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Intelligent anatomy of spinal tuberculosis

Region-specific performance analysis of a deep learning model based on multi-center CT axial images

Bibliographic Data

ID21113104
AuthorsSen Mo (0009-0002-6911-7461, Guangxi Medical University), Chong Liu (0009-0007-7425-8847, Guangxi Medical University), Jiang Xue (0000-0003-3995-9318, Guangxi Medical University), Jiarui Chen (0000-0003-2005-288X, First Affiliated Hospital of GuangXi Medical University), J Q Chen (Guangxi Medical University), Hui Li (0000-0001-9355-1116, Guangxi Medical University), Hao Li (0000-0001-5192-5458, First Affiliated Hospital of GuangXi Medical University), Zhaojun Lu (0000-0002-5467-6597, Guangxi Medical University), Zhongxian Zhou (Guangxi Medical University), Xiaopeng Qin (0000-0002-1726-6564, Guangxi Medical University), Rongqing He (Guangxi Medical University), Boli Qin (Guangxi Medical University), Yahui Huang (The Fourth People's Hospital), Wei Wei (0000-0003-1852-2811, Guangxi Medical University, corresponding author), Xinli Zhan (0000-0002-6936-481X, Guangxi Medical University, corresponding author)
Year2026
Volume36
Issue1
Publication date2026-12-31
Open AccessYes
TypeARTICLE
VenueCritical Public Health (JOURNAL)
Journal identifiersISSN: 0958-1596 • E-ISSN: 1469-3682
PublisherInforma UK Limited (PUBLISHER • GB)
DOI10.1080/09581596.2026.2670803
OpenAlexW7166522498
LanguageEN
References cited13

Objective To solve the problems of insufficient model generalization ability and unclear influence of anatomical regional differences in the intelligent diagnosis of spinal tuberculosis, and to construct a multi-center CT deep learning model.Method This study adopted a retrospective multi-center design and collected CT images of 1025 patients with spinal tuberculosis from 4 hospitals in the southwest region from 2012 to 2024. In the preprocessing stage, DICOM is converted to 224x224 RGB format and marked by senior radiologist. A binary classification model was constructed based on ResNet50 transfer learning and trained for 100 rounds using the Adam optimizer (lr = 1e-4, batch = 8). The verification framework is divided into three-stage validation framework: Center 1, 80% training of data/verification within 20%; Centers 2 to 4 were combined into the external test set and subdivided by cervical vertebrae/thoracic vertebrae/lumbar vertebrae/sacrum vertebrae. The evaluation indicators include AUC, accuracy, precision, recall and F1 score, supplemented by Grad-CAM visualization.Result The internal validation performance of the model was excellent (AUC = 0.90), but the external test decreased (AUC = 0.88). Anatomical stratification showed that the cervical vertebrae were the weakest (AUC = 0.70), the lumbar vertebrae were the most stable (AUC = 0.91), the sacral vertebrae had high sensitivity (recall rate = 0.756), and the thoracic vertebrae had a high false positive rate.Conclusion The anatomical dependence of diagnostic performance was revealed for the first time, and tiered deployment strategy is suggested: priority deployment of high-stability segments (lumbar vertebrae/sacrum), low-efficiency regions (cervical vertebrae) combined with MRI verification, and hierarchical data standards were established to optimize the algorithm

Computed tomography · Deep learning · Deep neural networks · Medical imaging · COVID-19 diagnosis using AI · Infectious Diseases and Tuberculosis · Medical Imaging and Analysis

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