Affiliation:
1. Department of Radiology The Tenth Affiliated Hospital of Southern Medical University (Dongguan People's Hospital) Dongguan Guangdong China
2. Medical AI Lab, School of Biomedical Engineering Shenzhen University Medical School, Shenzhen University Shenzhen China
3. Guangdong Key Laboratory of Biomedical Measurements and Ultrasound Imaging, School of Biomedical Engineering Shenzhen University Medical School, Shenzhen University Shenzhen China
4. Dongguan Maternal and Child Health Care Hospital Dongguan China
5. Faculty of Applied Sciences Macao Polytechnic University Macao China
6. Department of Radiology Suining Central Hospital Suining China
Abstract
BackgroundDifferent placenta accreta spectrum (PAS) subtypes pose varying surgical risks to the parturient. Machine learning model has the potential to diagnose PAS disorder.PurposeTo develop a cascaded deep semantic‐radiomic‐clinical (DRC) model for diagnosing PAS and its subtypes based on T2‐weighted MRI.Study TypeRetrospective.Population361 pregnant women (mean age: 33.10 ± 4.37 years), suspected of PAS, divided into segment training cohort (N = 40), internal training cohort (N = 139), internal testing cohort (N = 60), and external testing cohort (N = 122).Field Strength/SequenceCoronal T2‐weighted sequence at 1.5 T and 3.0 T.AssessmentClinical characteristics such as history of uterine surgery and the presence of placenta previa, complete placenta previa and dangerous placenta previa were extracted from clinical records. The DRC model (incorporating radiomics, deep semantic features, and clinical characteristics), a cumulative radiological score method performed by radiologists, and other models (including a radiomics and clinical, the clinical, radiomics and deep learning models) were developed for PAS disorder diagnosing (existence of PAS and its subtypes).Statistical TestsAUC, ACC, Student's t‐test, the Mann–Whitney U test, chi‐squared test, dice coefficient, intraclass correlation coefficients, least absolute shrinkage and selection operator regression, receiver operating characteristic curve, calibration curve with the Hosmer–Lemeshow test, decision curve analysis, DeLong test, and McNemar test. P < 0.05 indicated a significant difference.ResultsIn PAS diagnosis, the DRC‐1 outperformed than other models (AUC = 0.850 and 0.841 in internal and external testing cohorts, respectively). In PAS subtype classification (abnormal adherent placenta and abnormal invasive placenta), DRC‐2 model performed similarly with radiologists (P = 0.773 and 0.579 in the internal testing cohort and P = 0.429 and 0.874 in the external testing cohort, respectively).Data ConclusionThe DRC model offers efficiency and high diagnostic sensitivity in diagnosis, aiding in surgical planning.Level of Evidence3Technical EfficacyStage 2