Deep Learning Estimation of Sex, Age, Height, and Weight from CT-derived Digitally Reconstructed Radiographs
Authors: Tomohiro Kikuchi, Kohei Yamamoto, Yukihiro Nomura, Yosuke Yamagishi, Takeharu Yoshikawa, Toshiaki Akashi, Jun Kamohara, Hiroyuki Fujii, +1 more
Organizations: Department of Radiology, Jichi Medical University, 3311-1 Yakushiji, Shimotsuke-shi, Tochigi, 329-0498, Japan. · Data Science Center, Jichi Medical University, 3311-1 Yakushiji, Shimotsuke-shi, Tochigi, 329-0498, Japan. · Department of Computational Diagnostic Radiology and Preventive Medicine, The University of Tokyo Hospital, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan. · Center for Frontier Medical Engineering, Chiba University, 1-33 Yayoicho, Inage-Ku, Chiba, Japan. · Division of Radiology and Biomedical Engineering, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-Ku, Tokyo, 113-8655, Japan · Department of Diagnostic Radiology, Tokyo Metropolitan Institute for Geriatrics and Gerontology, 35-2 Sakae-cho, Itabashi-ku Tokyo 173-0015, Japan
Abstract
Purpose: To develop and validate a deep learning ensemble for estimating adult sex, age, height, and weight from coronal digitally reconstructed radiographs (DRRs) generated from diagnostic CT. Materials and Methods: This retrospective study included 128,621 CT examinations from 80,004 adults at nine institutions in Japan. Three multitask models-ConvNeXt-Base, ViT-Base/16, and MaxViT-Base-were fine-tuned using coronal DRRs and combined by weighted averaging. Data were split by institution into training (114,147 examinations; seven institutions), tuning (4,305; one institution), and test (10,169; one institution) sets; generalizability was assessed on two non-Japanese datasets. Accuracy and mean absolute error (MAE) were used to evaluate sex classification and age, height, and weight regression, respectively. Body surface area (BSA)-corrected heart and liver volume trends were compared using true versus estimated height and weight. Results: In the test set (median age, 69.9 years; 4,899 of 10,169 [48.2%] male), overall sex-classification accuracy was 0.997 (95% CI, 0.996-0.998), and MAEs were 3.57 years (3.51-3.63), 2.59 cm (2.54-2.64), and 3.40 kg (3.34-3.47) for age, height, and weight, respectively. In examinations covering the chest through pelvis, accuracy was 1.000, and MAEs were 3.15 years, 2.28 cm, and 3.18 kg, respectively. BSA calculated from estimated values reproduced age-related heart and liver volume trends obtained using true values. On non-Japanese datasets, height error increased but was reduced by continued fine-tuning. Conclusion: The ensemble estimated adult sex, age, height, and weight from CT-derived DRRs, with generally lower errors in examinations with broader anatomical coverage.
Sexual identification of decomposed cadavers challenges traditional methods dependent on visual anthropological analysis. This study evaluates state-of-the-art deep learning (including YOLO26, YOLO11, ConvNeXt-Tiny, EfficientNetV2, ViT-B16, VGG16, and ResNet50) with transfer learning to automatically determine biological sex from forensic computed tomography (CT) scans. We analyzed 141 autopsied cadavers from the Forensic Medical Institute of Goiânia-GO, including a broad age range and varying conditions of preservation. The three-dimensional reconstructions of the pelvis and skull were converted into standardized two-dimensional profile projections, contributing to the study of this new technical approach. Data augmentation techniques compensated for sample limitations. Two scenarios were validated: binary and quaternary classification (one class per sex vs. one class per anatomical region of each sex). The best-performing model achieved highly consistent results on the pelvis region and still satisfactory performance on the skull region, reaching an overall patient-level accuracy of 95.65%, recall of 92.86%, F1- score of 94.36%, and precision of 97.22%, maintaining consistent performance across the evaluated cases, including those with trauma-related artifacts. Results indicate the technical feasibility of the methodology, demonstrating that deep learning models can provide objective, high-speed skeletal analysis. Since the study was conducted using data from a single institution and a single computed tomography scanner, further validation across multiple centers and scanners is required to assess the generalizability of the proposed approach
Background: Patient details and acquisition metadata are important for clinical decisions, image quality control, and automated research pipelines, but may be missing or unreliable in imaging archives. Purpose: To develop and evaluate a fast open-source model that predicts patient and acquisition characteristics directly from CT and MR images. Materials and Methods: Separate 3D ResNet-10 ensembles for CT and MR were trained on 57,291 and 43,200 clinical examinations acquired from 2011 to 2025. Both predicted weight, height, age, sex, contrast presence, vertebral coverage, and image noise. The CT model additionally predicted scanner manufacturer, tube voltage, tube current, convolution kernel, and post-injection time; the MR model predicted sequence class. Performance was evaluated on internal CT (n=501) and MR (n=636) test sets and an external CT dataset (n=54). Results: Internal CT MAEs were 3.90 kg, 3.68 cm, and 4.42 years for weight, height, and age, with sex F1=0.990; corresponding MR results were 4.34 kg, 4.62 cm, 7.13 years, and F1=0.970. The CNN outperformed a segmentation-derived XGBoost baseline for all four core targets in both modalities (adjusted P<=.042). F1 scores were 0.963 for CT contrast, 0.953 for MR sequence, and 0.823 for MR contrast. External CT MAEs were 4.45 kg, 4.05 cm, and 5.17 years, with sex F1=0.971. CPU inference required 20 seconds for CT and 12 seconds for MR. Conclusion: One 3D multitask model per modality can rapidly recover patient and acquisition characteristics from heterogeneous CT and MR examinations. Models are available in TotalSegmentator: https://github.com/wasserth/TotalSegmentator
Chest radiography (CXR) remains the most widely used thoracic imaging modality, yet expert interpretation is constrained by a severe shortage of radiologists in Thailand and across Southeast Asia. Local adaptation of deep learning models to Thai data has been shown to substantially improve accuracy on Thai populations. Here we present the development and comprehensive validation of the chest radiograph analysis model in Inspectra CXR version 5, a deep learning system that performs multi-label thoracic disease classification and weakly supervised lesion localization within a single model. The architecture couples a DenseNet-121 backbone with Attend-and-Compare Modules (ACM) and a Probabilistic Class Activation Map (PCAM) aggregation layer, producing a per-condition classification score and heatmap simultaneously. The model was developed on 874,858 frontal chest radiographs with paired radiologist reports from Siriraj Hospital, Bangkok. On a held-out, radiologist-verified in-domain test set of 19,871 cases, it achieved a mean AUROC of 0.994 (mean sensitivity 92.4%, specificity 98.6%) across nine clinically important conditions. On an independent generalization set of 5,992 cases from 13 hospitals across Thailand, the mean AUROC was 0.970, indicating robust transfer across sites. For localization, evaluated on 4,549 radiologist-annotated cases, the model attained a mean lesion-localization fraction (LLF) of 77.9% at 0.59 non-lesion localizations per image. In a usability evaluation with five thoracic radiologists, the system reached a classification concordance of 93.6%, a localization concordance of 94.7%, and a mean System Usability Scale (SUS) score of 89. These results indicate that a locally developed, localization-capable CXR system can deliver high accuracy, generalize across heterogeneous Thai hospitals, and earn the trust of practicing radiologists.