中科院:乙肝纤维化临床智能诊断获新突破

2018-05-01 佚名 自动化研究所

我国拥有近一亿的乙型肝炎病毒携带者,并占有全球超过50%的慢性乙肝患者,这长期成为我国严重的公共医疗卫生问题乃至社会问题。肝纤维化是慢性乙肝患者向肝硬化、肝癌逐步发展的病理学表现,其精准分期诊断是临床监视、治疗决策和预后评估的重要依据。然而,临床对于肝纤维化分期依赖于肝脏活组织穿刺检测。该方法不仅对患者具有身体创伤、副作用明显,而且难以重复使用,无法长期、动态监视患者病情的发展。因此,乙肝患者的临

我国拥有近一亿的乙型肝炎病毒携带者,并占有全球超过50%的慢性乙肝患者,这长期成为我国严重的公共医疗卫生问题乃至社会问题。肝纤维化是慢性乙肝患者向肝硬化、肝癌逐步发展的病理学表现,其精准分期诊断临床监视、治疗决策和预后评估的重要依据。然而,临床对于肝纤维化分期依赖于肝脏活组织穿刺检测。该方法不仅对患者具有身体创伤、副作用明显,而且难以重复使用,无法长期、动态监视患者病情的发展。因此,乙肝患者的临床诊疗一直在寻求无创的影像学方法实现肝纤维化的精准分期。

针对这一临床挑战性问题,中科院分子影像重点实验室通过多项技术创新,将影像组学领域中基于深度学习的医学影像大数据人工智能分析技术,应用于超声弹性成像的计算机辅助诊断。通过相关模型和算法的定制化设计,使其能够基于超声弹性图像,无创、智能化分期诊断患者的肝纤维化程度,从而辅助医生实现乙肝患者的个性化治疗决策。相关方法由中山大学第三附属医院和中国人民解放军总医院牵头,开展了多中心、前瞻性临床试验验证。在全国12家医院共计入组398例乙肝患者,采集约2000张超声弹性图像,并以相应的肝脏活组织穿刺检测结果为金标准,进行了影像组学人工智能诊断、常规弹性成像诊断和临床血清学诊断三种方法对于乙肝纤维化分期精度的大数据对比。

统计结果表明,影像组学方法在肝纤维化分期无创诊断中,精度达到了惊人的97%-100%,实现了与有创肝脏活组织穿刺检测相同的诊断效能。相对于常规超声弹性成像,精度平均提高了15%以上;相对于血清学诊断,精度平均提高了30%以上(如下图)。此外,该项研究表明,随着样本量的逐步增大,影像组学人工智能的诊断精度会逐步提高,但是超声弹性成像和血清学诊断的精度达到峰值后则无法提高。国际EFSUMB临床指南推荐:针对单个患者,临床建议提取3张弹性图形进行诊断。本次试验证明,依照指南要求,影像组学方法已经显着超出常规弹性成像的诊断精度;如果单个病人提取5张弹性图像,则影像组学与弹性成像诊断精度的差距还会进一步拉大。这一结果表明了人工智能辅助临床诊断的显着优势和强大潜力。最后,该项研究还表明影像组学方法具有极高的鲁棒性。本次参与试验的医院虽然位于我国的不同地域,但是采用人工智能技术随机选取不同医院的患者来构建的多个影像组学模型,其诊断精度没有任何统计学差异。这为将影像组学方法进行全国范围推广,真正融入日常的临床诊断规范,提供了坚实的理论基础和临床数据证明。

相关研究由中科院分子影像重点实验室副研究员王坤作为第一作者,中山大学第三附属医院超声科主任郑荣琴、中科院分子影像重点实验室研究员田捷和中国人民解放军总医院介入超声科主任梁萍为并列通讯作者,发表于临床期刊Gut(2018,DOI:10.1136/gutjnl -2018-316204)。

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    2018-06-17 zxxiang
  2. [GetPortalCommentsPageByObjectIdResponse(id=1724978, encodeId=ebb71e2497896, content=<a href='/topic/show?id=9ee758586bb' target=_blank style='color:#2F92EE;'>#新突破#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=58586, encryptionId=9ee758586bb, topicName=新突破)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=792a33728807, createdName=zxxiang, createdTime=Sun Jun 17 15:56:00 CST 2018, time=2018-06-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=335788, encodeId=c5a4335e889d, content=几年就有的技术,新吗, beContent=null, objectType=article, channel=null, level=null, likeNumber=59, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/rksbdB7r2voRj1WicA7zz4yyCtO31GMqLQRHUiaO6cXS7p727HvMtGVD0pp4sJibybvicyGzB76ib2gN6QbYNl0Nesg/132, createdBy=985f2412953, createdName=dxj8042, createdTime=Thu Aug 02 13:58:45 CST 2018, time=2018-08-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1808203, encodeId=b9de180820345, content=<a href='/topic/show?id=f94d81342e5' target=_blank style='color:#2F92EE;'>#肝纤维#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=81342, encryptionId=f94d81342e5, topicName=肝纤维)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=8942242, createdName=jj000001, createdTime=Wed Feb 06 21:56:00 CST 2019, time=2019-02-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1862629, encodeId=681e18626296a, content=<a href='/topic/show?id=a121223385b' target=_blank style='color:#2F92EE;'>#中科院#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=22338, encryptionId=a121223385b, topicName=中科院)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=7a9987, createdName=gous, createdTime=Sun Oct 07 06:56:00 CST 2018, time=2018-10-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=310979, encodeId=11733109e967, content=学习了受益匪浅, beContent=null, objectType=article, channel=null, level=null, likeNumber=54, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/ajNVdqHZLLDicHg2ldsSNmib46PmdzpO7CQEmPjuULp1v45zPWwMYhrnXgvl3OtmUCZSQfgITWn96X9moL94nUGA/0, createdBy=28072041016, createdName=131****1460, createdTime=Tue May 01 12:56:13 CST 2018, time=2018-05-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=310961, encodeId=7012310961a7, content=优质资源.共同学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=55, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/oLAjfB7s1ib06iaV3D9Tg5K0LqDY57Aia0TOQByoJhNt3icm4sfukp500hLH6RHOpFdV01NbECtAV7s0qKpQPibyRukQAwAmqJU3X/0, createdBy=f91f1928792, createdName=九九消寒, createdTime=Tue May 01 10:07:20 CST 2018, time=2018-05-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=310960, encodeId=4bc2310960c7, content=优质资源.共同学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=44, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/oLAjfB7s1ib06iaV3D9Tg5K0LqDY57Aia0TOQByoJhNt3icm4sfukp500hLH6RHOpFdV01NbECtAV7s0qKpQPibyRukQAwAmqJU3X/0, createdBy=f91f1928792, createdName=九九消寒, createdTime=Tue May 01 10:07:04 CST 2018, time=2018-05-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=310953, encodeId=15d0310953a8, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=41, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2018/01/15/8213228fe923915543544ad3da7e1c64.jpg, createdBy=6bd82014262, createdName=秀红, createdTime=Tue May 01 09:57:56 CST 2018, time=2018-05-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=310946, encodeId=c2d631094607, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=19, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a8f22260741, createdName=121832a9m88暂无昵称, createdTime=Tue May 01 09:51:10 CST 2018, time=2018-05-01, status=1, ipAttribution=)]
    2018-08-02 dxj8042

    几年就有的技术,新吗

    0

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    2018-10-07 gous
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    2018-05-01 131****1460

    学习了受益匪浅

    0

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    2018-05-01 九九消寒

    优质资源.共同学习

    0

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    2018-05-01 九九消寒

    优质资源.共同学习

    0

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    2018-05-01 秀红

    学习了

    0

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    2018-05-01 121832a9m88暂无昵称

    学习了

    0

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