• Zixu Yuan, Tingyang Xu, Jian Cai, Yebiao Zhao, Wuteng Cao, Alessandro Fichera, Xiaoxia Liu, Jianhua Yao, and Hui Wang.
• Department of Colorectal Surgery, Guangdong Institute of Gastroenterology, Guangdong Provincial Key Laboratory of Colorectal and Pelvic Floor Diseases, Department of Radiology, The Sixth Affiliated Hospital of Sun Yat-Sen University, Guangzhou, Guangdong, China.
• Ann. Surg. 2022 Apr 1; 275 (4): e645-e651.

ObjectiveThe aim of this study was to build a SVM classifier using ResNet-3D algorithm by artificial intelligence for prediction of synchronous PC.BackgroundAdequate detection and staging of PC from CRC remain difficult.MethodsThe primary tumors in synchronous PC were delineated on preoperative contrast-enhanced computed tomography (CT) images. The features of adjacent peritoneum were extracted to build a ResNet3D + SVM classifier. The performance of ResNet3D + SVM classifier was evaluated in the test set and was compared to routine CT which was evaluated by radiologists.ResultsThe training set consisted of 19,814 images from 54 patients with PC and 76 patients without PC. The test set consisted of 7837 images from 40 test patients. The ResNet-3D spent only 34 seconds to analyze the test images. To increase the accuracy of PC detection, we have built a SVM classifier by integrating ResNet-3D features with twelve PC-specific features (P < 0.05). The ResNet3D + SVM classifier showed accuracy of 94.11% with AUC of 0.922 (0.912-0.944), sensitivity of 93.75%, specificity of 94.44%, positive predictive value (PPV) of 93.75%, and negative predictive value (NPV) of 94.44% in the test set. The performance was superior to routine contrast-enhanced CT (AUC: 0.791).ConclusionsThe ResNet3D + SVM classifier based on deep learning algorithm using ResNet-3D framework has shown great potential in prediction of synchronous PC in CRC.Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved.

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