AUTHOR=Duan Bo , Pan Li-Li , Chen Wen-Xia , Qiao Zhong-Wei , Xu Zheng-Min 

TITLE=An in-depth discussion of cholesteatoma, middle ear Inflammation, and langerhans cell histiocytosis of the temporal bone, based on diagnostic results

JOURNAL=Frontiers in Pediatrics

VOLUME=Volume 10 - 2022

YEAR=2022

URL=https://www.frontiersin.org/journals/pediatrics/articles/10.3389/fped.2022.809523

DOI=10.3389/fped.2022.809523

ISSN=2296-2360

ABSTRACT=Objectives: This study aimed to conduct an in-depth investigation of the learning framework used for deriving diagnostic results of temporal bone diseases, including cholesteatoma and Langerhans cell histiocytosis (LCH). In addition, middle-ear inflammation (MEI) was diagnosed by computed tomography (CT) scanning of the temporal bone in pediatric patients.
Design: A total of 119 patients were included in this retrospective study; among them, 40 had MEI, 38 had histology-proven cholesteatoma, and 41 had histology-proven LCH of the temporal bone. Each of the 119 patients was matched with one-third of the disease labels. The study included otologists and radiologists, and the reference criteria were histopathology results (70% of cases for training and 30% for validation). A multilayer perceptron artificial neural network (VGG16_BN) was employed and classified, based on radiometrics. This framework structure was compared and analyzed by clinical experts according to CT images and performance.
Results: The deep learning framework results vs. a physician’s diagnosis, respectively, in multi-classification tasks were as follows.
Receiver operating characteristic (ROC) (cholesteatoma): (0.98 vs. 0.91), LCH (0.99 vs. 0.98), MEI (0.99 vs. 0.85).
Accuracy: (cholesteatoma): (0.99 vs. 0.89), LCH (0.99 vs. 0.97), MEI (0.99 vs. 0.89).
Sensitivity: (cholesteatoma): (0.96 vs. 0.97), LCH (0.99 vs. 0.98), MEI (1 vs. 0.69).
Specificity: (cholesteatoma) (1 vs. 0.89), LCH (0.99 vs. 0.97), MEI (0.99 vs. 0.89).
Conclusions: This paper presents a research and learning framework for the diagnosis of cholesteatoma, MEI, and temporal bone LCH in children, based on CT scans. The research framework performed better than the clinical experts.