Background: The traditional Lund-Mackay score (TLMs) is unable to subgrade the volume of inflammatory disease. We aimed to propose an effective modification and calculated the volume-based modified LM score (VMLMs), which should correlate more strongly with clinical symptoms than the TLMs.

Methods: Semi-supervised learning with pseudo-labels used for self-training was adopted to train our convolutional neural networks, with the algorithm including a combination of MobileNet, SENet, and ResNet. A total of 175 CT sets, with 50 participants that would undergo sinus surgery, were recruited. The Sinonasal Outcomes Test-22 (SNOT-22) was used to assess disease-specific symptoms before and after surgery. A 3D-projected view was created and VMLMs were calculated for further comparison.

Results: Our methods showed a significant improvement both in sinus classification and segmentation as compared to state-of-the-art networks, with an average Dice coefficient of 91.57%, an MioU of 89.43%, and a pixel accuracy of 99.75%. The sinus volume exhibited sex dimorphism. There was a significant positive correlation between volume and height, but a trend toward a negative correlation between maxillary sinus and age. Subjects who underwent surgery had significantly greater TLMs (14.9 vs. 7.38) and VMLMs (11.65 vs. 4.34) than those who did not. ROC-AUC analyses showed that the VMLMs had excellent discrimination at classifying a high probability of postoperative improvement with SNOT-22 reduction.

Conclusions: Our method is suitable for obtaining detailed information, excellent sinus boundary prediction, and differentiating the target from its surrounding structure. These findings demonstrate the promise of CT-based volumetric analysis of sinus mucosal inflammation.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8938792PMC
http://dx.doi.org/10.3390/tomography8020059DOI Listing

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