arXiv:2602.10364cs.CV2026-02

开源且获FDA认证的AI工具,可从CT扫描中自动分析动脉瘤和骨密度。

Comp2Comp: Open-Source Software with FDA-Cleared Artificial Intelligence Algorithms for Computed Tomography Image Analysis

  • 开发了两个开源的FDA认证深度学习模型,用于腹部主动脉和骨密度分析。
  • 在多中心数据上验证:动脉瘤测量误差仅1.57毫米,骨密度识别准确率超80%。
  • 既保证透明度又提升临床可用性,适合医院和研究者直接使用。

人工智能可从已有的影像数据中自动提取生物标志物,实现无需额外检查或辐射的‘机会性影像’分析。然而,多数开源工具缺乏严格验证,而商业方案又缺乏透明度,导致实际部署时易出问题。本文报告了两个首个完全开源、通过FDA-510(k)认证的深度学习流程:腹部主动脉量化(AAQ)和骨密度(BMD)估计,均集成于Comp2Comp软件包中,用于对常规CT扫描进行机会性分析。AAQ自动分割腹主动脉以评估动脉瘤大小;BMD则分割椎体以估算松质骨密度和骨质疏松风险。在4个外部机构共258例富含腹主动脉瘤的患者扫描中,AAQ的平均绝对误差为1.57毫米(95% CI 1.38–1.80毫米)。在371例患者中,与同期双能X线吸收检测(DXA)结果对比,BMD分类的敏感性达81.0%(95% CI 74.0–86.8%),特异性为78.4%(95% CI 72.3–83.7%)。结果表明,Comp2Comp的AAQ与BMD具备临床应用所需精度。开源这些算法提升了通常封闭的FDA审批过程的透明度,使医疗机构可在正式临床试验前测试模型,并为研究者提供顶尖的技术方法。

原文摘要 · Abstract (English)

Artificial intelligence allows automatic extraction of imaging biomarkers from already-acquired radiologic images. This paradigm of opportunistic imaging adds value to medical imaging without additional imaging costs or patient radiation exposure. However, many open-source image analysis solutions lack rigorous validation while commercial solutions lack transparency, leading to unexpected failures when deployed. Here, we report development and validation for two of the first fully open-sourced, FDA-510(k)-cleared deep learning pipelines to mitigate both challenges: Abdominal Aortic Quantification (AAQ) and Bone Mineral Density (BMD) estimation are both offered within the Comp2Comp package for opportunistic analysis of computed tomography scans. AAQ segments the abdominal aorta to assess aneurysm size; BMD segments vertebral bodies to estimate trabecular bone density and osteoporosis risk. AAQ-derived maximal aortic diameters were compared against radiologist ground-truth measurements on 258 patient scans enriched for abdominal aortic aneurysms from four external institutions. BMD binary classifications (low vs. normal bone density) were compared against concurrent DXA scan ground truths obtained on 371 patient scans from four external institutions. AAQ had an overall mean absolute error of 1.57 mm (95% CI 1.38-1.80 mm). BMD had a sensitivity of 81.0% (95% CI 74.0-86.8%) and specificity of 78.4% (95% CI 72.3-83.7%). Comp2Comp AAQ and BMD demonstrated sufficient accuracy for clinical use. Open-sourcing these algorithms improves transparency of typically opaque FDA clearance processes, allows hospitals to test the algorithms before cumbersome clinical pilots, and provides researchers with best-in-class methods.

AI医疗CT分析FDA认证开源工具

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