The Lancet: Digital Health (Sep 2023)
Pan-mediastinal neoplasm diagnosis via nationwide federated learning: a multicentre cohort study
- Ruijie Tang, PhD,
- Hengrui Liang, PhD,
- Yuchen Guo, PhD,
- Zhigang Li, PhD,
- Zhichao Liu, MD,
- Xu Lin, PhD,
- Zeping Yan, BS,
- Jun Liu, PhD,
- Xin Xu, PhD,
- Wenlong Shao, PhD,
- Shuben Li, PhD,
- Wenhua Liang, ProfPhD,
- Wei Wang, PhD,
- Fei Cui, PhD,
- Huanghe He, PhD,
- Chao Yang, PhD,
- Long Jiang, PhD,
- Haixuan Wang, MD,
- Huai Chen, MD,
- Chenguang Guo, MD,
- Haipeng Zhang, MD,
- Zebin Gao, PhD,
- Yuwei He, PhD,
- Xiangru Chen, ME,
- Lei Zhao, PhD,
- Hong Yu, MD,
- Jian Hu, ProfPhD,
- Jiangang Zhao, MD,
- Bin Li, PhD,
- Ci Yin, MD,
- Wenjie Mao, MD,
- Wanli Lin, MD,
- Yujie Xie, MD,
- Jixian Liu, MD,
- Xiaoqiang Li, PhD,
- Dingwang Wu, MD,
- Qinghua Hou, MD,
- Yongbing Chen, PhD,
- Donglai Chen, PhD,
- Yuhang Xue, MD,
- Yi Liang, MD,
- Wenfang Tang, MD,
- Qi Wang, ProfPhD,
- Encheng Li, MD,
- Hongxu Liu, MD,
- Guan Wang, MD,
- Pingwen Yu, MD,
- Chun Chen, ProfPhD,
- Bin Zheng, PhD,
- Hao Chen, MD,
- Zhe Zhang, MD,
- Lunqing Wang, MD,
- Ailin Wang, MD,
- Zongqi Li, MD,
- Junke Fu, MD,
- Guangjian Zhang, MD,
- Jia Zhang, MD,
- Bohao Liu, MD,
- Jian Zhao, MD,
- Boyun Deng, MD,
- Yongtao Han, PhD,
- Xuefeng Leng, PhD,
- Zhiyu Li, MD,
- Man Zhang, MD,
- Changling Liu, MD,
- Tianhu Wang, MD,
- Zhilin Luo, MD,
- Chenglin Yang, MD,
- Xiaotong Guo, MD,
- Kai Ma, MD,
- Lixu Wang, MD,
- Wenjun Jiang, MD,
- Xu Han, MD,
- Qing Wang, MD,
- Kun Qiao, MD,
- Zhaohua Xia, MD,
- Shuo Zheng, MD,
- Chenyang Xu, MD,
- Jidong Peng, MD,
- Shilong Wu, MD,
- Zhifeng Zhang, MD,
- Haoda Huang, MD,
- Dazhi Pang, MD,
- Qiao Liu, BSN,
- Jinglong Li, MD,
- Xueru Ding, MD,
- Xiang Liu, MD,
- Liucheng Zhong, MD,
- Yutong Lu, MD,
- Feng Xu, PhD,
- Qionghai Dai, ProfPhD,
- Jianxing He, ProfPhD
Affiliations
- Ruijie Tang, PhD
- School of Software, Beijing National Research Center for Information Science and Technology, Institute for Brain and Cognitive Sciences, Tsinghua University, Beijing, China
- Hengrui Liang, PhD
- Department of Thoracic Oncology and Surgery, China State Key Laboratory of Respiratory Disease & National Clinical Research Center for Respiratory Disease, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
- Yuchen Guo, PhD
- Institute for Brain and Cognitive Sciences, Beijing National Research Center for Information Science and Technology, Tsinghua University, Beijing, China
- Zhigang Li, PhD
- Department of Thoracic Surgery, Shanghai Chest Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Zhichao Liu, MD
- Department of Thoracic Surgery, Shanghai Chest Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Xu Lin, PhD
- Department of Thoracic Surgery, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
- Zeping Yan, BS
- Department of Thoracic Oncology and Surgery, China State Key Laboratory of Respiratory Disease & National Clinical Research Center for Respiratory Disease, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China; Guangdong Association of Thoracic Disease, Guangzhou, China
- Jun Liu, PhD
- Department of Thoracic Oncology and Surgery, China State Key Laboratory of Respiratory Disease & National Clinical Research Center for Respiratory Disease, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
- Xin Xu, PhD
- Department of Thoracic Oncology and Surgery, China State Key Laboratory of Respiratory Disease & National Clinical Research Center for Respiratory Disease, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
- Wenlong Shao, PhD
- Department of Thoracic Oncology and Surgery, China State Key Laboratory of Respiratory Disease & National Clinical Research Center for Respiratory Disease, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
- Shuben Li, PhD
- Department of Thoracic Oncology and Surgery, China State Key Laboratory of Respiratory Disease & National Clinical Research Center for Respiratory Disease, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
- Wenhua Liang, ProfPhD
- Department of Thoracic Oncology and Surgery, China State Key Laboratory of Respiratory Disease & National Clinical Research Center for Respiratory Disease, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
- Wei Wang, PhD
- Department of Thoracic Oncology and Surgery, China State Key Laboratory of Respiratory Disease & National Clinical Research Center for Respiratory Disease, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
- Fei Cui, PhD
- Department of Thoracic Oncology and Surgery, China State Key Laboratory of Respiratory Disease & National Clinical Research Center for Respiratory Disease, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
- Huanghe He, PhD
- Department of Thoracic Oncology and Surgery, China State Key Laboratory of Respiratory Disease & National Clinical Research Center for Respiratory Disease, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
- Chao Yang, PhD
- Department of Thoracic Oncology and Surgery, China State Key Laboratory of Respiratory Disease & National Clinical Research Center for Respiratory Disease, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
- Long Jiang, PhD
- Department of Thoracic Oncology and Surgery, China State Key Laboratory of Respiratory Disease & National Clinical Research Center for Respiratory Disease, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
- Haixuan Wang, MD
- Department of Thoracic Oncology and Surgery, China State Key Laboratory of Respiratory Disease & National Clinical Research Center for Respiratory Disease, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
- Huai Chen, MD
- Department of Radiology, The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
- Chenguang Guo, MD
- Guangdong Association of Thoracic Disease, Guangzhou, China
- Haipeng Zhang, MD
- Guangdong Association of Thoracic Disease, Guangzhou, China
- Zebin Gao, PhD
- School of Information Science and Technology, Fudan University, Shanghai, China
- Yuwei He, PhD
- Hangzhou Zhuoxi Institute of Brain and Intelligence, Hangzhou, China
- Xiangru Chen, ME
- Hangzhou Zhuoxi Institute of Brain and Intelligence, Hangzhou, China
- Lei Zhao, PhD
- Department of Physiology, School of Basic Medical Sciences, Guangzhou Medical University, Guangzhou, China
- Hong Yu, MD
- Department of Radiology, Shanghai Chest Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Jian Hu, ProfPhD
- Department of Thoracic Surgery, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
- Jiangang Zhao, MD
- Department of Thoracic Surgery, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
- Bin Li, PhD
- Department of Thoracic Surgery, Lanzhou University Second Hospital, Lanzhou University Second Clinical Medical College, Lanzhou, China
- Ci Yin, MD
- Department of Thoracic Surgery, Lanzhou University Second Hospital, Lanzhou University Second Clinical Medical College, Lanzhou, China
- Wenjie Mao, MD
- Department of Thoracic Surgery, Lanzhou University Second Hospital, Lanzhou University Second Clinical Medical College, Lanzhou, China
- Wanli Lin, MD
- Department of Thoracic Surgery, Gaozhou People's Hospital, Gaozhou, China
- Yujie Xie, MD
- Department of Thoracic Surgery, Gaozhou People's Hospital, Gaozhou, China
- Jixian Liu, MD
- Department of Thoracic Surgery, Peking University Shenzhen Hospital, Shenzhen, China
- Xiaoqiang Li, PhD
- Department of Thoracic Surgery, Peking University Shenzhen Hospital, Shenzhen, China
- Dingwang Wu, MD
- Department of Thoracic Surgery, Peking University Shenzhen Hospital, Shenzhen, China
- Qinghua Hou, MD
- Department of Thoracic Surgery, Peking University Shenzhen Hospital, Shenzhen, China
- Yongbing Chen, PhD
- Department of Thoracic Surgery, The Second Affiliated Hospital of Soochow University, Suzhou, China
- Donglai Chen, PhD
- Department of Thoracic Surgery, Zhongshan Hospital Fudan University, Shanghai, China
- Yuhang Xue, MD
- Department of Thoracic Surgery, The Second Affiliated Hospital of Soochow University, Suzhou, China
- Yi Liang, MD
- Department of Cardiothoracic Surgery, Zhongshan City People's Hospital, Zhongshan, China
- Wenfang Tang, MD
- Department of Cardiothoracic Surgery, Zhongshan City People's Hospital, Zhongshan, China
- Qi Wang, ProfPhD
- Department of Respiratory Medicine, The Second Hospital of Dalian Medical University, Dalian, China
- Encheng Li, MD
- Department of Respiratory Medicine, The Second Hospital of Dalian Medical University, Dalian, China
- Hongxu Liu, MD
- Department of Thoracic Surgery, Cancer Hospital of Dalian University of Technology, Liaoning Cancer Hospital & Institute, Shenyang, China
- Guan Wang, MD
- Department of Thoracic Surgery, Cancer Hospital of Dalian University of Technology, Liaoning Cancer Hospital & Institute, Shenyang, China
- Pingwen Yu, MD
- Department of Thoracic Surgery, Cancer Hospital of Dalian University of Technology, Liaoning Cancer Hospital & Institute, Shenyang, China
- Chun Chen, ProfPhD
- Department of Thoracic Surgery, Fujian Medical University Union Hospital, Fuzhou, China
- Bin Zheng, PhD
- Department of Thoracic Surgery, Fujian Medical University Union Hospital, Fuzhou, China
- Hao Chen, MD
- Department of Thoracic Surgery, Fujian Medical University Union Hospital, Fuzhou, China
- Zhe Zhang, MD
- Department of Thoracic Surgery, Qingdao Municipal Hospital, University of Health and Rehabilitation Sciences, Qingdao, China
- Lunqing Wang, MD
- Department of Thoracic Surgery, Qingdao Municipal Hospital, University of Health and Rehabilitation Sciences, Qingdao, China
- Ailin Wang, MD
- Department of Thoracic Surgery, Qingdao Municipal Hospital, University of Health and Rehabilitation Sciences, Qingdao, China
- Zongqi Li, MD
- Department of Thoracic Surgery, Qingdao Municipal Hospital, University of Health and Rehabilitation Sciences, Qingdao, China
- Junke Fu, MD
- Department of Thoracic Surgery, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
- Guangjian Zhang, MD
- Department of Thoracic Surgery, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
- Jia Zhang, MD
- Department of Thoracic Surgery, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
- Bohao Liu, MD
- Department of Thoracic Surgery, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
- Jian Zhao, MD
- Department of Chest Surgery, Affiliated Cancer Hospital & Institute of Guangzhou Medical University, Guangzhou, China
- Boyun Deng, MD
- Department of Thoracic Surgery, Central People's Hospital of Zhanjiang, Zhanjiang, China
- Yongtao Han, PhD
- Division of Thoracic Surgery, Sichuan Cancer Hospital & Institute, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
- Xuefeng Leng, PhD
- Division of Thoracic Surgery, Sichuan Cancer Hospital & Institute, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
- Zhiyu Li, MD
- Division of Thoracic Surgery, Sichuan Cancer Hospital & Institute, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
- Man Zhang, MD
- Department of Thoracic Oncology and Surgery, China State Key Laboratory of Respiratory Disease & National Clinical Research Center for Respiratory Disease, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China; Department of Thoracic Surgery, The Affiliated Hospital of Inner Mongolia Medical University, Hohhot, China
- Changling Liu, MD
- Department of Thoracic Surgery, The Affiliated Hospital of Inner Mongolia Medical University, Hohhot, China
- Tianhu Wang, MD
- Department of Thoracic Surgery, The Third Affiliated Hospital of Chongqing Medical University, Chongqing, China
- Zhilin Luo, MD
- Department of Thoracic Surgery, The Third Affiliated Hospital of Chongqing Medical University, Chongqing, China
- Chenglin Yang, MD
- National Cancer Center, National Clinical Research Center for Cancer, Cancer Hospital & Shenzhen Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shenzhen, China
- Xiaotong Guo, MD
- National Cancer Center, National Clinical Research Center for Cancer, Cancer Hospital & Shenzhen Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shenzhen, China
- Kai Ma, MD
- National Cancer Center, National Clinical Research Center for Cancer, Cancer Hospital & Shenzhen Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shenzhen, China
- Lixu Wang, MD
- National Cancer Center, National Clinical Research Center for Cancer, Cancer Hospital & Shenzhen Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shenzhen, China
- Wenjun Jiang, MD
- Department of Thoracic Surgery, The Fourth Affiliated Hospital of China Medical University, Shenyang, China
- Xu Han, MD
- Department of Thoracic Surgery, The Fourth Affiliated Hospital of China Medical University, Shenyang, China
- Qing Wang, MD
- Department of Thoracic Surgery, The Fourth Affiliated Hospital of China Medical University, Shenyang, China
- Kun Qiao, MD
- Department of Thoracic Surgery, The Third People's Hospital of Shenzhen, Shenzhen, China
- Zhaohua Xia, MD
- Department of Thoracic Surgery, The Third People's Hospital of Shenzhen, Shenzhen, China
- Shuo Zheng, MD
- Department of Thoracic Surgery, The Third People's Hospital of Shenzhen, Shenzhen, China
- Chenyang Xu, MD
- Department of Thoracic Surgery, Ganzhou People's Hospital, Ganzhou, China
- Jidong Peng, MD
- Department of Radiology, Ganzhou People's Hospital, Ganzhou, China
- Shilong Wu, MD
- Department of Thoracic Surgery, Ganzhou People's Hospital, Ganzhou, China
- Zhifeng Zhang, MD
- Department of Cardiothoracic Surgery, Jieyang People's Hospital, Jieyang, China
- Haoda Huang, MD
- Department of Cardiothoracic Surgery, Jieyang People's Hospital, Jieyang, China
- Dazhi Pang, MD
- Department of Thoracic Surgery, The University of Hong Kong-Shenzhen Hospital, Shenzhen, China
- Qiao Liu, BSN
- Department of Thoracic Surgery, The University of Hong Kong-Shenzhen Hospital, Shenzhen, China
- Jinglong Li, MD
- Department of Thoracic Surgery, The University of Hong Kong-Shenzhen Hospital, Shenzhen, China
- Xueru Ding, MD
- Department of Thoracic Surgery, The University of Hong Kong-Shenzhen Hospital, Shenzhen, China
- Xiang Liu, MD
- Department of Thoracic Surgery, The Second Affiliated Hospital, Hengyang Medical School, University of South China, Hengyang, China
- Liucheng Zhong, MD
- Department of Radiology, Huizhou First People's Hospital, Huizhou, China
- Yutong Lu, MD
- School of Computer Science and Engineering, Sun Yat-sen University, National Supercomputer Center, Guangzhou, China
- Feng Xu, PhD
- School of Software, Beijing National Research Center for Information Science and Technology, Institute for Brain and Cognitive Sciences, Tsinghua University, Beijing, China; Correspondence to: Dr Feng Xu, School of Software, Beijing National Research Center for Information Science and Technology, Institute for Brain and Cognitive Sciences, Tsinghua University, Beijing 100084, China
- Qionghai Dai, ProfPhD
- Institute for Brain and Cognitive Sciences, Department of Automation, Beijing National Research Center for Information Science and Technology, Tsinghua University, Beijing, China; Correspondence to: Prof Qionghai Dai, Institute for Brain and Cognitive Sciences, Department of Automation, Beijing National Research Center for Information Science and Technology, Tsinghua University, Beijing 100084, China
- Jianxing He, ProfPhD
- Department of Thoracic Oncology and Surgery, China State Key Laboratory of Respiratory Disease & National Clinical Research Center for Respiratory Disease, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China; Correspondence to: Prof Jianxing He, Department of Thoracic Oncology and Surgery, China State Key Laboratory of Respiratory Disease & National Clinical Research Center for Respiratory Disease, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou 510120, China
- Journal volume & issue
-
Vol. 5,
no. 9
pp. e560 – e570
Abstract
Summary: Background: Mediastinal neoplasms are typical thoracic diseases with increasing incidence in the general global population and can lead to poor prognosis. In clinical practice, the mediastinum's complex anatomic structures and intertype confusion among different mediastinal neoplasm pathologies severely hinder accurate diagnosis. To solve these difficulties, we organised a multicentre national collaboration on the basis of privacy-secured federated learning and developed CAIMEN, an efficient chest CT-based artificial intelligence (AI) mediastinal neoplasm diagnosis system. Methods: In this multicentre cohort study, 7825 mediastinal neoplasm cases and 796 normal controls were collected from 24 centres in China to develop CAIMEN. We further enhanced CAIMEN with several novel algorithms in a multiview, knowledge-transferred, multilevel decision-making pattern. CAIMEN was tested by internal (929 cases at 15 centres), external (1216 cases at five centres and a real-world cohort of 11 162 cases), and human–AI (60 positive cases from four centres and radiologists from 15 institutions) test sets to evaluate its detection, segmentation, and classification performance. Findings: In the external test experiments, the area under the receiver operating characteristic curve for detecting mediastinal neoplasms of CAIMEN was 0·973 (95% CI 0·969–0·977). In the real-world cohort, CAIMEN detected 13 false-negative cases confirmed by radiologists. The dice score for segmenting mediastinal neoplasms of CAIMEN was 0·765 (0·738–0·792). The mediastinal neoplasm classification top-1 and top-3 accuracy of CAIMEN were 0·523 (0·497–0·554) and 0·799 (0·778–0·822), respectively. In the human–AI test experiments, CAIMEN outperformed clinicians with top-1 and top-3 accuracy of 0·500 (0·383–0·633) and 0·800 (0·700–0·900), respectively. Meanwhile, with assistance from the computer aided diagnosis software based on CAIMEN, the 46 clinicians improved their average top-1 accuracy by 19·1% (0·345–0·411) and top-3 accuracy by 13·0% (0·545–0·616). Interpretation: For mediastinal neoplasms, CAIMEN can produce high diagnostic accuracy and assist the diagnosis of human experts, showing its potential for clinical practice. Funding: National Key R&D Program of China, National Natural Science Foundation of China, and Beijing Natural Science Foundation.