{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T14:56:32Z","timestamp":1786114592160,"version":"build-2736575974"},"reference-count":30,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2025,12,1]],"date-time":"2025-12-01T00:00:00Z","timestamp":1764547200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2025,12,1]],"date-time":"2025-12-01T00:00:00Z","timestamp":1764547200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["bjui-journals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["BJU International"],"published-print":{"date-parts":[[2026,2]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To develop a deep learning model for differential diagnosis of acute scrotum using single ultrasound (US) images.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Patients and Methods<\/jats:title>\n                    <jats:p>We analysed 1172 patients with acute scrotal pain evaluated by Doppler US at four hospitals. From each case, we selected a representative axial colour Doppler US image. We trained a binary classification model to distinguish torsion from non\u2010torsion using an EfficientNet architecture. The dataset was split 70% for training and 30% for validation. We addressed class imbalance with data augmentation and class weighting. Class Activation Mapping was used to interpret model decisions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The model achieved robust performance: accuracy 97%, precision 98%, sensitivity 97%, and F1 score 97%. Class activation mapping heatmaps localised decision\u2010making to pathologically critical regions, including absent testicular blood flow and whirlpool signs. In a 20\u2010patient prospective pilot study, the system correctly identified both surgically confirmed torsion cases, with one non\u2010torsion case misclassified as torsion.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>A deep learning model demonstrated promising diagnostic performance in differentiating acute scrotal emergencies using single US images. Its feasibility was preliminarily assessed in a small pilot study. These findings support further investigation, with larger and more balanced multicentre studies required to establish clinical utility and effective workflow integration.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/bju.70091","type":"journal-article","created":{"date-parts":[[2025,12,2]],"date-time":"2025-12-02T07:24:28Z","timestamp":1764660268000},"page":"376-382","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Deep learning\u2010based classification of acute scrotum using single ultrasound images"],"prefix":"10.1111","volume":"137","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7015-4943","authenticated-orcid":false,"given":"Sahyun","family":"Pak","sequence":"first","affiliation":[{"name":"Department of Urology, Kangnam Sacred Heart Hospital Hallym University College of Medicine  Seoul Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sung Gon","family":"Park","sequence":"additional","affiliation":[{"name":"Department of Urology, Kangnam Sacred Heart Hospital Hallym University College of Medicine  Seoul Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6507-2628","authenticated-orcid":false,"given":"Jong Keun","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Urology, Dongtan Sacred Heart Hospital Hallym University College of Medicine  Hwaseong Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Seong Ho","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Urology, Dongtan Sacred Heart Hospital Hallym University College of Medicine  Hwaseong Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Won Ki","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Urology, Chuncheon Sacred Heart Hospital Hallym University College of Medicine  Chuncheon Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cheol Young","family":"Oh","sequence":"additional","affiliation":[{"name":"Department of Urology, Hallym University Sacred Heart Hospital Hallym University College of Medicine  Anyang Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ji Young","family":"Woo","sequence":"additional","affiliation":[{"name":"Department of Radiology, Kangnam Sacred Heart Hospital Hallym University College of Medicine  Seoul Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sung Tae","family":"Cho","sequence":"additional","affiliation":[{"name":"Department of Urology, Kangnam Sacred Heart Hospital Hallym University College of Medicine  Seoul Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Young Goo","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Urology, Kangnam Sacred Heart Hospital Hallym University College of Medicine  Seoul Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,12,1]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.urology.2016.05.018"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.eursup.2017.01.003"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1038\/nrurol.2014.135"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.5534\/wjmh.190037"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1553-2712.2001.tb00562.x"},{"key":"e_1_2_11_7_1","first-page":"835","article-title":"Testicular torsion: diagnosis, evaluation, and management","volume":"88","author":"Sharp VJ","year":"2013","journal-title":"Am Fam Physician"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpurol.2018.09.017"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1049\/cit2.12356"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41698-024-00514-z"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.14366\/usg.21031"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2589-7500(21)00278-8"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.euf.2019.04.009"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00345-024-04889-3"},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10994-022-06268-8"},{"key":"e_1_2_11_16_1","unstructured":"Thyroid\u2010ultrasound\u2010image\u2010classification\u2010EfficientNet model.2024. 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