In a groundbreaking advance poised to transform diagnostic radiology, researchers have harnessed the power of convolutional neural networks (CNNs) to automate the scoring of computed tomography (CT) scans of the paranasal sinuses. This innovative approach promises to standardize and expedite the evaluation of chronic rhinosinusitis (CRS), a condition that affects millions worldwide and has long depended on labor-intensive manual scoring methods for clinical decision-making.
Chronic rhinosinusitis diagnosis traditionally relies on a combination of patient symptoms and objective assessments such as endoscopy and CT imaging. Among the most widely accepted tools for radiologic grading is the Lund–Mackay score (LMS), which assigns severity points based on the extent of sinus opacification visible on CT scans. Despite its clinical utility, LMS calculation demands experienced radiologists to meticulously inspect multiple sinus regions, a process that is time-consuming and vulnerable to inter-observer variability.
The newly developed automated algorithm skillfully integrates the capabilities of CNN-based segmentation with advanced post-processing techniques to calculate LMS directly from CT data. This proof-of-concept study demonstrates how artificial intelligence can replicate, and in some aspects exceed, human accuracy in evaluating paranasal sinus inflammation, heralding a new era of radiologic efficiency.
Leveraging a rich dataset, the researchers sourced 1,399 outpatient paranasal sinus CT scans from a tertiary care medical center’s Radiology Information System. Each scan came with manually assigned LMS values for individual sinuses, creating an essential gold standard for training and validating the CNN model. Additionally, a subset of 77 CT scans encompassing 13,668 coronal images underwent meticulous manual segmentation, serving as the foundation for the network’s learning phase.
The CNN architecture employed was tailored to segment critical sinus regions with a remarkable mean Dice similarity coefficient of 0.85, reflecting outstanding spatial overlap between automated predictions and expert annotations. Notably, segmentation performance varied by sinus type: the maxillary sinuses achieved an exceptional Dice score of 0.95, while the anterior ethmoid sinuses registered a relatively lower but still solid 0.71 score. The posterior ethmoid, sphenoid, and frontal sinuses reached respective Dice scores of 0.78, 0.93, and 0.86.
Following segmentation, the team devised an adaptive image thresholding technique coupled with precise pixel counting to quantify sinus opacification objectively. This post-processing innovation enabled the automated LMS calculator to assign scores reflecting the presence and extent of sinonasal mucosal disease. Intriguingly, the automated LMS values exhibited striking concordance with manual scores, achieving accuracy metrics of 0.92 for the maxillary sinus and near-perfect levels of 0.99 for the anterior and posterior ethmoid sinuses.
These findings underscore the model’s potential to act as a reliable surrogate for human readers, drastically reducing the workload of radiologists and streamlining patient management. By automating the laborious scoring process, clinicians can benefit from rapid, consistent assessments that enhance diagnostic precision and facilitate timely interventions.
The study’s implications extend beyond mere efficiency; standardized LMS reporting via AI algorithms can mitigate subjective bias and inter-rater discrepancies that have historically complicated CRS research and treatment protocols. This harmonization could revolutionize clinical trials by ensuring uniformity in radiologic endpoints, ultimately driving more robust evidence-based practices.
While the approach presently excludes certain anatomical nuances such as the osteomeatal complex, the high segmentation accuracies for other sinus regions establish a solid foundation for further refinement and future integration into clinical workflows. The researchers anticipate that continuous improvements in deep learning models and image processing algorithms will soon enable comprehensive automated evaluations encompassing all sinonasal structures.
Moreover, the methodology holds promise for scalability across diverse imaging platforms and patient populations, potentially democratizing advanced radiologic scoring in under-resourced healthcare settings. As machine learning techniques evolve, their ability to decode complex anatomical patterns will only deepen, ushering in unprecedented levels of diagnostic automation.
In summary, this innovative application of CNNs effectively bridges artificial intelligence and clinical radiology, marking a significant leap toward automating chronic rhinosinusitis evaluation. The resulting tool not only expedites interpretation of paranasal sinus CT scans but also fosters greater reproducibility and objectivity in patient care.
The success of this model foreshadows a future where AI-driven radiology is integral to otolaryngology and beyond, ensuring that precision medicine is accessible, efficient, and standardized. As researchers continue to push the boundaries of convolutional neural networks, their potential to reshape medical diagnostics becomes increasingly apparent, signifying a paradigm shift in how imaging data is analyzed and leveraged for improved health outcomes.
With chronic rhinosinusitis affecting quality of life globally, such technological advancements represent a much-needed stride toward enhancing patient diagnosis, monitoring, and treatment optimization. The fusion of deep learning with medical imaging opens avenues for innovation that could extend well beyond sinus disease, influencing a broad spectrum of radiologic scoring systems.
This study exemplifies the transformative impact of artificial intelligence on healthcare, highlighting collaborative efforts between clinicians and data scientists to translate complex algorithms into practical, clinically relevant tools. As AI tools like this convolutional neural network gain traction, radiology’s future looks increasingly automated, accurate, and patient-centric.
Subject of Research: Automated radiologic scoring of chronic rhinosinusitis using a convolutional neural network applied to CT imaging of paranasal sinuses.
Article Title: The use of a convolutional neural network to automate radiologic scoring of computed tomography of paranasal sinuses.
Article References:
Lee, D.J., Hamghalam, M., Wang, L. et al. The use of a convolutional neural network to automate radiologic scoring of computed tomography of paranasal sinuses. BioMed Eng OnLine 24, 49 (2025). https://doi.org/10.1186/s12938-025-01376-7
Image Credits: AI Generated
