본문 바로가기
KERD
논문KCI 등재

Development of an Automatic Interpretation Algorithm for Uroflowmetry Results: Application of Artificial Intelligence

0

조회

0

다운로드

1

인용

0

참고문헌

키워드

초록

Purpose: To develop an automatic interpretation system for uroflowmetry (UFM) results using machine learning (ML), a form of artificial intelligence (AI). Methods: A prospectively collected 1,574 UFM results (1,031 males, 543 females) with voided volume>150 mL was labelled as normal, borderline, or abnormal by 3 urologists. If the 3 experts disagreed, the majority decision was accepted. Abnormality was defined as a condition in which a urologist judges from the UFM results that further evaluation is required and that the patient should visit a urology clinic. To develop the optimal automatic interpretation system, we applied 4 ML algorithms and 2 deep learning (DL) algorithms. ML models were trained with all UFM parameters. DL models were trained to digitally analyze 2-dimensional images of UFM curves. Results: The automatic interpretation algorithm achieved a maximum accuracy of 88.9% in males and 90.8% in females when using 6 parameters: voided volume, maximum flow rate, time to maximal flow rate, average flow rate, flow time, and voiding time. In females, the DL models showed a dramatic improvement in accuracy over the other models, reaching 95.4% accuracy in the convolutional neural network model. The performance of the DL models in clinical discrimination was outstanding in both genders, with an area under the curve of up to 0.957 in males and 0.974 in females. Conclusions: We developed an automatic interpretation algorithm for UFM results by training AI models using 6 key parameters and the shape of the curve; this algorithm agreed closely with the decisions of urology specialists.

Abstract

Purpose: To develop an automatic interpretation system for uroflowmetry (UFM) results using machine learning (ML), a form of artificial intelligence (AI). Methods: A prospectively collected 1,574 UFM results (1,031 males, 543 females) with voided volume>150 mL was labelled as normal, borderline, or abnormal by 3 urologists. If the 3 experts disagreed, the majority decision was accepted. Abnormality was defined as a condition in which a urologist judges from the UFM results that further evaluation is required and that the patient should visit a urology clinic. To develop the optimal automatic interpretation system, we applied 4 ML algorithms and 2 deep learning (DL) algorithms. ML models were trained with all UFM parameters. DL models were trained to digitally analyze 2-dimensional images of UFM curves. Results: The automatic interpretation algorithm achieved a maximum accuracy of 88.9% in males and 90.8% in females when using 6 parameters: voided volume, maximum flow rate, time to maximal flow rate, average flow rate, flow time, and voiding time. In females, the DL models showed a dramatic improvement in accuracy over the other models, reaching 95.4% accuracy in the convolutional neural network model. The performance of the DL models in clinical discrimination was outstanding in both genders, with an area under the curve of up to 0.957 in males and 0.974 in females. Conclusions: We developed an automatic interpretation algorithm for UFM results by training AI models using 6 key parameters and the shape of the curve; this algorithm agreed closely with the decisions of urology specialists.

참고문헌 (26)

  1. Gammie A, "The fundamentals of uroflowmetry practice, based on International Continence Society good urodynamic practices recommendations", Neurourol Urodyn, 37(S6), pp.S44~S49 (2018)
  2. Schäfer W, "Good urodynamic practices: Uroflowmetry, filling cystometry, and pressure-flow studies", Neurourol Urodyn, 21, pp.261~274 (2002)
  3. 이광석, "Clinical Factors Associated With the Feeling of Incomplete Bladder Emptying in Women With Little Postvoided Residue", International Neurourology Journal, 24(2), pp.172~179 (2020), 대한배뇨장애요실금학회[DOI]
  4. Jørgensen JB, "Uroflowmetry", Urol Clin North Am, 23, pp.237~242 (1996)
  5. Krhut J, "Comparison between uroflowmetry and sonouroflowmetry in recording of urinary flow in healthy men", Int J Urol, 22, pp.761~765 (2015)
  6. Gärtner M, "Evaluation of voiding parameters in healthy women using sound analysis", Low Urin Tract Symptoms, 10, pp.12~16 (2018)
  7. Zvarova K, "Recording urinary flow and lower urinary tract symptoms using sonouroflowmetry", Can J Urol, 18, pp.5689~5694 (2011)
  8. 이영주, "A Novel Mobile Acoustic Uroflowmetry: Comparison With Contemporary Uroflowmetry", International Neurourology Journal, 25(2), pp.150~156 (2021), 대한배뇨장애요실금학회[DOI]
  9. Costantini E, "Uroflowmetry in female voiding disturbances", Neurourol Urodyn, 22, pp.569~573 (2003)
  10. Liu YB, "Inter-observer, intra-observer and intra-individual reliability of uroflowmetry tests in aged men: a generalizability theory approach", Low Urin Tract Symptoms, 6, pp.76~80 (2014)
  11. Landis JR, "The measurement of observer agreement for categorical data", Biometrics, 33, pp.159~174 (1977)
  12. Mandrekar JN, "Receiver operating characteristic curve in diagnostic test assessment", J Thorac Oncol, 5, pp.1315~1316 (2010)
  13. Sorel MR, "Uroflowmetry in healthy women : a systematic review", Neurourol Urodyn, 36, pp.953~959 (2017)
  14. Sand PK, "Urodynamics and the evaluation of female incontinence: a practical guide", pp.6~10 (1995), Springer
  15. Boci R, "Home uroflowmetry : improved accuracy in outflow assessment", Neurourol Urodyn, 18, pp.25~32 (1999)
  16. Porru D, "Home and office uroflowmetry for evaluation of LUTS from benign prostatic enlargement", Prostate Cancer Prostatic Dis, 8, pp.45~49 (2005)
  17. Bray A, "Methods and value of home uroflowmetry in the assessment of men with lower urinary tract symptoms : a literature review", Neurourol Urodyn, 31, pp.7~12 (2012)
  18. Hansen MV, "The use of a simple home flow test as a quality indicator for male patients treated for lower urinary tract symptoms suggestive of bladder outlet obstruction", Eur Urol, 32, pp.34~38 (1997)
  19. Yuan-Hong Jiang, "Frontiers in the Clinical Applications of Botulinum Toxin A as Treatment for Neurogenic Lower Urinary Tract Dysfunction", International Neurourology Journal, 24(4), pp.301~312 (2020), 대한배뇨장애요실금학회[DOI]
  20. Pel JJ, "Development of a low-cost flow meter to grade the maximum flow rate", Neurourol Urodyn, 21, pp.48~54 (2002)
  21. Sonke GS, "A method for estimating within-patient variability in maximal urinary flow rate adjusted for voided volume", Urology, 59, pp.368~372 (2002)
  22. Gratzke C, "EAU guidelines on the assessment of nonneurogenic male lower urinary tract symptoms including benign prostatic obstruction", Eur Urol, 67, pp.1099~1109 (2015)
  23. Oelke M, "Diagnostic accuracy of noninvasive tests to evaluate bladder outlet obstruction in men: detrusor wall thickness, uroflowmetry, postvoid residual urine, and prostate volume", Eur Urol, 52, pp.827~834 (2007)
  24. Jørgensen JB, "Mechanical versus visual evaluation of urinary flow curves and patterns", Urol Int, 51, pp.15~18 (1993)
  25. Gacci M, "Visual assessment of uroflowmetry curves : description and interpretation by urodynamists", World J Urol, 25, pp.333~337 (2007)
  26. Grino PB, "Maximum urinary flow rate by uroflowmetry : automatic or visual interpretation", J Urol, 149, pp.339~341 (1993)

관련 논문AI추천

Deep Learning-Based Uroflowmetry Curve Analysis Improves the Noninvasive Diagnosis of Lower Urinary Tract SymptomsChung Un Lee, Deok-Hyun Han, Jong Hoon Lee, Jung Hyun Kim, Kwang Jin Ko, Myung Jin Chung, Yungon Lee대한배뇨장애요실금학회 · International Neurourology Journal2025 · 제29권 제1호Real-Time Typical Urodynamic Signal Recognition System Using Deep LearningDi Chen, Limin Liao, Ping Zhong, Xin Liu대한배뇨장애요실금학회 · International Neurourology Journal2025 · 제29권 제1호Machine Learning Models for the Noninvasive Diagnosis of Bladder Outlet Obstruction and Detrusor Underactivity in Men With Lower Urinary Tract Symptoms고광진, 박위진, 신형경, 염익준, 이규성, 한덕현대한배뇨장애요실금학회 · International Neurourology Journal2024 · 제28권 제1호A Novel Mobile Acoustic Uroflowmetry: Comparison With Contemporary Uroflowmetry송상훈, 이상철, 이영주, Michelle M. Kim대한배뇨장애요실금학회 · International Neurourology Journal2021 · 제25권 제2호Development of a Deep Learning-Based Predictive Model for Improvement after Holmium Laser Enucleation of the Prostate According to Detrusor Contractility고광진, 김정현, 이규성, 이종훈, 정명진대한배뇨장애요실금학회 · International Neurourology Journal2024 · 제28권 제1호New Trends in Innovative Technologies Applying Artificial Intelligence to Urinary Diseases박종목, 오진규, 은성종, 이준영대한배뇨장애요실금학회 · International Neurourology Journal2022 · 제26권 제4호

이 간행물의 다른 논문 (25건)