Abstract

Surgery is the most commonly used method of curing inverted papilloma (IP) or nasal polyp (NP). Although accurate preoperative recognition by computed tomography (CT) is a critical aspect of surgical planning, the minor CT imaging differences in such lesions may be a challenge. Therefore, we have devised a deep learning framework for automatic recognition of IP and NP in CT. The proposed framework involves two major steps: (a) use of a convolutional neural network (CNN) to preclassify lesions and (b) automatic IP/NP recognition. The preclassify CNN enables classification of CT slices according to anatomic structure. Separate networks are then implemented to differentiate IP and NP accordingly. Once the framework was trained using a CT dataset (5681 slices) from 136 patients, it outperformed other methods during evaluation, achieving 89.30% accuracy (area under the curve [AUC]=0.95) in classification. The proposed framework has clear potential as a clinical tool, enabling effective and highly accurate preoperative recognition of IP and NP.

Highlights

  • Inverted papilloma (IP) is a common but benign sinonasal neoplasm that has recently drawn much attention in the realm of otolaryngology, given its potential for local invasion/recurrence or malignant transformation [1]

  • Open-source platforms were chosen as deep learning frameworks of preclassification (Keras) and recognition (Tensorflow) networks

  • The training processes of all experiments were conducted on a workstation powered by a NVIDIA (Santa Clara, CA, USA) GeForce GTX 1060 GPU (6 GB of memory), using the compute unified device architecture (CUDA) toolkit 8.0

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Summary

Introduction

Inverted papilloma (IP) is a common but benign sinonasal neoplasm that has recently drawn much attention in the realm of otolaryngology, given its potential for local invasion/recurrence or malignant transformation [1]. As the most common benign nasal mass, nasal polyp (NP) shares clinical symptoms of IP [5], making it difficult for otolaryngologists to distinguish the two. Both IP and NP are cured through surgery, albeit by quite different means. Computed tomography (CT) and magnetic resonance imaging (MRI), are indispensable for preoperative assessments in this setting [6], IP lacks distinctive features on CT (as does NP), appearing only as a soft tissue density

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