Radiologist-Trained and -Tested (R2.2.4) Deep Learning Models for Identifying Anatomical Landmarks in Chest CT.

(1) Background: Optimal anatomic coverage is important for radiation-dose optimization. We trained and tested (R2.2.4) two (R3-2) deep learning (DL) algorithms on a machine vision tool library platform (Cognex Vision Pro Deep Learning software) to recognize anatomic landmarks and classify chest CT as those with optimum, under-scanned, or over-scanned scan length. (2) Methods: To test our hypothesis, we performed a study with 428 consecutive chest CT examinations (mean age 70 ± 14 years; male:female 190:238) performed at one of the four hospitals. CT examinations from two hospitals were used to train the DL classification algorithms to identify lung apices and bases. The developed algorithms were then tested on the data from the remaining two hospitals. For each CT, we recorded the scan lengths above and below the lung apices and bases. Model performance was assessed with receiver operating characteristics (ROC) analysis. (3) Results: The two DL models for lung apex and bases had high sensitivity, specificity, accuracy, and areas under the curve (AUC) for identifying under-scanning (100%, 99%, 99%, and 0.999 (95% CI 0.996-1.000)) and over-scanning (99%, 99%, 99%, and 0.998 (95%CI 0.992-1.000)). (4) Conclusions: Our DL models can accurately identify markers for missing anatomic coverage and over-scanning in chest CTs.