Abstract
To develop and test the performance of deep convolutional neural networks (DCNNs) for automated classification of age and sex on chest radiographs (CXR). We obtained 112,120 frontal CXRs from the NIH ChestX-ray14 database performed in 48,780 females (44%) and 63,340 males (56%) ranging from 1 to 95years old. The dataset was split into training (70%), validation (10%), and test (20%) datasets, and used to fine-tune ResNet-18 DCNNs pretrained on ImageNet for (1) determination of sex (using entire dataset and only pediatric CXRs); (2) determination of age < 18years old or ≥ 18years old (using entire dataset); and (3) determination of age < 11years old or 11-18years old (using only pediatric CXRs). External testing was performed on 662 CXRs from China. Area under the receiver operating characteristic curve (AUC) was used to evaluate DCNN test performance. DCNNs trained to determine sex on the entire dataset and pediatric CXRs only had AUCs of 1.0 and 0.91, respectively (p < 0.0001). DCNNs trained to determine age < or ≥ 18years old and < 11 vs. 11-18years old had AUCs of 0.99 and 0.96 (p < 0.0001), respectively. External testing showed AUC of 0.98 for sex (p = 0.01) and 0.91 for determining age < or ≥ 18years old (p < 0.001). DCNNs can accurately predict sex from CXRs and distinguish between adult and pediatric patients in both American and Chinese populations. The ability to glean demographic information from CXRs may aid forensic investigations, as well as help identify novel anatomic landmarks for sex and age.
Published Version
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