• Masataka Motohashi, Yuki Funauchi, Takuya Adachi, Tomoyuki Fujioka, Naoya Otaka, Yuka Kamiko, Takashi Okada, Ukihide Tateishi, Atsushi Okawa, Toshitaka Yoshii, and Shingo Sato.
• Department of Orthopaedic Surgery, Tokyo Medical and Dental University (TMDU), Tokyo, Japan.
• Spine. 2024 Mar 15; 49 (6): 390397390-397.

Study DesignRetrospective diagnostic study.ObjectiveTo automatically detect osteolytic bone metastasis lesions in the thoracolumbar region using conventional computed tomography (CT) scans, we developed a new deep learning (DL)-based computer-aided detection model.Summary Of Background DataRadiographic detection of bone metastasis is often difficult, even for orthopedic surgeons and diagnostic radiologists, with a consequent risk for pathologic fracture or spinal cord injury. If we can improve detection rates, we will be able to prevent the deterioration of patients' quality of life at the end stage of cancer.Materials And MethodsThis study included CT scans acquired at Tokyo Medical and Dental University (TMDU) Hospital between 2016 and 2022. A total of 263 positive CT scans that included at least one osteolytic bone metastasis lesion in the thoracolumbar spine and 172 negative CT scans without bone metastasis were collected for the datasets to train and validate the DL algorithm. As a test data set, 20 positive and 20 negative CT scans were separately collected from the training and validation datasets. To evaluate the performance of the established artificial intelligence (AI) model, sensitivity, precision, F1-score, and specificity were calculated. The clinical utility of our AI model was also evaluated through observer studies involving six orthopaedic surgeons and six radiologists.ResultsOur AI model showed a sensitivity, precision, and F1-score of 0.78, 0.68, and 0.72 (per slice) and 0.75, 0.36, and 0.48 (per lesion), respectively. The observer studies revealed that our AI model had comparable sensitivity to orthopaedic or radiology experts and improved the sensitivity and F1-score of residents.ConclusionWe developed a novel DL-based AI model for detecting osteolytic bone metastases in the thoracolumbar spine. Although further improvement in accuracy is needed, the current AI model may be applied to current clinical practice.Level Of EvidenceLevel III.Copyright © 2023 The Author(s). Published by Wolters Kluwer Health, Inc.

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