{
    "abstract": "To develop a machine learning (ML)-based model using MRI and clinical risk factors to enhance diagnostic accuracy for axial spondyloarthritis (axSpA).\nWe retrospectively analyzed datasets from four centers (A-D), focusing on patients with chronic low back pain. A subset from center A was used for prospective validation. A deep learning (DL) model based on ResNet50 was constructed using sacroiliac joint MRI. Clinical variables were integrated with DL scores in ML algorithms to distinguish axSpA from non-axSpA patients. Model performance was assessed by the area under the receiver operating characteristic curve (AUC), sensitivity, specificity, and accuracy.\nThe study included 1294 patients (median age 31 years [interquartile range 24-42]; 35.5% females). Clinical risk factors identified were age, sex, and human leukocyte antigen-B27 status. The MRI-based DL model demonstrated an AUC of 0.837, 0.636, 0.724, 0.710, and 0.812 on the internal test set, three external test sets, and the prospective validation set, respectively. The combined model, particularly the K-nearest-neighbors-11 algorithm, demonstrated superior performance across multiple test sets with AUCs ranging from 0.853 to 0.912. It surpassed the Assessment of SpondyloArthritis International Society criteria with better AUC (0.858 vs. 0.650, p\u2009<\u20090.001), sensitivity (87.8% vs. 42.4%, p\u2009<\u20090.001), and accuracy (78.7% vs. 56.9%, p\u2009<\u20090.001).\nThe ML method integrating MRI and clinical risk factors effectively identified axSpA, representing a promising tool for the diagnosis and management of axSpA.\nThe machine learning model combining MRI and clinical risk factors potentially enables earlier diagnosis and intervention for axial spondyloarthritis patients, reducing the delays commonly associated with traditional diagnostic approaches.\nAxial spondyloarthritis (AxSpA) lacks definitive diagnostic criteria or markers, leading to diagnostic delay. MRI-based deep learning provided quantitative analysis of sacroiliac joint changes indicative of axSpA. A machine learning model combining sacroiliac joint MRI and clinical risk factors enhanced axSpA identification.",
    "authors": [
        {
            "affiliation": "Department of Radiology, The Third Affiliated Hospital of Southern Medical University (Academy of Orthopedics Guangdong Province), Guangzhou, China.",
            "firstname": "Zhuoyao",
            "initials": "Z",
            "lastname": "Xie"
        },
        {
            "affiliation": "Guangdong Provincial Key Laboratory of Medical Image Processing, School of Biomedical Engineering, Southern Medical University, Guangzhou, China.",
            "firstname": "Zefeiyun",
            "initials": "Z",
            "lastname": "Chen"
        },
        {
            "affiliation": "Department of Radiology, The Third Affiliated Hospital of Southern Medical University (Academy of Orthopedics Guangdong Province), Guangzhou, China.",
            "firstname": "Qinmei",
            "initials": "Q",
            "lastname": "Yang"
        },
        {
            "affiliation": "Department of Radiology, The Third Affiliated Hospital of Southern Medical University (Academy of Orthopedics Guangdong Province), Guangzhou, China.",
            "firstname": "Qiang",
            "initials": "Q",
            "lastname": "Ye"
        },
        {
            "affiliation": "Department of Radiology, The Third Affiliated Hospital of Southern Medical University (Academy of Orthopedics Guangdong Province), Guangzhou, China.",
            "firstname": "Xin",
            "initials": "X",
            "lastname": "Li"
        },
        {
            "affiliation": "Department of Radiology, The Third Affiliated Hospital of Southern Medical University (Academy of Orthopedics Guangdong Province), Guangzhou, China.",
            "firstname": "Qiuxia",
            "initials": "Q",
            "lastname": "Xie"
        },
        {
            "affiliation": "Department of Radiology, The Third Affiliated Hospital of Southern Medical University (Academy of Orthopedics Guangdong Province), Guangzhou, China.\nDepartment of Radiology, The Sixth Affiliated Hospital of South China University of Technology, Nanhai, China.",
            "firstname": "Caolin",
            "initials": "C",
            "lastname": "Liu"
        },
        {
            "affiliation": "Department of Radiology, Zhujiang Hospital of Southern Medical University, Guangzhou, China.",
            "firstname": "Bomiao",
            "initials": "B",
            "lastname": "Lin"
        },
        {
            "affiliation": "Department of Rheumatology and Immunology, The Third Affiliated Hospital of Southern Medical University (Academy of Orthopedics Guangdong Province), Guangzhou, China.",
            "firstname": "Xinai",
            "initials": "X",
            "lastname": "Han"
        },
        {
            "affiliation": "Department of Rheumatology and Immunology, The Third Affiliated Hospital of Southern Medical University (Academy of Orthopedics Guangdong Province), Guangzhou, China.",
            "firstname": "Yi",
            "initials": "Y",
            "lastname": "He"
        },
        {
            "affiliation": "Department of Radiology, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China. wxhcrz@163.com.",
            "firstname": "Xiaohong",
            "initials": "X",
            "lastname": "Wang"
        },
        {
            "affiliation": "Guangdong Provincial Key Laboratory of Medical Image Processing, School of Biomedical Engineering, Southern Medical University, Guangzhou, China. weiyanggm@gmail.com.",
            "firstname": "Wei",
            "initials": "W",
            "lastname": "Yang"
        },
        {
            "affiliation": "Department of Radiology, The Third Affiliated Hospital of Southern Medical University (Academy of Orthopedics Guangdong Province), Guangzhou, China. zhaoyh@smu.edu.cn.",
            "firstname": "Yinghua",
            "initials": "Y",
            "lastname": "Zhao"
        }
    ],
    "conclusions": "The ML method integrating MRI and clinical risk factors effectively identified axSpA, representing a promising tool for the diagnosis and management of axSpA.",
    "copyrights": "\u00a9 2025. The Author(s).",
    "doi": "10.1186/s13244-025-01967-x",
    "journal": "Insights into imaging",
    "keywords": [
        "Axial spondyloarthritis",
        "Deep learning",
        "MRI",
        "Machine learning",
        "Sacroiliac joints"
    ],
    "methods": null,
    "publication_date": "2025-04-26",
    "pubmed_id": "40281350\n30527429\n33361770\n33207078\n33053193\n33053191\n33968964\n19297344\n34049855\n33428758\n34728818\n30877217\n35333316\n35104321\n26511519\n24141714\n37012131\n35943339\n31422357\n33523107\n28422666\n35436388\n34260699\n32521322\n36737644\n37321799\n34194471\n37222563",
    "results": "The study included 1294 patients (median age 31 years [interquartile range 24-42]; 35.5% females). Clinical risk factors identified were age, sex, and human leukocyte antigen-B27 status. The MRI-based DL model demonstrated an AUC of 0.837, 0.636, 0.724, 0.710, and 0.812 on the internal test set, three external test sets, and the prospective validation set, respectively. The combined model, particularly the K-nearest-neighbors-11 algorithm, demonstrated superior performance across multiple test sets with AUCs ranging from 0.853 to 0.912. It surpassed the Assessment of SpondyloArthritis International Society criteria with better AUC (0.858 vs. 0.650, p\u2009<\u20090.001), sensitivity (87.8% vs. 42.4%, p\u2009<\u20090.001), and accuracy (78.7% vs. 56.9%, p\u2009<\u20090.001).",
    "title": "Enhanced diagnosis of axial spondyloarthritis using machine learning with sacroiliac joint MRI: a multicenter study.",
    "xml": "<Element 'PubmedArticle' at 0x78850455f4c0>"
}