Artificial Intelligence to Determine Correct Midsagittal Plane in Dynamic Transperineal Ultrasound

Abstract

Purpose To create and validate a machine learning(ML) model that allows for identifying the correct capture of the midsagittal plane in a dynamic ultrasound study, as well as establishing its concordance with a senior explorer and a junior explorer.

Methods Observational and prospective study with 90 patients without pelvic floor pathology. Each patient was given an ultrasound video where the midsagittal plane of the pelvic floor was recorded at rest and during the Valsalva maneuver. A segmentation model was used that was trained on a previously published article, generating the segmentations of the 90 new videos to create the model. The algorithm selected to build the model in this project was XGBoost(Gradient Boosting). To obtain a tabular dataset on which to train the model, feature engineering was carried out on the raw segmentation data. The concordance of the model, of a junior examiner and a senior examiner, with the expert examiner was studied using the kappa index.

Results The first 60 videos were used to train the model and the last 30 videos were reserved for the test set. The model presented a kappa index 0.930(p < 0.001) with very good agreement for detection of the correct midsagittal plane. The junior explorer presented a very good agreement (kappa index = 0.930(p < 0.001)). The senior explorer presented a kappa index 0.789(p < 0.001) (good agreement) for detection of the correct midsagittal plane.

Conclusion We have developed a model that allows determining the correct midsagittal plane captured through dynamic transperineal ultrasound with a level of agreement comparable to or greater than that of a junior or senior examiner, using expert examiner assessment as the gold standard.