Evaluation of acute pulmonary embolism and clot burden on CTPA with deep learning.

Objectives: To take advantage of the deep learning algorithms to detect and calculate clot burden of acute pulmonary embolism (APE) on computed tomographic pulmonary angiography (CTPA).Materials and Methods: The training set in this retrospective study consisted of 590 patients (460 with APE and 130...

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Publicado en:European Radiology Vol. 30; no. 6; pp. 3567 - 3576
Autores principales: Liu, Weifang, Liu, Min, Guo, Xiaojuan, Zhang, Peiyao, Zhang, Ling, Zhang, Rongguo, Kang, Han, Zhai, Zhenguo, Tao, Xincao, Wan, Jun, Xie, Sheng
Formato: research Journal Article
Publicado: Springer Nature Jun2020
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Jun2020
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        atl: Evaluation of acute pulmonary embolism and clot burden on CTPA with deep learning.
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          Liu, Weifang
          Liu, Min
          Guo, Xiaojuan
          Zhang, Peiyao
          Zhang, Ling
          Zhang, Rongguo
          Kang, Han
          Zhai, Zhenguo
          Tao, Xincao
          Wan, Jun
          Xie, Sheng
        affil: Peking University Health Science Center, 100871, Beijing, China
      sug:
        subj:
          Pulmonary Embolism
          Ventricular Function, Right
          Heart Ventricle
          Sensitivity and Specificity
          Aged
          Middle Age
          Acute Disease
          Retrospective Design
          Pulmonary Embolism Physiopathology
          Adult
          Reproducibility of Results
          Male
          Female
          Human
          Funding Source
          Aged: 65+ years
          Middle Aged: 45-64 years
          Adult: 19-44 years
          Male
          Female
      ab: Objectives: To take advantage of the deep learning algorithms to detect and calculate clot burden of acute pulmonary embolism (APE) on computed tomographic pulmonary angiography (CTPA).Materials and Methods: The training set in this retrospective study consisted of 590 patients (460 with APE and 130 without APE) who underwent CTPA. A fully deep learning convolutional neural network (DL-CNN), called U-Net, was trained for the segmentation of clot. Additionally, an in-house validation set consisted of 288 patients (186 with APE and 102 without APE). In this study, we set different probability thresholds to test the performance of U-Net for the clot detection and selected sensitivity, specificity, and area under the curve (AUC) as the metrics of performance evaluation. Furthermore, we investigated the relationship between the clot burden assessed by the Qanadli score, Mastora score, and other imaging parameters on CTPA and the clot burden calculated by the DL-CNN model.Results: There was no statistically significant difference in AUCs with the different probability thresholds. When the probability threshold for segmentation was 0.1, the sensitivity and specificity of U-Net in detecting clot respectively were 94.6% and 76.5% while the AUC was 0.926 (95% CI 0.884-0.968). Moreover, this study displayed that the clot burden measured with U-Net was significantly correlated with the Qanadli score (r = 0.819, p < 0.001), Mastora score (r = 0.874, p < 0.001), and right ventricular functional parameters on CTPA.Conclusions: DL-CNN achieved a high AUC for the detection of pulmonary emboli and can be applied to quantitatively calculate the clot burden of APE patients, which may contribute to reducing the workloads of clinicians.Key Points: • Deep learning can detect APE with a good performance and efficiently calculate the clot burden to reduce the physicians' workload. • Clot burden measured with deep learning highly correlates with Qanadli and Mastora scores of CTPA. • Clot burden measured with deep learning correlates with parameters of right ventricular function on CTPA.
      pubtype: Academic Journal
      doctype:
        research
        Journal Article
      ougenre: Article
    language: English
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