A Deep Learning Model for the Diagnosis and Discrimination of Gram-Positive and Gram-Negative Bacterial Pneumonia for Children Using Chest Radiography Images and Clinical Information

Abstract

Ru Wen,1– 3,* Peng Xu,3,* Yimin Cai,1,* Fang Wang,3 Mengfei Li,3 Xianchun Zeng,2 Chen Liu3 1Medical College, Guizhou University, Guizhou, 550000, People’s Republic of China; 2Department of Medical Imaging, Guizhou Provincial People Hospital, Guiyang City, Guizhou Province, 550000, People’s Republic of China; 3Department of Radiology, Southwest Hospital, Army Medical University (Third Military Medical University), Chongqing, 400038, People’s Republic of China*These authors contributed equally to this workCorrespondence: Chen Liu, Department of Radiology, Southwest Hospital, Army Medical University (Third Military Medical University), 30 Gao Tan Yan St, Chongqing, 400038, People’s Republic of China, Tel [phone], Email [email protected] Xianchun Zeng, Department of Medical Imaging, Guizhou Provincial People Hospital, No. 83, East Zhongshan Road, Nanming District, Guiyang City, Guizhou Province, 550000, People’s Republic of China, Tel [phone], Email [email protected]: This study aimed to develop a deep learning model based on chest radiography (CXR) images and clinical data to accurately classify gram-positive and gram-negative bacterial pneumonia in children to guide the use of antibiotics.Methods: We retrospectively collected CXR images along with clinical information for gram-positive (n=447) and gram-negative (n=395) bacterial pneumonia in children from January 1, 2016, to June 30, 2021. Four types of machine learning models based on clinical data and six types of deep learning algorithm models based on image data were constructed, and multi-modal decision fusion was performed.Results: In the machine learning models, CatBoost, which only used clinical data, had the best performance; its area under the receiver operating characteristic curve (AUC) was significantly higher than that of the other models (P< 0.05). The incorporation of clinical information improved the performance of deep learning models that relied solely on image-based classification. Consequently, AUC and F1 increased by 5.6% and 10.2% on average, respectively. The best quality was achieved with ResNet101 (model accuracy: 0.75, recall rate: 0.84, AUC: 0.803, F1: 0.782).Conclusion: Our study established a pediatric bacterial pneumonia model that utilizes CXR and clinical data to accurately classify cases of gram-negative and gram-positive bacterial pneumonia. The results confirmed that the addition of image data to the convolutional neural network model significantly improved its performance. While the CatBoost-based classifier had greater advantages owing to a smaller dataset, the quality of the Resnet101 model trained using multi-modal data was comparable to that of the CatBoost model, even with a limited number of samples.Keywords: pediatrics, antibiotics, clinical data, X-ray, multi-modal data

Keywords

• pediatrics
• antibiotics
• clinical data
• x-ray
• multi-modal data