• Dong-Kyu Kim, Bum-Joo Cho, Myung-Je Lee, and Ju Han Kim.
• Department of Otorhinolaryngology-Head and Neck Surgery.
• Medicine (Baltimore). 2021 Feb 19; 100 (7): e24756e24756.

AbstractThis study was conducted to develop a convolutional neural network (CNN)-based model to predict the sex and age of patients by identifying unique unknown features from paranasal sinus (PNS) X-ray images.We employed a retrospective study design and used anonymized patient imaging data. Two CNN models, adopting ResNet-152 and DenseNet-169 architectures, were trained to predict sex and age groups (20-39, 40-59, 60+ years). The area under the curve (AUC), algorithm accuracy, sensitivity, and specificity were assessed. Class-activation map (CAM) was used to detect deterministic areas. A total of 4160 PNS X-ray images were collected from 4160 patients. The PNS X-ray images of patients aged ≥20 years were retrieved from the picture archiving and communication database system of our institution. The classification performances in predicting the sex (male vs female) and 3 age groups (20-39, 40-59, 60+ years) for each established CNN model were evaluated.For sex prediction, ResNet-152 performed slightly better (accuracy = 98.0%, sensitivity = 96.9%, specificity = 98.7%, and AUC = 0.939) than DenseNet-169. CAM indicated that maxillary sinuses (males) and ethmoid sinuses (females) were major factors in identifying sex. Meanwhile, for age prediction, the DenseNet-169 model was slightly more accurate in predicting age groups (77.6 ± 1.5% vs 76.3 ± 1.1%). CAM suggested that the maxillary sinus and the periodontal area were primary factors in identifying age groups.Our deep learning model could predict sex and age based on PNS X-ray images. Therefore, it can assist in reducing the risk of patient misidentification in clinics.Copyright © 2021 the Author(s). Published by Wolters Kluwer Health, Inc.

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