Deep-learning based detection of vessel occlusions on CT-angiography in patients with suspected acute ischemic stroke.

Journal: Nature communications
Published Date:

Abstract

Swift diagnosis and treatment play a decisive role in the clinical outcome of patients with acute ischemic stroke (AIS), and computer-aided diagnosis (CAD) systems can accelerate the underlying diagnostic processes. Here, we developed an artificial neural network (ANN) which allows automated detection of abnormal vessel findings without any a-priori restrictions and in <2 minutes. Pseudo-prospective external validation was performed in consecutive patients with suspected AIS from 4 different hospitals during a 6-month timeframe and demonstrated high sensitivity (≥87%) and negative predictive value (≥93%). Benchmarking against two CE- and FDA-approved software solutions showed significantly higher performance for our ANN with improvements of 25-45% for sensitivity and 4-11% for NPV (p ≤ 0.003 each). We provide an imaging platform ( https://stroke.neuroAI-HD.org ) for online processing of medical imaging data with the developed ANN, including provisions for data crowdsourcing, which will allow continuous refinements and serve as a blueprint to build robust and generalizable AI algorithms.

Authors

  • Gianluca Brugnara
    Department of Neuroradiology, Heidelberg University Hospital, Heidelberg, Germany.
  • Michael Baumgartner
    Division of Medical Image Computing, German Cancer Research Center (DKFZ), Heidelberg, Germany.
  • Edwin David Scholze
    Department of Neuroradiology, Heidelberg University Hospital, Heidelberg, Germany.
  • Katerina Deike-Hofmann
    Department of Neuroradiology, University Hospital Bonn, Germany.
  • Klaus Kades
    Division of Medical Image Computing, German Cancer Research Center, Heidelberg, Germany.
  • Jonas Scherer
    Division of Medical Image Computing, German Cancer Research Center, Heidelberg, Germany.
  • Stefan Denner
    Division of Medical Image Computing, German Cancer Research Center (DKFZ), Heidelberg, Germany.
  • Hagen Meredig
    Department of Neuroradiology, Heidelberg University Hospital, Heidelberg, Germany.
  • Aditya Rastogi
    Department of Computational and Data Sciences, Indian Institute of Science, Bangalore, 560012, India.
  • Mustafa Ahmed Mahmutoglu
    Department of Neuroradiology, Heidelberg University Hospital, Heidelberg, Germany.
  • Christian Ulfert
    Department of Neuroradiology, Heidelberg University Hospital, Heidelberg, Germany.
  • Ulf Neuberger
    Department of Neuroradiology, Heidelberg University Hospital, Heidelberg, Germany.
  • Silvia Schönenberger
    Neurology Clinic, Heidelberg University Hospital, Heidelberg, Germany.
  • Kai Schlamp
  • Zeynep Bendella
    Department of Neuroradiology, Bonn University Hospital, Bonn, Germany.
  • Thomas Pinetz
    Institute of Applied Mathematics, Rheinische Friedrich-Wilhelms-Universität Bonn, Bonn, Germany.
  • Carsten Schmeel
    Department of Neuroradiology, Bonn University Hospital, Bonn, Germany.
  • Wolfgang Wick
    Neurology Clinic, Heidelberg University Hospital, Heidelberg, Germany; German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ), Heidelberg, Germany.
  • Peter A Ringleb
    Neurology Clinic, Heidelberg University Hospital, Heidelberg, Germany.
  • Ralf Floca
    Division of Medical Image Computing, German Cancer Research Center, Heidelberg, Germany.
  • Markus Möhlenbruch
    Dept. of Neuroradiology, Heidelberg University Hospital, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany.
  • Alexander Radbruch
    Department of Neuroradiology, Heidelberg University Hospital, Heidelberg, Germany; Department of Radiology, German Cancer Research Center (DKFZ), Heidelberg, Germany.
  • Martin Bendszus
    Department of Neuroradiology, Heidelberg University Hospital, Heidelberg, Germany.
  • Klaus Maier-Hein
    Medical Image Analysis, Division Medical Image Computing, DKFZ Heidelberg, Germany.
  • Philipp Vollmuth
    Department of Neuroradiology, Heidelberg University Hospital, Heidelberg, Germany. Electronic address: philipp.vollmuth@med.uni-heidelberg.de.