Automatic Segmentation and Radiomics for Identification and Activity Assessment of CTE Lesions in Crohn's Disease

Inflamm Bowel Dis. 2023 Nov 27:izad285. doi: 10.1093/ibd/izad285. Online ahead of print.

Abstract

Background: The purpose of this article is to develop a deep learning automatic segmentation model for the segmentation of Crohn's disease (CD) lesions in computed tomography enterography (CTE) images. Additionally, the radiomics features extracted from the segmented CD lesions will be analyzed and multiple machine learning classifiers will be built to distinguish CD activity.

Methods: This was a retrospective study with 2 sets of CTE image data. Segmentation datasets were used to establish nnU-Net neural network's automatic segmentation model. The classification dataset was processed using the automatic segmentation model to obtain segmentation results and extract radiomics features. The most optimal features were then selected to build 5 machine learning classifiers to distinguish CD activity. The performance of the automatic segmentation model was evaluated using the Dice similarity coefficient, while the performance of the machine learning classifier was evaluated using the area under the curve, sensitivity, specificity, and accuracy.

Results: The segmentation dataset had 84 CTE examinations of CD patients (mean age 31 ± 13 years , 60 males), and the classification dataset had 193 (mean age 31 ± 12 years , 136 males). The deep learning segmentation model achieved a Dice similarity coefficient of 0.824 on the testing set. The logistic regression model showed the best performance among the 5 classifiers in the testing set, with an area under the curve, sensitivity, specificity, and accuracy of 0.862, 0.697, 0.840, and 0.759, respectively.

Conclusion: The automated segmentation model accurately segments CD lesions, and machine learning classifier distinguishes CD activity well. This method can assist radiologists in promptly and precisely evaluating CD activity.

Keywords: Crohn’s disease; computed tomography enterography; deep learning; radiomics.

Plain language summary

The automatic segmentation and radiomics of computed tomography enterography images can assist radiologists in accurately and quickly identifying Crohn’s disease lesions and evaluating Crohn’s disease activity.