Improving Sensitivity on Identification and Delineation of Intracranial Hemorrhage Lesion Using Cascaded Deep Learning Models.

Journal: Journal of digital imaging
Published Date:

Abstract

Highly accurate detection of the intracranial hemorrhage without delay is a critical clinical issue for the diagnostic decision and treatment in an emergency room. In the context of a study on diagnostic accuracy, there is a tradeoff between sensitivity and specificity. In order to improve sensitivity while preserving specificity, we propose a cascade deep learning model constructed using two convolutional neural networks (CNNs) and dual fully convolutional networks (FCNs). The cascade CNN model is built for identifying bleeding; hereafter the dual FCN is to detect five different subtypes of intracranial hemorrhage and to delineate their lesions. Using a total of 135,974 CT images including 33,391 images labeled as bleeding, each of CNN/FCN models was trained separately on image data preprocessed by two different settings of window level/width. One is a default window (50/100[level/width]) and the other is a stroke window setting (40/40). By combining them, we obtained a better outcome on both binary classification and segmentation of hemorrhagic lesions compared to a single CNN and FCN model. In determining whether it is bleeding or not, there was around 1% improvement in sensitivity (97.91% [± 0.47]) while retaining specificity (98.76% [± 0.10]). For delineation of bleeding lesions, we obtained overall segmentation performance at 80.19% in precision and 82.15% in recall which is 3.44% improvement compared to using a single FCN model.

Authors

  • Junghwan Cho
    CAIDE Systems Inc., 110 Canal St., Lowell, MA, 01852, USA. jcho@caidesystems.com.
  • Ki-Su Park
    Department of Neurosurgery, School of Medicine of Kyungpook National University, 680 Gukchaebosang-ro, Jung-gu, Daegu, 41944, South Korea.
  • Manohar Karki
    Louisiana State University, Baton Rouge, LA, USA.
  • Eunmi Lee
    CAIDE Systems Inc., 110 Canal St., Lowell, MA, 01852, USA.
  • Seokhwan Ko
    CAIDE Systems Inc., 110 Canal St., Lowell, MA, 01852, USA.
  • Jong Kun Kim
    Department of Emergency Medicine, School of Medicine of Kyungpook National University, 680 Gukchaebosang-ro, Jung-gu, Daegu, 41944, South Korea.
  • Dongeun Lee
    Department of Emergency Medicine, School of Medicine of Kyungpook National University, 680 Gukchaebosang-ro, Jung-gu, Daegu, 41944, South Korea.
  • Jaeyoung Choe
    Department of Emergency Medicine, School of Medicine of Kyungpook National University, 680 Gukchaebosang-ro, Jung-gu, Daegu, 41944, South Korea.
  • Jeongwoo Son
    Department of Emergency Medicine, School of Medicine of Kyungpook National University, 680 Gukchaebosang-ro, Jung-gu, Daegu, 41944, South Korea.
  • Myungsoo Kim
    Department of Neurosurgery, School of Medicine of Kyungpook National University, 680 Gukchaebosang-ro, Jung-gu, Daegu, 41944, South Korea.
  • Sukhee Lee
    Department of Emergency Medicine, School of Medicine of Daegu Catholic University, 33 Duryugongwon-ro, 17-gil, Nam-gu, Daegu, Gyeongsangbuk-do, South Korea.
  • Jeongho Lee
    Department of Neurosurgery, Daegu Fatima Hospital, 99 Ayang-ro, Dong-gu, Daegu, South Korea.
  • Changhyo Yoon
    Department of Neurology, Changwon Hospital Gyeongsang National University, 11 Samjeongja-ro, Seongsan-gu, Changwon, South Korea.
  • Sinyoul Park
    Department of Emergency Medicine, College of Medicine of Yeungnam University, 317-1 Daemyung-dong, Nam-gu, Daegu, 705-717, South Korea.