Abstract
Objective
Chronic kidney disease (CKD) is evaluated based on glomerular filtration rate (GFR) using a gamma camera in the nuclear medicine center or hospital in a routine procedure, but the gamma camera does not provide the accurate stages of the diseases. Therefore, this research aimed to find out the normal or abnormal stages of CKD based on the value of GFR using an artificial neural network (ANN).
Methods
Two hundred fifty (Training 188, Testing 62) kidney patients who underwent the ultrasonography test to diagnose the renal test in our nuclear medical centre were scanned using gamma camera. The patients were injected with 99mTc-DTPA before the scanning procedure. After pushing the syringe into the patient's vein, the pre-syringe and post syringe radioactive counts were calculated using the gamma camera. The artificial neural network uses the softmax function with cross-entropy loss to diagnose CKD normal or abnormal labels depending on the value of GFR in the output layer.
Results
The results showed that the accuracy of the proposed ANN model was 99.20% for K-fold cross-validation. The sensitivity and specificity were 99.10% and 99.20%, respectively. The Area under the curve (AUC) was 0.9994.
Conclusion
The proposed model using an artificial neural network can classify the normal or abnormal stages of CKD. After implementing the proposed model clinically, it may upgrade the gamma camera to diagnose the normal or abnormal stages of the CKD with an appropriate GFR value.
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Data availability
The institution at which the work was performed—Institute of Nuclear Medicine and Allied Sciences, Rajshahi-6000, Bangladesh.
References
Webster AC, Nagler EV, Morton RL, Masson P. Chronic kidney disease. Lancet. 2017;389:1238–52.
Glassock RJ, Warnock DG, Delanaye P. The global burden of chronic kidney disease: estimates, variability and pitfalls. Nat Rev Nephrol. 2017;13:104.
Waller DG, Keast CM, Fleming JS, Ackery DM. Measurement of glomerular filtration rate with technetium-99m DTPA: comparison of plasma clearance techniques. J Nucl Med. 1987;28:372–7.
Levey AS, Inker LA. GFR as the “Gold Standard”: estimated, measured, and true. Am J Kidney Dis. 2016;67:9–12.
Schlegel JU, Hamway SA. Individual renal plasma flow determination in 2 minutes. J Urol. 1976;116:282–5.
Keopke, John A, Keopke, John F. Guide to clinical laboratory diagnosis. 3rd ed. US California: Appleton and Lange; 1987. pp. 40–56.
Gates GF. Creatinine clearance estimation from serum creatinine values: an analysis of three mathematical models of glomerular function. Am J Kidney Dis. 1985;5:199–205.
Stevens LA, Levey AS. Measured GFR as a confirmatory test for estimated GFR. J Am Soc Nephrol. 2009;20:2305–13.
Levey AS, Stevens LA, Schmid CH, Zhang YL, Castro AF, Feldman HI, et al. A new equation to estimate glomerular filtration rate. Ann Intern Med. 2009;150:604–12.
Matsuo S, Imai E, Horio M, Yasuda Y, Tomita K, Nitta K, et al. Revised equations for estimated GFR from serum creatinine in Japan. Am J Kidney Dis. 2009;53:982–92.
Gates GF. Split renal function testing using Tc-99m DTPA. A rapid technique for determining differential glomerular filtration. Clin Nucl Med. 1983;8:400–7.
Itoh K. Comparison of methods for determination of glomerular filtration rate: Tc-99m-DTPA renography, predicted creatinine clearance method and plasma sample method. Ann Nucl Med. 2003;17:561–5.
Ma Y-C, Zuo L, Zhang C-L, Wang M, Wang R-F, Wang H-Y. Comparison of 99mTc-DTPA renal dynamic imaging with modified MDRD equation for glomerular filtration rate estimation in Chinese patients in different stages of chronic kidney disease. Nephrol Dial Transplant. 2007;22:417–23.
Liu X, Pei X, Li N, Zhang Y, Zhang X, Chen J, et al. Improved glomerular filtration rate estimation by an artificial neural network. PLoS ONE. 2013;8: e58242.
Young J, Macke CJ, Tsoukalas LH. Short-term acoustic forecasting via artificial neural networks for neonatal intensive care units. J Acoust Soc Am. 2012;132:3234–9.
Hu K, Wan JQ, Ma YW, Wang Y, Huang MZ. A fuzzy neural network model for monitoring A2/O process using on-line monitoring parameters. J Environ Sci Health Part A. 2012;47:744–54.
Emoto T, Abeyratne UR, Chen Y, Kawata I, Akutagawa M, Kinouchi Y. Artificial neural networks for breathing and snoring episode detection in sleep sounds. Physiol Meas. 2012;33:1675.
Nick TG, Campbell KM. Logistic regression. Top Biostat. 2007. https://doi.org/10.1007/978-1-59745-530-5_14.
Harrell FE Jr, Lee KL, Mark DB. Multivariable prognostic models: issues in developing models, evaluating assumptions and adequacy, and measuring and reducing errors. Stat Med. 1996;15:361–87.
Li YX, Jiang LC. Application of ANN algorithm in tree height modeling. App Mech Mater. 2010;20:756–61.
Patel JL, Goyal RK. Applications of artificial neural networks in medical science. Curr Clin Pharmacol. 2007;2:217–26.
Stergiou C, Siganos D. Neural Networks. Imperial College of London, Computer Department; 2017. http://www.doc.ic.ac.uk/~nd/surprise_96/journal/vol4/cs11/report.html#Contents.
Miller S, Bews J, Kinsner W. Brachytherapy cancer treatment optimization using simulated annealing and artificial neural networks. Canadian Conference on Electrical and Computer Engineering 2001 Conference Proceedings (Cat No 01TH8555). IEEE; 2001. pp. 649–54.
Cross SS, Harrison RF, Kennedy RL. Introduction to neural networks. Lancet. 1995;346:1075–9.
Gao J, Zagadailov P, Merchant AM. The use of artificial neural network to predict surgical outcomes after inguinal hernia repair. J Surg Res. 2021;259:372–8.
Xun L, Xiaoming W, Ningshan L, Tanqi L. Application of radial basis function neural network to estimate glomerular filtration rate in Chinese patients with chronic kidney disease. 2010 International Conference on Computer Application and System Modeling (ICCASM 2010). IEEE; 2010. pp. V15–332.
Gaweda AE, Jacobs AA, Aronoff GR, Brier ME. Model predictive control of erythropoietin administration in the anemia of ESRD. Am J Kidney Dis. 2008;51:71–9.
Baxt WG, Skora J. Prospective validation of artificial neural network trained to identify acute myocardial infarction. Lancet. 1996;347:12–5.
Dybowski R, Gant V, Weller P, Chang R. Prediction of outcome in critically ill patients using artificial neural network synthesised by genetic algorithm. Lancet. 1996;347:1146–50.
Guh J-Y, Yang C-Y, Yang J-M, Chen L-M, Lai Y-H. Prediction of equilibrated postdialysis BUN by an artificial neural network in high-efficiency hemodialysis. Am J Kidney Dis. 1998;31:638–46.
Rajković KM, Dabić-Stanković K, Stanković J, Aćimović M, Đukanović N, Nikolin B. Modelling and optimisation of treatment parameters in high-dose-rate mono brachytherapy for localised prostate carcinoma using a multilayer artificial neural network and a genetic algorithm: Pilot study. Comput Biol Med. 2020;126:104045.
Jaberi R, Siavashpour Z, Aghamiri MR, Kirisits C, Ghaderi R. Artificial neural network based gynaecological image-guided adaptive brachytherapy treatment planning correction of intra-fractional organs at risk dose variation. J Contemp Brachytherapy. 2017;9:508–18.
Widrow B, Rumelhart DE, Lehr MA. Neural networks: applications in industry, business and science. Commun ACM. 1994;37:93–106.
Baxt WG. Use of an artificial neural network for the diagnosis of myocardial infarction. Ann Intern Med. 1991;115:843–8.
Wang J-L, Jin G-L, Yuan Z-G. Artificial neural network predicts hemorrhagic contusions following decompressive craniotomy in traumatic brain injury. J Neurosurg Sci. 2021;65:69–74.
Azimi P, Benzel EC, Shahzadi S, Azhari S, Mohammadi HR. Use of artificial neural networks to predict surgical satisfaction in patients with lumbar spinal canal stenosis. J Neurosurg Spine. 2014;20:300–5.
Bottaci L, Drew PJ, Hartley JE, Hadfield MB, Farouk R, Lee PW, et al. Artificial neural networks applied to outcome prediction for colorectal cancer patients in separate institutions. Lancet. 1997;350:469–72.
Kim JS, Merrill RK, Arvind V, Kaji D, Pasik SD, Nwachukwu CC, et al. Examining the ability of artificial neural networks machine learning models to accurately predict complications following posterior lumbar spine fusion. Spine. 2018;43:853.
Li N, Huang H, Qian H-Z, Liu P, Lu H, Liu X. Improving accuracy of estimating glomerular filtration rate using artificial neural network: model development and validation. J Transl Med. 2020;18:1–8.
Fink HA, Ishani A, Taylor BC, Greer NL, MacDonald R, Rossini D, et al. Chronic kidney disease stages 1–3: screening, monitoring, and treatment. 2012.
Assadi M, Eftekhari M, Hozhabrosadati M, Saghari M, Ebrahimi A, Nabipour I, et al. Comparison of methods for determination of glomerular filtration rate: low and high-dose Tc-99m-DTPA renography, predicted creatinine clearance method, and plasma sample method. Int Urol Nephrol. 2008;40:1059.
Stevens LA, Zhang Y, Schmid CH. Evaluating the performance of equations for estimating glomerular filtration rate. J Nephrol. 2008;21:797–807.
Du X, Liu L, Hu B, Wang F, Wan X, Jiang L, et al. Is the Chronic Kidney Disease Epidemiology Collaboration four-level race equation better than the cystatin C equation? Nephrology. 2012;17:407–14.
Li Q, Zhang C, Fu Z, Wang R, Ma Y, Zuo L. Development of formulae for accurate measurement of the glomerular filtration rate by renal dynamic imaging. Nucl Med Commun. 2007;28:407–13.
Liu X, Lv L, Wang C, Shi C, Cheng C, Tang H, et al. Comparison of prediction equations to estimate glomerular filtration rate in Chinese patients with chronic kidney disease. Intern Med J. 2012;42:e59-67.
Palaz D, Doss MM-, Collobert R. Convolutional neural networks-based continuous speech recognition using raw speech signal. 2015 IEEE International Conference on Acoustics, Speech and Signal Processing (ICASSP). IEEE; 2015. pp. 4295–9.
Luo Y, Wong Y, Kankanhalli M, Zhao Q. G-Softmax: improving intraclass compactness and interclass separability of features. IEEE Trans Neural Netw Learn Syst. 2020;31:685–99.
Abdel-Hamid O, Mohamed A, Jiang H, Deng L, Penn G, Yu D. Convolutional neural networks for speech recognition. IEEE/ACM Trans Audio Speech Lang Process. 2014;22:1533–45.
Moons KG, Altman DG, Reitsma JB, Ioannidis JP, Macaskill P, Steyerberg EW, et al. Transparent Reporting of a multivariable prediction model for Individual Prognosis or Diagnosis (TRIPOD): explanation and elaboration. Ann Intern Med. 2015;162:W1-73.
Sugawara S, Ishii S, Kojima Y, Ito H, Suzuki Y, Oriuchi N. Feasibility of gamma camera-based GFR measurement using renal depth evaluated by lateral scan of 99m Tc-DTPA renography. Ann Nucl Med. 2020;34:349–57. https://doi.org/10.1007/s12149-020-01455-w.
Chen J, Tang H, Huang H, Lv L, Wang Y, Liu X, et al. Development and validation of new glomerular filtration rate predicting models for Chinese patients with type 2 diabetes. J Transl Med. 2015;13:317.
Liu X, Chen Y-R, Li N, Wang C, Lv L-S, Li M, et al. Estimation of glomerular filtration rate by a radial basis function neural network in patients with type-2 diabetes mellitus. BMC Nephrol. 2013;14:1–9.
Usberti M, Federico S, Di Minno G, Ungaro B, Ardillo G, Pecoraro C, et al. Effects of angiotensin II on plasma ADH, prostaglandin synthesis, and water excretion in normal humans. Am J Physiol. 1985;248:F254–9.
Stengel B, Tarver-Carr ME, Powe NR, Eberhardt MS, Brancati FL. Lifestyle factors, obesity and the risk of chronic kidney disease. Epidemiology. 2003;14:479–87.
Kuo C-C, Chang C-M, Liu K-T, Lin W-K, Chiang H-Y, Chung C-W, et al. Automation of the kidney function prediction and classification through ultrasound-based kidney imaging using deep learning. NPJ Digit Med. 2019;2:29.
Liu X, Pei X, Li N, Zhang Y, Zhang X, Chen J, et al. Improved glomerular filtration rate estimation by an artificial neural network. PLoS One [Internet]. 2013 [cited 2021 Apr 20];8. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3596400/
Liu X, Li N, Lv L, Huang J, Tang H, Chen J, et al. A comparison of the performances of an artificial neural network and a regression model for GFR estimation. Am J Kidney Dis. 2013;62:1109–15.
Li N, Huang H, Qian H-Z, Liu P, Lu H, Liu X. Improving accuracy of estimating glomerular filtration rate using artificial neural network: model development and validation. J Transl Med. 2020;18:120.
Liu X, Li N, Lv L, Fu Y, Cheng C, Wang C, et al. Improving precision of glomerular filtration rate estimating model by ensemble learning. J Transl Med. 2017;15:231.
Almansour NA, Syed HF, Khayat NR, Altheeb RK, Juri RE, Alhiyafi J, et al. Neural network and support vector machine for the prediction of chronic kidney disease: A comparative study. Comput Biol Med. 2019;109:101–11.
Soveri I, Berg UB, Björk J, Elinder C-G, Grubb A, Mejare I, et al. Measuring GFR: a systematic review. Am J Kidney Dis. 2014;64:411–24.
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12149_2021_1676_MOESM1_ESM.tif
Supplementary file1 Supplementary Figure 1. Predicted pseudo probability curve for the stages of chronic kidney diseases. (TIF 66 kb)
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Supplementary file2 Supplementary Figure 2: Output values for the artificial neural network using cross-entropy and softmax function in the output layers based on output label normal (TIF 127 kb)
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Supplementary file3 Supplementary Figure 3: Output values for the artificial neural network using cross-entropy and softmax function in the output layers based on output label abnormal (TIF 101 kb)
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Hossain, A., Chowdhury, S.I., Sarker, S. et al. Artificial neural network for the prediction model of glomerular filtration rate to estimate the normal or abnormal stages of kidney using gamma camera. Ann Nucl Med 35, 1342–1352 (2021). https://doi.org/10.1007/s12149-021-01676-7
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DOI: https://doi.org/10.1007/s12149-021-01676-7