Background: To achieve imaging report standardization and improve the quality and efficiency of the intra-interdisciplinary clinical workflow, we proposed an intelligent imaging layout system (IILS) for a clinical decision support system-based ubiquitous healthcare service, which is a lung nodule management system using medical images.
Methods: We created a lung IILS based on deep learning for imaging report standardization and workflow optimization for the identification of nodules. Our IILS utilized a deep learning plus adaptive auto layout tool, which trained and tested a neural network with imaging data from all the main CT manufacturers from 11,205 patients. Model performance was evaluated by the receiver operating characteristic curve (ROC) and calculating the corresponding area under the curve (AUC). The clinical application value for our IILS was assessed by a comprehensive comparison of multiple aspects.
Findings: Our IILS is clinically applicable due to the consistency with nodules detected by IILS, with its highest consistency of 0·94 and an AUC of 90·6% for malignant pulmonary nodules versus benign nodules with a sensitivity of 76·5% and specificity of 89·1%. Applying this IILS to a dataset of chest CT images, we demonstrate performance comparable to that of human experts in providing a better layout and aiding in diagnosis in 100% valid images and nodule display. The IILS was superior to the traditional manual system in performance, such as reducing the number of clicks from 14·45 ± 0·38 to 2, time consumed from 16·87 ± 0·38 s to 6·92 ± 0·10 s, number of invalid images from 7·06 ± 0·24 to 0, and missing lung nodules from 46·8% to 0%.
Interpretation: This IILS might achieve imaging report standardization, and improve the clinical workflow therefore opening a new window for clinical application of artificial intelligence. FUND: The National Natural Science Foundation of China.
Keywords: Artificial intelligence; Clinical workflow; Deep learning algorithms; Intelligent image layout system; Lung nodule; Standardized e-film and visualized structured report.
Copyright © 2019 The Authors. Published by Elsevier B.V. All rights reserved.