Detection of protein-losing enteropathy (PLE) ultrasonographic imaging features in dogs using deep learning neural networks

Artificial intelligence (AI)-based models and algorithms may aid in achieving overall more efficient and accurate diagnostics in various medical specialties. Such AI-based tools could be integrated and potentially offer advantages over currently used diagnostic and monitoring algorithms, enabling the pursue of more individualized treatment options with potentially improved patient outcomes in the future. However, very few studies exploring the potential of AI-based tools have been reported in veterinary medicine. Diagnosis and subclassification of chronic inflammatory enteropathy (CIE) and protein-losing enteropathy (PLE), requiring an integrated approach including several diagnostic modalities, remains a challenge in clinical canine gastroenterology and might benefit from AI-based tools. Thus, we aimed to use AI-based <i>deep learning</i> to develop a model that can differentiate clinical cases of protein-losing PLE from non-PLE CIE using ultrasonographic (B-mode) images. This pilot study included anonymized data extracted from the electronic medical records and diagnostic images from routine diagnostic evaluations of 59 dogs. Following several optimization steps, the final model had a high accuracy (91.57%), precision (0.9286), recall (0.9070), F1 score (0.9176), and AUC-ROC (0.9529). This model was highly sensitive and specific for the detection of ultrasonographic features associated with clinicopathologic and/or histological lesions consistent with a PLE diagnosis. Combining sonographic diagnostics with <i>machine learning</i> yielded a high degree of accuracy in PLE differentiation. The results of this study underscore the potential of integrating an AI-based model into CIE diagnostics and PLE differentiation in clinical canine gastroenterology.