Automatic Determination of the Need for Intravenous Contrast in Musculoskeletal MRI Examinations Using IBM Watson's Natural Language Processing Algorithm.

Magnetic resonance imaging (MRI) protocoling can be time- and resource-intensive, and protocols can often be suboptimal dependent upon the expertise or preferences of the protocoling radiologist. Providing a best-practice recommendation for an MRI protocol has the potential to improve efficiency and...

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Publicado en:Journal of Digital Imaging Vol. 31; no. 2; pp. 245 - 252
Autores principales: Trivedi, Hari, Mesterhazy, Joseph, Laguna, Benjamin, Thienkhai Vu, Jae Ho Sohn
Formato: pictorial protocol research tables/charts Journal Article
Publicado: Springer Nature Apr2018
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Apr2018
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      pub: Springer Nature
      place: New York, New York
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        10.1007/s10278-017-0021-3
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        atl: Automatic Determination of the Need for Intravenous Contrast in Musculoskeletal MRI Examinations Using IBM Watson's Natural Language Processing Algorithm.
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        au:
          Trivedi, Hari
          Mesterhazy, Joseph
          Laguna, Benjamin
          Thienkhai Vu
          Jae Ho Sohn
        affil: Radiology & Biomedical Imaging, UCSF Medical Center, 505 Parnassus Ave, San Francisco, CA 94158, USA
      sug:
        subj:
          Contrast Media
          Administration, Intravenous
          Diagnosis, Musculoskeletal
          Magnetic Resonance Imaging
          Natural Language Processing Utilization
          IBM Compatible Microcomputers Utilization
          Human Error
          Radiologists
          Human
          Medical Records
          Validity
          Computer Systems
          Athletes
          Guideline Adherence
          Instrument Validation
          Workflow
          Decision Making, Clinical
      ab: Magnetic resonance imaging (MRI) protocoling can be time- and resource-intensive, and protocols can often be suboptimal dependent upon the expertise or preferences of the protocoling radiologist. Providing a best-practice recommendation for an MRI protocol has the potential to improve efficiency and decrease the likelihood of a suboptimal or erroneous study. The goal of this study was to develop and validate a machine learning-based natural language classifier that can automatically assign the use of intravenous contrast for musculoskeletal MRI protocols based upon the free-text clinical indication of the study, thereby improving efficiency of the protocoling radiologist and potentially decreasing errors. We utilized a deep learning-based natural language classification system from IBM Watson, a question-answering supercomputer that gained fame after challenging the best human players on Jeopardy! in 2011. We compared this solution to a series of traditional machine learning-based natural language processing techniques that utilize a term-document frequency matrix. Each classifier was trained with 1240 MRI protocols plus their respective clinical indications and validated with a test set of 280. Ground truth of contrast assignment was obtained from the clinical record. For evaluation of interreader agreement, a blinded second reader radiologist analyzed all cases and determined contrast assignment based on only the free-text clinical indication. In the test set, Watson demonstrated overall accuracy of 83.2% when compared to the original protocol. This was similar to the overall accuracy of 80.2% achieved by an ensemble of eight traditional machine learning algorithms based on a term-document matrix. When compared to the second reader's contrast assignment, Watson achieved 88.6% agreement. When evaluating only the subset of cases where the original protocol and second reader were concordant (n = 251), agreement climbed further to 90.0%. The classifier was relatively robust to spelling and grammatical errors, which were frequent. Implementation of this automated MR contrast determination system as a clinical decision support tool may save considerable time and effort of the radiologist while potentially decreasing error rates, and require no change in order entry or workflow.
      pubtype: Academic Journal
      doctype:
        pictorial
        protocol
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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