was tested in a cohort of 193 volumetric CT scans diagnosed with Acute PE, and it demonstrated a superior performance by significantly outperforming baseline models (76-78\%) with an accuracy of 94.5\% (+/-0.3) and 94.0\% (+/-0.7) when the input image is either lung region (Lung-ROI) or heart region (Cardiac-ROI). Our results advance PE prognostics by using only initial imaging data, setting a new benchmark in the field. While purely deep learning models have become the go-to for many medical classification (diagnostic) tasks, combined ResNet and XGBoost models herein outperform sole deep learning models due to a potential reason for having lack of enough data.
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