Jihye Yun, PhD
Department of Radiology, Asan Medical Center, Seoul, South Korea
Department of Radiology, Asan Medical Center, Seoul, South Korea
Jihye Yun, Yura Ahn, Kyungjin Cho, Sang Young Oh, Sang Min Lee, Namkug Kim, and Joon Beom Seo
Background: Most artificial intelligence algorithms that interpret chest radiographs are restricted to an image from a single time point. However, in clinical practice, multiple radiographs are used for longitudinal follow-up, especially in intensive care units (ICUs).
Purpose: To develop and validate a deep learning algorithm using thoracic cage registration and subtraction to triage pairs of chest radiographs showing no change by using longitudinal follow-up data.
Materials and Methods: A deep learning algorithm was retrospectively developed using baseline and follow-up chest radiographs in adults from January 2011 to December 2018 at a tertiary referral hospital. Two thoracic radiologists reviewed randomly selected pairs of “change” and “no change” images to establish the ground truth, including normal or abnormal status. Algorithm performance was evaluated using area under the receiver operating characteristic curve (AUC) analysis in a validation set and temporally separated internal test sets (January 2019 to August 2021) from the emergency department (ED) and ICU. Threshold calibration for the test sets was conducted, and performance with 40% and 60% triage thresholds was assessed.
Results: This study included 3 304 996 chest radiographs in 329 036 patients (mean age, 59 years ± 14 [SD]; 170 433 male patients). The training set included 550 779 pairs of radiographs. The validation set included 1620 pairs (810 no change, 810 change). The test sets included 533 pairs (ED; 265 no change, 268 change) and 600 pairs (ICU; 310 no change, 290 change). The algorithm had AUCs of 0.77 (validation), 0.80 (ED), and 0.80 (ICU). With a 40% triage threshold, specificity was 88.4% (237 of 268 pairs) and 90.0% (261 of 290 pairs) in the ED and ICU, respectively. With a 60% triage threshold, specificity was 79.9% (214 of 268 pairs) and 79.3% (230 of 290 pairs) in the ED and ICU, respectively. For urgent findings (consolidation, pleural effusion, pneumothorax), specificity was 78.6%–100% (ED) and 85.5%–93.9% (ICU) with a 40% triage threshold.
Conclusion: The deep learning algorithm could triage pairs of chest radiographs showing no change while detecting urgent interval changes during longitudinal follow-up.
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Jooae Choe, Jihye Yun, Myeong Jun Kim, Yu Jin Oh, Seungbin Bae, Donghoon Yu, Joon Beom Seo, Sang Min Lee, Ho Yun Lee, European Radiology, May 2025.
Jooae Choe, Hye Jeon Hwang, Min Seon Kim, Jong Chul Ye, Gyutaek Oh, Sang Min Lee, Jihye Yun, Ho Yun Lee, Joo Sung Sun, Seulgi You, Jaeyoun Yi, Joon Beom Seo, European Journal of Radiology, Feburary 2025.
Kiduk Kim, Kyungjin Cho, Yujeong Eo, Jeeyoung Kim, Jihye Yun, Yura Ahn, Joon Beom Seo, Gil-Sun Hong, Namkug Kim, Journal of Imaging Informatics in Medicine, September 2024.
Sungwon Ham, Beomhee Park, Jihye Yun, Sang Min Lee, Joon Beom Seo, Namkug Kim, International Journal of Imaging Systems and Technology, September 2024.
Kyung Hwa Lee, Jungwook Lee, Gwang Hyeon Choi, Jihye Yun, Jiseon Kang, Jonggi Choi, Kang Mo Kim, Namkug Kim , Journal of Imaging Informatics in Medicine, August2024.
Han Na Lee, Jin An, Miji Lee, Hye Jeon Hwang, Jooae Choe, Jihye Yun, Ji-Hyang Lee, Min-Hye Kim, Young-Joo Cho, Sang Min Lee, Tae-Bum Kim, Joon Beom Seo, Korean Journal of Radiology, June 2024.
Jooae Choe, Hye Young Choi, Sang Min Lee, Sang Young Oh, Hye Jeon Hwang, Namkug Kim, Jihye Yun, Jae Seung Lee, Yeon-Mok Oh, Donghoon Yu, Byeongsoo Kim, Joon Beom Seo, Scientific Reports, February 2024.
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Ji Young Choi, Jihye Yun, Subin Heo, Dong Wook Kim, Sang Hyun Choi, Jiyoung Yoon, Kyuwon Kim, Kee Wook Jung, and Seung-Jae Myung, Korean Journal of Radiology, November 2023.
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Gwang Hyeon Choi, Jihye Yun, Jonggi Choi, Danbi Lee, Ju Hyun Shim, Han Chu Lee, Young-Hwa Chung, Yung Sang Lee, Beomhee Park, Namkug Kim, Kang Mo Kim, Scientific Reports, September 2020.
Jongha Park, Jihye Yun, Namkug Kim, Beomhee Park, Yongwon Cho, Hee Jun Park, Mijeong Song, Minho Lee, Joon Beom Seo, Journal of Digital Imaging, February 2020.
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Jihye Yun, Ji Eun Park, Hyunna Lee, Sungwon Ham, Namkug Kim, Ho Sung Kim, Scientific Reports, April 2019.
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