{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,8]],"date-time":"2026-03-08T20:20:57Z","timestamp":1773001257373,"version":"3.50.1"},"reference-count":43,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2025,3,6]],"date-time":"2025-03-06T00:00:00Z","timestamp":1741219200000},"content-version":"vor","delay-in-days":64,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,1,1]],"date-time":"2025-01-01T00:00:00Z","timestamp":1735689600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100003453","name":"Natural Science Foundation of Guangdong Province","doi-asserted-by":"publisher","award":["2022A1515012241"],"award-info":[{"award-number":["2022A1515012241"]}],"id":[{"id":"10.13039\/501100003453","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100003453","name":"Natural Science Foundation of Guangdong Province","doi-asserted-by":"publisher","award":["2022A1515011044"],"award-info":[{"award-number":["2022A1515011044"]}],"id":[{"id":"10.13039\/501100003453","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100003453","name":"Natural Science Foundation of Guangdong Province","doi-asserted-by":"publisher","award":["2023A1515010885"],"award-info":[{"award-number":["2023A1515010885"]}],"id":[{"id":"10.13039\/501100003453","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["62276074"],"award-info":[{"award-number":["62276074"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100012166","name":"National Key Research and Development Program of China","doi-asserted-by":"publisher","award":["2023YFB4706800"],"award-info":[{"award-number":["2023YFB4706800"]}],"id":[{"id":"10.13039\/501100012166","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100010819","name":"Bureau of Education of Guangzhou Municipality","doi-asserted-by":"publisher","award":["202235325"],"award-info":[{"award-number":["202235325"]}],"id":[{"id":"10.13039\/501100010819","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100010226","name":"Department of Education of Guangdong Province","doi-asserted-by":"publisher","award":["2023KQNCX060"],"award-info":[{"award-number":["2023KQNCX060"]}],"id":[{"id":"10.13039\/501100010226","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["International Journal of Intelligent Systems"],"published-print":{"date-parts":[[2025,1]]},"abstract":"<jats:p>\n                    Clinical diagnosis of cervical lymphadenopathy (CLA) using ultrasound images is a time\u2010consuming and laborious process that heavily relies on expert experience. This study aimed to develop an intelligent computer\u2010aided diagnosis (CAD) system using deep learning models (DLMs) to enhance the efficiency of ultrasound screening and diagnostic accuracy of CLA. We retrospectively collected 4089 ultrasound images of cervical lymph nodes across four categories from two hospitals: normal, benign CLA, primary malignant CLA, and metastatic malignant CLA. We employed transfer learning, data augmentation, and five\u2010fold cross\u2010validation to evaluate the diagnostic performance of DLMs with different architectures. To boost the application potential of DLMs, we investigated the potential impact of various optimizers and machine learning classifiers on their diagnostic performance. Our findings revealed that EfficientNet\u2010B1 with transfer learning and root\u2010mean\u2010square\u2010propagation optimizer achieved state\u2010of\u2010the\u2010art performance, with overall accuracies of 97.0% and 90.8% on the internal and external test sets, respectively. Additionally, human\u2013machine comparison experiments and the implementation of explainable artificial intelligence technology further enhance the reliability and safety of DLMs and help clinicians easily understand the DLM results. Finally, we developed an application that can be implemented in systems running Microsoft Windows. However, additional prospective studies are required to validate the clinical utility of the developed application. All pretrained DLMs, codes, and application are available at\n                    <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"https:\/\/github.com\/YubiaoYue\/DeepUS-CLN\">https:\/\/github.com\/YubiaoYue\/DeepUS-CLN<\/jats:ext-link>\n                    .\n                  <\/jats:p>","DOI":"10.1155\/int\/5432766","type":"journal-article","created":{"date-parts":[[2025,3,9]],"date-time":"2025-03-09T22:08:49Z","timestamp":1741558129000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Development and Validation of Explainable Artificial Intelligence System for Automatic Diagnosis of Cervical Lymphadenopathy From Ultrasound Images"],"prefix":"10.1155","volume":"2025","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-7425-9974","authenticated-orcid":false,"given":"Ming","family":"Xu","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6348-555X","authenticated-orcid":false,"given":"Yubiao","family":"Yue","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5504-7197","authenticated-orcid":false,"given":"Zhenzhang","family":"Li","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-9729-527X","authenticated-orcid":false,"given":"Yinhong","family":"Li","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-7611-9377","authenticated-orcid":false,"given":"Guoying","family":"Li","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2815-053X","authenticated-orcid":false,"given":"Haihua","family":"Liang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-9221-1691","authenticated-orcid":false,"given":"Di","family":"Liu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3893-7638","authenticated-orcid":false,"given":"Xiaohong","family":"Xu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,3,6]]},"reference":[{"key":"e_1_2_10_1_2","doi-asserted-by":"publisher","DOI":"10.1007\/s10585-021-10123-w"},{"key":"e_1_2_10_2_2","doi-asserted-by":"publisher","DOI":"10.1080\/01926230600867727"},{"key":"e_1_2_10_3_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2249.2012.04602.x"},{"key":"e_1_2_10_4_2","doi-asserted-by":"publisher","DOI":"10.1102\/1470-7330.2008.0006"},{"key":"e_1_2_10_5_2","doi-asserted-by":"publisher","DOI":"10.1002\/lary.21227"},{"key":"e_1_2_10_6_2","doi-asserted-by":"publisher","DOI":"10.1002\/hed.24344"},{"key":"e_1_2_10_7_2","doi-asserted-by":"publisher","DOI":"10.3389\/fped.2022.1020437"},{"key":"e_1_2_10_8_2","doi-asserted-by":"publisher","DOI":"10.3389\/fonc.2022.856605"},{"key":"e_1_2_10_9_2","doi-asserted-by":"publisher","DOI":"10.4132\/jptm.2023.06.12"},{"key":"e_1_2_10_10_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11154-023-09841-1"},{"key":"e_1_2_10_11_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41467-024-48421-y"},{"key":"e_1_2_10_12_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41569-023-00900-3"},{"key":"e_1_2_10_13_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.bspc.2021.103277"},{"key":"e_1_2_10_14_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.bspc.2023.104871"},{"key":"e_1_2_10_15_2","doi-asserted-by":"publisher","DOI":"10.1177\/01617346231162906"},{"key":"e_1_2_10_16_2","doi-asserted-by":"publisher","DOI":"10.1002\/ima.22894"},{"key":"e_1_2_10_17_2","doi-asserted-by":"publisher","DOI":"10.1007\/s13369-023-07674-3"},{"key":"e_1_2_10_18_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.bspc.2022.104073"},{"key":"e_1_2_10_19_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11517-022-02502-6"},{"key":"e_1_2_10_20_2","doi-asserted-by":"publisher","DOI":"10.3390\/jpm12101707"},{"key":"e_1_2_10_21_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11063-023-11333-x"},{"key":"e_1_2_10_22_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.cmpb.2020.105709"},{"key":"e_1_2_10_23_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.future.2020.09.014"},{"key":"e_1_2_10_24_2","doi-asserted-by":"publisher","DOI":"10.3389\/fnagi.2021.828214"},{"key":"e_1_2_10_25_2","volume-title":"Ultrasound-Assisted Diagnosis of Benign and Malignant Cervical Lymph Nodes in Patients With Lung Cancer Based on Deep Learning","author":"Xia L.","year":"2020"},{"key":"e_1_2_10_26_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.compbiomed.2022.105821"},{"key":"e_1_2_10_27_2","doi-asserted-by":"publisher","DOI":"10.1109\/JPROC.2020.3004555"},{"key":"e_1_2_10_28_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12880-022-00793-7"},{"key":"e_1_2_10_29_2","first-page":"3347","volume-title":"Proceedings of the 33rd International Conference on Neural Information Processing Systems","author":"Raghu M.","year":"2019"},{"key":"e_1_2_10_30_2","unstructured":"SimonyanK.andZissermanA. Very Deep Convolutional Networks for Large-Scale Image Recognition 2015 https:\/\/doi.org\/10.48550\/arXiv.1409.1556."},{"key":"e_1_2_10_31_2","doi-asserted-by":"publisher","DOI":"10.1109\/CVPR.2016.90"},{"key":"e_1_2_10_32_2","doi-asserted-by":"publisher","DOI":"10.1109\/ICCV.2019.00140"},{"key":"e_1_2_10_33_2","doi-asserted-by":"publisher","DOI":"10.1007\/978-3-030-01264-9_8"},{"key":"e_1_2_10_34_2","doi-asserted-by":"publisher","DOI":"10.1109\/CVPR.2017.243"},{"key":"e_1_2_10_35_2","doi-asserted-by":"publisher","DOI":"10.48550\/arXiv.1905.11946"},{"key":"e_1_2_10_36_2","doi-asserted-by":"publisher","DOI":"10.48550\/arXiv.2104.00298"},{"key":"e_1_2_10_37_2","unstructured":"DosovitskiyA. BeyerL. KolesnikovA.et al. An Image Is Worth 16 \u00d7 16 Words: Transformers for Image Recognition at Scale 2021 https:\/\/doi.org\/10.48550\/arXiv.2010.11929."},{"key":"e_1_2_10_38_2","doi-asserted-by":"publisher","DOI":"10.1109\/ICCV48922.2021.00986"},{"key":"e_1_2_10_39_2","unstructured":"MehtaS.andRastegariM. MobileViT: Light-Weight General-Purpose and Mobile-Friendly Vision Transformer 2022 https:\/\/doi.org\/10.48550\/arXiv.2110.02178."},{"key":"e_1_2_10_40_2","unstructured":"KingmaD. P.andJimmyBa. Adam: A Method for Stochastic Optimization 2017 https:\/\/doi.org\/10.48550\/arXiv.1412.6980."},{"key":"e_1_2_10_41_2","unstructured":"SamekW. WiegandT. andM\u00fcllerK.-R. Explainable Artificial Intelligence: Understanding Visualizing and Interpreting Deep Learning Models 2017 https:\/\/doi.org\/10.48550\/arXiv.1708.08296."},{"key":"e_1_2_10_42_2","doi-asserted-by":"publisher","DOI":"10.3390\/app11104573"},{"key":"e_1_2_10_43_2","doi-asserted-by":"publisher","DOI":"10.1109\/ICCV.2017.74"}],"container-title":["International Journal of Intelligent Systems"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1155\/int\/5432766","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1155\/int\/5432766","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1155\/int\/5432766","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,8]],"date-time":"2026-03-08T17:56:39Z","timestamp":1772992599000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1155\/int\/5432766"}},"subtitle":[],"editor":[{"given":"Mohamadreza (Mohammad)","family":"Khosravi","sequence":"additional","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]}],"short-title":[],"issued":{"date-parts":[[2025,1]]},"references-count":43,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2025,1]]}},"alternative-id":["10.1155\/int\/5432766"],"URL":"https:\/\/doi.org\/10.1155\/int\/5432766","archive":["Portico"],"relation":{},"ISSN":["0884-8173","1098-111X"],"issn-type":[{"value":"0884-8173","type":"print"},{"value":"1098-111X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,1]]},"assertion":[{"value":"2024-02-26","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-01-04","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-03-06","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"5432766"}}