Deep Learning Achieves Neuroradiologist-Level Performance in Detecting Hydrocephalus Requiring Treatment.

In large clinical centers a small subset of patients present with hydrocephalus that requires surgical treatment. We aimed to develop a screening tool to detect such cases from the head MRI with performance comparable to neuroradiologists. We leveraged 496 clinical MRI exams collected retrospectivel...

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Published in:Journal of Digital Imaging Vol. 35; no. 6; pp. 1662 - 1673
Main Authors: Huang, Yu, Moreno, Raquel, Malani, Rachna, Meng, Alicia, Swinburne, Nathaniel, Holodny, Andrei I., Choi, Ye, Rusinek, Henry, Golomb, James B., George, Ajax, Parra, Lucas C., Young, Robert J.
Format: diagnostic images research tables/charts Journal Article
Published: Springer Nature Dec2022
Online Access:View this record in EBSCOhost
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      dt: Dec2022
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      pub: Springer Nature
      place: New York, New York
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        10.1007/s10278-022-00654-3
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        atl: Deep Learning Achieves Neuroradiologist-Level Performance in Detecting Hydrocephalus Requiring Treatment.
      aug:
        au:
          Huang, Yu
          Moreno, Raquel
          Malani, Rachna
          Meng, Alicia
          Swinburne, Nathaniel
          Holodny, Andrei I.
          Choi, Ye
          Rusinek, Henry
          Golomb, James B.
          George, Ajax
          Parra, Lucas C.
          Young, Robert J.
        affil: Department of Radiology, Memorial Sloan Kettering Cancer Center, 10065, New York, NY, USA
      sug:
        subj:
          Hydrocephalus Diagnosis
          Hydrocephalus Surgery
          Magnetic Resonance Imaging
          Health Screening
          Deep Learning
          Neural Networks (Computer)
          Diagnosis, Computer Assisted
          Image Interpretation, Computer Assisted
          Radiologists
          Neuroradiography
          Human
          Retrospective Design
          Record Review
          Algorithms
          Automation
          Imaging, Three-Dimensional
          Image Processing, Computer Assisted
          Comparative Studies
          Clinical Assessment Tools
          Sensitivity and Specificity
          Descriptive Statistics
      ab: In large clinical centers a small subset of patients present with hydrocephalus that requires surgical treatment. We aimed to develop a screening tool to detect such cases from the head MRI with performance comparable to neuroradiologists. We leveraged 496 clinical MRI exams collected retrospectively at a single clinical site from patients referred for any reason. This diagnostic dataset was enriched to have 259 hydrocephalus cases. A 3D convolutional neural network was trained on 16 manually segmented exams (ten hydrocephalus) and subsequently used to automatically segment the remaining 480 exams and extract volumetric anatomical features. A linear classifier of these features was trained on 240 exams to detect cases of hydrocephalus that required treatment with surgical intervention. Performance was compared to four neuroradiologists on the remaining 240 exams. Performance was also evaluated on a separate screening dataset of 451 exams collected from a routine clinical population to predict the consensus reading from four neuroradiologists using images alone. The pipeline was also tested on an external dataset of 31 exams from a 2nd clinical site. The most discriminant features were the Magnetic Resonance Hydrocephalic Index (MRHI), ventricle volume, and the ratio between ventricle and brain volume. At matching sensitivity, the specificity of the machine and the neuroradiologists did not show significant differences for detection of hydrocephalus on either dataset (proportions test, p > 0.05). ROC performance compared favorably with the state-of-the-art (AUC 0.90–0.96), and replicated in the external validation. Hydrocephalus cases requiring treatment can be detected automatically from MRI in a heterogeneous patient population based on quantitative characterization of brain anatomy with performance comparable to that of neuroradiologists.
      pubtype: Academic Journal
      doctype:
        diagnostic images
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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