Deep learning models for triaging hospital head MRI examinations.

Journal: Medical image analysis
Published Date:

Abstract

The growing demand for head magnetic resonance imaging (MRI) examinations, along with a global shortage of radiologists, has led to an increase in the time taken to report head MRI scans in recent years. For many neurological conditions, this delay can result in poorer patient outcomes and inflated healthcare costs. Potentially, computer vision models could help reduce reporting times for abnormal examinations by flagging abnormalities at the time of imaging, allowing radiology departments to prioritise limited resources into reporting these scans first. To date, however, the difficulty of obtaining large, clinically-representative labelled datasets has been a bottleneck to model development. In this work, we present a deep learning framework, based on convolutional neural networks, for detecting clinically-relevant abnormalities in minimally processed, hospital-grade axial T2-weighted and axial diffusion-weighted head MRI scans. The models were trained at scale using a Transformer-based neuroradiology report classifier to generate a labelled dataset of 70,206 examinations from two large UK hospital networks, and demonstrate fast (< 5 s), accurate (area under the receiver operating characteristic curve (AUC) > 0.9), and interpretable classification, with good generalisability between hospitals (ΔAUC ≤ 0.02). Through a simulation study we show that our best model would reduce the mean reporting time for abnormal examinations from 28 days to 14 days and from 9 days to 5 days at the two hospital networks, demonstrating feasibility for use in a clinical triage environment.

Authors

  • David A Wood
    School of Biomedical Engineering & Imaging Sciences, Kings College London, Rayne Institute, 4th Floor, Lambeth Wing, London, SE1 7EH, UK.
  • Sina Kafiabadi
    Department of Neuroradiology, Ruskin Wing, King's College Hospital NHS Foundation Trust, London, SE5 9RS, UK.
  • Ayisha Al Busaidi
    King's College Hospital NHS Foundation Trust, United Kingdom.
  • Emily Guilhem
    King's College Hospital NHS Foundation Trust, United Kingdom.
  • Antanas Montvila
    Department of Neuroradiology, Ruskin Wing, King's College Hospital NHS Foundation Trust, London, SE5 9RS, UK.
  • Jeremy Lynch
    Department of Neuroradiology, Ruskin Wing, King's College Hospital NHS Foundation Trust, London, SE5 9RS, UK.
  • Matthew Townend
    Wrightington, Wigan and Leigh NHSFT, United Kingdom.
  • Siddharth Agarwal
    School of Biomedical Engineering and Imaging Sciences, King's College London, United Kingdom.
  • Asif Mazumder
    Guy's and St Thomas' NHS Foundation Trust, Westminster Bridge Road, London, SE1 7EH, UK.
  • Gareth J Barker
    Department of Neuroimaging, Institute of Psychiatry, Psychology, & Neuroscience, King's College London, United Kingdom.
  • Sébastien Ourselin
    Wellcome / EPSRC Centre for Interventional and Surgical Sciences (WEISS), University College London, UK.
  • James H Cole
    Computational, Clinical, and Cognitive Neuroimaging Laboratory, Department of Medicine, Imperial College London, London, United Kingdom.
  • Thomas C Booth
    School of Biomedical Engineering and Imaging Sciences, King's College London, St. Thomas' Hospital, London, United Kingdom.