用合成数据训练模型,自动评估颈肌张力障碍患者的姿势异常。
Image-based Quantification of Postural Deviations on Patients with Cervical Dystonia: A Machine Learning Approach Using Synthetic Training Data
- 用1.6万张合成头像训练深度学习模型,解决临床数据少的问题。
- 对旋转症状的评估与专家评分相关性高达0.91,对侧移症状相关性0.55。
- 适合临床研究和治疗效果客观评估,可提升诊断一致性。
颈肌张力障碍(CD)是最常见的肌张力障碍类型,但现有评估依赖主观量表(如TWSTRS),存在专家间可靠性低的问题。为建立客观评估工具,本研究验证了一种基于图像的头部姿态与位移自动估计系统。该系统结合预训练的姿态估计算法(用于旋转症状)与仅在约1.6万张合成虚拟人像上训练的深度学习模型(用于罕见的水平位移症状)。在多中心研究中,通过对比20位临床专家的共识评分,使用100张真实患者图像和100张标注合成头像进行验证。系统对旋转症状的评估与专家评分高度一致:扭转(r=0.91)、侧倾(r=0.81)、前后倾(r=0.78);对侧移症状的相关性为中等(r=0.55),在合成头像基准测试中准确率高于人类评分者。该方法通过合成数据填补临床数据缺口,成功推广至真实患者,提供一种可验证的客观评估工具,支持标准化临床决策与疗效评价。
原文摘要 · Abstract (English)
Cervical dystonia (CD) is the most common form of dystonia, yet current assessment relies on subjective clinical rating scales, such as the Toronto Western Spasmodic Torticollis Rating Scale (TWSTRS), which requires expertise, is subjective and faces low inter-rater reliability some items of the score. To address the lack of established objective tools for monitoring disease severity and treatment response, this study validates an automated image-based head pose and shift estimation system for patients with CD. We developed an assessment tool that combines a pretrained head-pose estimation algorithm for rotational symptoms with a deep learning model trained exclusively on ~16,000 synthetic avatar images to evaluate rare translational symptoms, specifically lateral shift. This synthetic data approach overcomes the scarcity of clinical training examples. The system's performance was validated in a multicenter study by comparing its predicted scores against the consensus ratings of 20 clinical experts using a dataset of 100 real patient images and 100 labeled synthetic avatars. The automated system demonstrated strong agreement with expert clinical ratings for rotational symptoms, achieving high correlations for torticollis (r=0.91), laterocollis (r=0.81), and anteroretrocollis (r=0.78). For lateral shift, the tool achieved a moderate correlation (r=0.55) with clinical ratings and demonstrated higher accuracy than human raters in controlled benchmark tests on avatars. By leveraging synthetic training data to bridge the clinical data gap, this model successfully generalizes to real-world patients, providing a validated, objective tool for CD postural assessment that can enable standardized clinical decision-making and trial evaluation.
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