Integrating Natural Language Processing and Machine Learning Algorithms to Categorize Oncologic Response in Radiology Reports.

Journal: Journal of digital imaging
Published Date:

Abstract

A significant volume of medical data remains unstructured. Natural language processing (NLP) and machine learning (ML) techniques have shown to successfully extract insights from radiology reports. However, the codependent effects of NLP and ML in this context have not been well-studied. Between April 1, 2015 and November 1, 2016, 9418 cross-sectional abdomen/pelvis CT and MR examinations containing our internal structured reporting element for cancer were separated into four categories: Progression, Stable Disease, Improvement, or No Cancer. We combined each of three NLP techniques with five ML algorithms to predict the assigned label using the unstructured report text and compared the performance of each combination. The three NLP algorithms included term frequency-inverse document frequency (TF-IDF), term frequency weighting (TF), and 16-bit feature hashing. The ML algorithms included logistic regression (LR), random decision forest (RDF), one-vs-all support vector machine (SVM), one-vs-all Bayes point machine (BPM), and fully connected neural network (NN). The best-performing NLP model consisted of tokenized unigrams and bigrams with TF-IDF. Increasing N-gram length yielded little to no added benefit for most ML algorithms. With all parameters optimized, SVM had the best performance on the test dataset, with 90.6 average accuracy and F score of 0.813. The interplay between ML and NLP algorithms and their effect on interpretation accuracy is complex. The best accuracy is achieved when both algorithms are optimized concurrently.

Authors

  • Po-Hao Chen
    Department of Radiology, Perelman School of Medicine, Hospital of the University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA, 19104, USA. po-hao.chen@uphs.upenn.edu.
  • Hanna Zafar
    Department of Radiology, Perelman School of Medicine, Hospital of the University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA, 19104, USA.
  • Maya Galperin-Aizenberg
    Department of Radiology, Perelman School of Medicine, Hospital of the University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA, 19104, USA.
  • Tessa Cook
    Department of Radiology, Hospital of the University of Pennsylvania, 3400 Spruce St, Philadelphia, PA 19104 (J.D.R., L.X., A.K., J.M.E., T.C., I.M.N., S.M., J.C.G.); Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, Calif (J.D.R., A.M.R.); Penn Image Computing and Science Laboratory, University of Pennsylvania, Philadelphia, Pa (X.L., J.W.); University of Pennsylvania Perelman School of Medicine, Philadelphia, Pa (M.T.D.); Mecklenburg Radiology Associates, Charlotte, NC (E.J.B.); Department of Radiology, University of Texas, Austin, Tex (R.N.B.); and Division of Nuclear Medicine and Clinical Molecular Imaging, Department of Radiology, University of Pennsylvania, Philadelphia, Pa (I.M.N.).