Evidence map›Paper›PMID 37093263›Full record

ArticleEuropean spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society2023

A deep learning-based technique for the diagnosis of epidural spinal cord compression on thoracolumbar CT.

James Thomas Patrick Decourcy Hallinan, Lei Zhu, Hui Wen Natalie Tan, Si Jian Hui, Xinyi Lim, Bryan Wei Loong Ong, Han Yang Ong, Sterling Ellis Eide, Amanda J L Cheng, Shuliang Ge and 12 more

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In one paragraph

Article in European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed.

  1. Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

22 authors.

James Thomas Patrick Decourcy Hallinan *Department of Diagnostic Imaging, National University Hospital, 5 Lower Kent Ridge Rd, Singapore, 119074, Singapore. james_hallinan@nuhs.edu.sg.ORCID 0000-0002-0082-9033
Lei Zhu *Department of Computer Science, School of Computing, National University of Singapore, 13 Computing Drive, Singapore, 117417, Singapore.ORCID 0000-0002-9193-8234
Hui Wen Natalie TanDepartment of Orthopaedic Surgery, University Spine Centre, National University Health System, 1E, Lower Kent Ridge Road, Singapore, 119228, Singapore.ORCID 0000-0002-5185-4095
Si Jian HuiDepartment of Orthopaedic Surgery, University Spine Centre, National University Health System, 1E, Lower Kent Ridge Road, Singapore, 119228, Singapore.
Xinyi LimOrthopaedic Centre, Alexandra Hospital, 378 Alexandra Road, Singapore, 159964, Singapore.
Bryan Wei Loong OngDepartment of Orthopaedic Surgery, University Spine Centre, National University Health System, 1E, Lower Kent Ridge Road, Singapore, 119228, Singapore.ORCID 0000-0003-2243-4566
Han Yang OngDepartment of Diagnostic Imaging, National University Hospital, 5 Lower Kent Ridge Rd, Singapore, 119074, Singapore.ORCID 0000-0002-6241-4132
Sterling Ellis EideDepartment of Diagnostic Imaging, National University Hospital, 5 Lower Kent Ridge Rd, Singapore, 119074, Singapore.
Amanda J L ChengDepartment of Diagnostic Imaging, National University Hospital, 5 Lower Kent Ridge Rd, Singapore, 119074, Singapore.
Shuliang GeDepartment of Diagnostic Imaging, National University Hospital, 5 Lower Kent Ridge Rd, Singapore, 119074, Singapore.
Tricia KuahDepartment of Diagnostic Imaging, National University Hospital, 5 Lower Kent Ridge Rd, Singapore, 119074, Singapore.
Shi Wei Desmond LimDepartment of Diagnostic Imaging, National University Hospital, 5 Lower Kent Ridge Rd, Singapore, 119074, Singapore.
Xi Zhen LowDepartment of Diagnostic Imaging, National University Hospital, 5 Lower Kent Ridge Rd, Singapore, 119074, Singapore.
Ee Chin TeoDepartment of Diagnostic Imaging, National University Hospital, 5 Lower Kent Ridge Rd, Singapore, 119074, Singapore.
Qai Ven YapBiostatistics Unit, Yong Loo Lin School of Medicine, 10 Medical Drive, Singapore, 117597, Singapore.
Yiong Huak ChanBiostatistics Unit, Yong Loo Lin School of Medicine, 10 Medical Drive, Singapore, 117597, Singapore.
Naresh KumarDepartment of Orthopaedic Surgery, University Spine Centre, National University Health System, 1E, Lower Kent Ridge Road, Singapore, 119228, Singapore.ORCID 0000-0003-4538-5031
Balamurugan A VellayappanDepartment of Radiation Oncology, National University Cancer Institute Singapore, National University Hospital, Singapore, Singapore.
Beng Chin OoiDepartment of Computer Science, School of Computing, National University of Singapore, 13 Computing Drive, Singapore, 117417, Singapore.
Swee Tian QuekDepartment of Diagnostic Imaging, National University Hospital, 5 Lower Kent Ridge Rd, Singapore, 119074, Singapore.
Andrew MakmurDepartment of Diagnostic Imaging, National University Hospital, 5 Lower Kent Ridge Rd, Singapore, 119074, Singapore.
Jiong Hao TanDepartment of Orthopaedic Surgery, University Spine Centre, National University Health System, 1E, Lower Kent Ridge Road, Singapore, 119228, Singapore.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeTo develop a deep learning (DL) model for epidural spinal cord compression (ESCC) on CT, which will aid earlier ESCC diagnosis for less experienced clinicians.

methodsWe retrospectively collected CT and MRI data from adult patients with suspected ESCC at a tertiary referral institute from 2007 till 2020. A total of 183 patients were used for training/validation of the DL model. A separate test set of 40 patients was used for DL model evaluation and comprised 60 staging CT and matched MRI scans performed with an interval of up to 2 months. DL model performance was compared to eight readers: one musculoskeletal radiologist, two body radiologists, one spine surgeon, and four trainee spine surgeons. Diagnostic performance was evaluated using inter-rater agreement, sensitivity, specificity and AUC.

resultsOverall, 3115 axial CT slices were assessed. The DL model showed high kappa of 0.872 for normal, low and high-grade ESCC (trichotomous), which was superior compared to a body radiologist (R4, κ = 0.667) and all four trainee spine surgeons (κ range = 0.625-0.838)(all p < 0.001). In addition, for dichotomous normal versus any grade of ESCC detection, the DL model showed high kappa (κ = 0.879), sensitivity (91.82), specificity (92.01) and AUC (0.919), with the latter AUC superior to all readers (AUC range = 0.732-0.859, all p < 0.001).

conclusionA deep learning model for the objective assessment of ESCC on CT had comparable or superior performance to radiologists and spine surgeons. Earlier diagnosis of ESCC on CT could reduce treatment delays, which are associated with poor outcomes, increased costs, and reduced survival.

Indexed as

Deep LearningSpinal Cord CompressionAdultHumansRetrospective StudiesSpineTomography, X-Ray ComputedArtificial intelligenceCTDeep learningEpidural spinal cord compressionMetastatic epidural spinal cord compressionMRI

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.