Investig Clin Urol.  2022 May;63(3):301-308. 10.4111/icu.20210434.

Feasibility of a deep learning-based diagnostic platform to evaluate lower urinary tract disorders in men using simple uroflowmetry

• Bang S
• Tukhtaev S
• Ko KJ
• Han DH
• Baek M
• Jeon HG
• Cho BH
• Lee KS

• KMID: 2529351
• DOI: http://doi.org/10.4111/icu.20210434

Abstract

Purpose
To diagnose lower urinary tract symptoms (LUTS) in a noninvasive manner, we created a prediction model for bladder outlet obstruction (BOO) and detrusor underactivity (DUA) using simple uroflowmetry. In this study, we used deep learning to analyze simple uroflowmetry.
Materials and Methods
We performed a retrospective review of 4,835 male patients aged ≥40 years who underwent a urodynamic study at a single center. We excluded patients with a disease or a history of surgery that could affect LUTS. A total of 1,792 patients were included in the study. We extracted a simple uroflowmetry graph automatically using the ABBYY Flexicapture® image capture program (ABBYY, Moscow, Russia). We applied a convolutional neural network (CNN), a deep learning method to predict DUA and BOO. A 5-fold cross-validation average value of the area under the receiver operating characteristic (AUROC) curve was chosen as an evaluation metric. When it comes to binary classification, this metric provides a richer measure of classification performance. Additionally, we provided the corresponding average precision-recall (PR) curves.
Results
Among the 1,792 patients, 482 (26.90%) had BOO, and 893 (49.83%) had DUA. The average AUROC scores of DUA and BOO, which were measured using 5-fold cross-validation, were 73.30% (mean average precision [mAP]=0.70) and 72.23% (mAP=0.45), respectively.
Conclusions
Our study suggests that it is possible to differentiate DUA from non-DUA and BOO from non-BOO using a simple uroflowmetry graph with a fine-tuned VGG16, which is a well-known CNN model.

Keyword

Artificial intelligence; Bladder outlet obstruction; Detrusor underactivity; Lower urinary tract symptoms