JMIR Publications

ABSTRACT

Background:

Detection and quantification of intraabdominal free fluid (i.e., ascites) on computed tomography (CT) are essential processes to find emergent or urgent conditions in patients. In an emergent department, automatic detection and quantification of ascites will be beneficial.

Objective:

We aimed to develop an artificial intelligence (AI) algorithm for the automatic detection and quantification of ascites simultaneously using a single deep learning model (DLM).

Methods:

2D deep learning models (DLMs) based on a deep residual U-Net, U-Net, bi-directional U-Net, and recurrent residual U-net were developed to segment areas of ascites on an abdominopelvic CT. Based on segmentation results, the DLMs detected ascites by classifying CT images into ascites images and non-ascites images. The AI algorithms were trained using 6,337 CT images from 160 subjects (80 with ascites and 80 without ascites) and tested using 1,635 CT images from 40 subjects (20 with ascites and 20 without ascites). The performance of AI algorithms was evaluated for diagnostic accuracy of ascites detection and for segmentation accuracy of ascites areas. Of these DLMs, we proposed an AI algorithm with the best performance.

Results:

The segmentation accuracy was the highest in the deep residual U-Net with a mean intersection over union (mIoU) value of 0.87, followed by U-Net, bi-directional U-Net, and recurrent residual U-net (mIoU values 0.80, 0.77, and 0.67, respectively). The detection accuracy was the highest in the deep residual U-net (0.96), followed by U-Net, bi-directional U-net, and recurrent residual U-net (0.90, 0.88, and 0.82, respectively). The deep residual U-net also achieved high sensitivity (0.96) and high specificity (0.96).

Conclusions:

We propose the deep residual U-net-based AI algorithm for automatic detection and quantification of ascites on abdominopelvic CT scans, which provides excellent performance.