{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T05:18:22Z","timestamp":1787030302725,"version":"build-2736575974"},"reference-count":33,"publisher":"American Association for the Advancement of Science (AAAS)","funder":[{"name":"the Project of Qinghai Provincial Department of Science and Technology of China","award":["2021-ZJ-963Q"],"award-info":[{"award-number":["2021-ZJ-963Q"]}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["61721003"],"award-info":[{"award-number":["61721003"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100021165","name":"Tsinghua-Fuzhou Institute for Data Technology","doi-asserted-by":"publisher","award":["TFIDT2021005"],"award-info":[{"award-number":["TFIDT2021005"]}],"id":[{"id":"10.13039\/501100021165","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["spj.science.org"],"crossmark-restriction":true},"short-container-title":["Research"],"published-print":{"date-parts":[[2025,1]]},"abstract":"<jats:p>\n                    We aimed to develop a voiding cystourethrography (VCUG) diagnostic artificial intelligence model (VCUG-DAM), which relies on a novel architecture to automatically segment and diagnose the bladder, urethra, and ureters using a single VCUG image, while dynamically assessing the relative importance of each image. A total of 7,899 VCUG images from 1,660 patients across 15 Chinese hospitals were collected between 2021 and 2023. In stage 1, we assessed the performances of the VCUG-DAM model. The patient-level area under the curve (AUC) of VCUG-DAM was 0.8772, 0.7752, 0.9443, and 0.9342 for bladder, urethral, left, and right vesicoureteral reflux (VUR), respectively. In stage 2, we explored whether the VCUG-DAM model could improve the diagnostic ability of clinicians. VCUG-DAM improved the clinician\u2019s diagnostic performance, with mean AUCs increasing from 0.8185 to 0.9456 for the bladder, 0.6507 to 0.7943 for the urethra, 0.6288 to 0.9641 for the left VUR, and 0.7305 to 0.9506 for the right VUR (all\n                    <jats:italic>P<\/jats:italic>\n                    &lt; 0.0001). In stage 3, the consistency of the VCUG-DAM for VUR grading was validated. VCUG-DAM improved inter-clinician agreement for VUR grading. The fully automated VCUG-DAM demonstrated high accuracy, reliability, and robustness in multitask diagnoses of urinary tract abnormalities across multiple VCUG images, while improving the diagnostic ability of clinicians as an auxiliary tool.\n                  <\/jats:p>","DOI":"10.34133\/research.0771","type":"journal-article","created":{"date-parts":[[2025,6,16]],"date-time":"2025-06-16T02:22:34Z","timestamp":1750040554000},"update-policy":"https:\/\/doi.org\/10.34133\/aaas_crossmark_01","source":"Crossref","is-referenced-by-count":5,"title":["Dynamic Multi-Image Weighting for Automated Detection and Diagnosis of Abnormal Urinary Tract on Voiding Cystourethrography with a Deep Learning System: A Retrospective, Large-Scale, Multicenter Study"],"prefix":"10.34133","volume":"8","author":[{"ORCID":"https:\/\/orcid.org\/0009-0001-7183-0023","authenticated-orcid":false,"given":"Min","family":"Wu","sequence":"first","affiliation":[{"name":"Department of Urology, Shanghai Children\u2019s Hospital, School of Medicine, \rShanghai Jiao Tong University, Shanghai 200062, China."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhanchi","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Urology, \rShanghai Punan Hospital of Pudong New District, Punan Branch of Renji Hospital, Shanghai 200000, China."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"YiDong","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Urology, Renji Hospital, School of Medicine, \rShanghai Jiao Tong University, Shanghai, China."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zelong","family":"Tan","sequence":"additional","affiliation":[{"name":"Department of Electronic Engineering, \rTsinghua University, Beijing, China."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wenjuan","family":"Tang","sequence":"additional","affiliation":[{"name":"Department of Radiology, Shanghai Children\u2019s Hospital, School of Medicine, \rShanghai Jiao Tong University, Shanghai 200062, China."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaoqi","family":"Xuan","sequence":"additional","affiliation":[{"name":"Department of Urology, \rWuxi Children\u2019s Hospital, Wuxi, China."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hui","family":"Feng","sequence":"additional","affiliation":[{"name":"Department of Urology, \rThe Sixth Affiliated Hospital of Harbin Medical University, Harbin, China."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Weihua","family":"Lao","sequence":"additional","affiliation":[{"name":"Department of Urology, \rGuangdong Women and Children Hospital, Guangzhou, China."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ning","family":"Ding","sequence":"additional","affiliation":[{"name":"Department of Urology, \rJiangxi Provincial Children\u2019s Hospital, Nanchang, China."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"BoJun","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Radiology, \rChildren\u2032s Hospital of Fudan University, Shanghai 201102, China."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zheyuan","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Computer Science and Engineering, \rShanghai Jiao Tong University, Shanghai 200240, China."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Likai","family":"Zhuang","sequence":"additional","affiliation":[{"name":"Department of Urology, \rChildren\u2032s Hospital of Fudan University, Shanghai 201102, China."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"221","published-online":{"date-parts":[[2025,7,22]]},"reference":[{"issue":"3","key":"e_1_3_4_2_2","doi-asserted-by":"crossref","first-page":"378","DOI":"10.1016\/j.jpurol.2022.02.008","article-title":"Voiding cystourethrogram: Who gets a cyclic study and does it matter?","volume":"18","author":"Arlen AM","year":"2022","unstructured":"Arlen AM, Amin J, Leong T. Voiding cystourethrogram: Who gets a cyclic study and does it matter? J Pediatr Urol. 2022;18(3):378\u2013382.","journal-title":"J Pediatr Urol"},{"issue":"4","key":"e_1_3_4_3_2","doi-asserted-by":"crossref","first-page":"606","DOI":"10.1007\/s00247-024-05883-y","article-title":"Update on imaging recommendations in paediatric uroradiology: The European Society of Paediatric Radiology workgroup session on voiding cystourethrography","volume":"54","author":"Damasio MB","year":"2024","unstructured":"Damasio MB, Donati F, Bruno C, Darge K, Mentzel HJ, Klju\u010dev\u0161ek D, Napolitano M, Ozcan HN, Riccabona M, Smets AM, et al. Update on imaging recommendations in paediatric uroradiology: The European Society of Paediatric Radiology workgroup session on voiding cystourethrography. Pediatr Radiol. 2024;54(4):606\u2013619.","journal-title":"Pediatr Radiol"},{"issue":"3","key":"e_1_3_4_4_2","first-page":"152","article-title":"Diagnosis of the congenital urethral anomalies of male child by voiding cystourethrography","volume":"40","author":"Lo WC","year":"1999","unstructured":"Lo WC, Wang CR, Lim KE. Diagnosis of the congenital urethral anomalies of male child by voiding cystourethrography. Acta Paediatr Taiwan. 1999;40(3):152\u2013156.","journal-title":"Acta Paediatr Taiwan"},{"issue":"9","key":"e_1_3_4_5_2","doi-asserted-by":"crossref","first-page":"2443","DOI":"10.1007\/s00345-023-04527-4","article-title":"A grading system for evaluation of bladder trabeculation","volume":"41","author":"Wang X","year":"2023","unstructured":"Wang X, Chen HS, Wang C, Luo XG, Wang YX, Ye ZH, Liu X, Wei GH. A grading system for evaluation of bladder trabeculation. 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