Background and objective: Hydronephrosis is essential in the diagnosis of renal colic. We automated the detection of hydronephrosis from ultrasound images to standardize the therapy and reduce the misdiagnosis of renal colic.

Methods: Anonymously collected ultrasound images of human kidneys, both normal and hydronephrotic, were preprocessed for neural networks. Six "state of the art" models were trained and cross-validated for the detection of hydronephrosis, and two convolutional networks were used for kidney segmentation. In the testing phase, performance metrics included true positives, true negatives, false positives, false negatives, accuracy, and F1 score, while the evaluation of the segmentation task involved accuracy, precision, dice, jaccard, recall, and ASSD.

Key findings and limitations: A total of 523 sonographic kidney images (423 nonhydronephrotic and 100 hydronephrotic) were collected from three different ultrasound devices. After training on this dataset, all models were used to evaluate 200 new ultrasound kidney images (142 nonhydronephrotic and 58 hydronephrotic kidneys). The highest validation accuracy (98.5%) was achieved by the AlexNet model (GoogLeNet 97%, AlexNet_v2 96%, ResNet50 96%, ResNet101 97.5%, and ResNet152 95%). The deeplabv3_resnet50 and deeplabv3_resnet101 reached a dice coefficient of 94.74% and 94.48%, respectively, on the task of automated kidney segmentation. The study is limited by analyzing only hydronephrosis, but this specific focus enabled high detection accuracy.

Conclusions and clinical implications: We show that our automated ultrasound deep learning model can be trained and used to interpret and segmentate ultrasound images from different sources with high accuracy. This method will serve as an automated tool in the diagnostic algorithm of acute renal failure in the future.

Patient summary: Hydronephrosis is crucial in the diagnosis of renal colic. Recent advances in artificial intelligence allow automated detection of hydronephrosis in ultrasound images with high accuracy. These methods will help standardize the diagnosis and treatment renal colic.

Radu Alexa, Jennifer Kranz, Rafael Kramann, Christoph Kuppe, Ritabrata Sanyal, Sikander Hayat, Luis Felipe Casas Murillo, Turkan Hajili, Marco Hoffmann, Matthias Saar. “Harnessing Artificial Intelligence for Enhanced Renal Analysis: Automated Detection of Hydronephrosis and Precise Kidney Segmentation” Eur Urol Open Sci, February 2024 , doi: 10.1016/j.euros.2024.01.017, Add to Citavi project by DOI PMID: 38585207 Add to Citavi project by Pubmed ID.