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Clinical Neuroradiology
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Clinical Neuroradiology
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Automated Detection of Ischemic Stroke and Subsequent Patient Triage in Routinely Acquired Head CT

Authors: Tom Finck; David Schinz; Lioba Grundl; Rami Eisawy; Mehmet Yiğitsoy; Julia Moosbauer; Claus Zimmer; +2 Authors

Automated Detection of Ischemic Stroke and Subsequent Patient Triage in Routinely Acquired Head CT

Abstract

Abstract Purpose Advanced machine-learning (ML) techniques can potentially detect the entire spectrum of pathology through deviations from a learned norm. We investigated the utility of a weakly supervised ML tool to detect characteristic findings related to ischemic stroke in head CT and provide subsequent patient triage. Methods Patients having undergone non-enhanced head CT at a tertiary care hospital in April 2020 with either no anomalies, subacute or chronic ischemia, lacunar infarcts of the deep white matter or hyperdense vessel signs were retrospectively analyzed. Anomaly detection was performed using a weakly supervised ML classifier. Findings were displayed on a voxel-level (heatmap) and pooled to an anomaly score. Thresholds for this score classified patients into i) normal, ii) inconclusive, iii) pathological. Expert-validated radiological reports were considered as ground truth. Test assessment was performed with ROC analysis; inconclusive results were pooled to pathological predictions for accuracy measurements. Results During the investigation period 208 patients were referred for head CT of which 111 could be included. Definite ratings into normal/pathological were feasible in 77 (69.4%) patients. Based on anomaly scores, the AUC to differentiate normal from pathological scans was 0.98 (95% CI 0.97–1.00). The sensitivity, specificity, positive and negative predictive values were 100%, 40.6%, 80.6% and 100%, respectively. Conclusion Our study demonstrates the potential of a weakly supervised anomaly-detection tool to detect stroke findings in head CT. Definite classification into normal/pathological was made with high accuracy in > 2/3 of patients. Anomaly heatmaps further provide guidance towards pathologies, also in cases with inconclusive ratings.

Country
Germany
Keywords

Stroke, Humans, Original Article, Triage, Original Article ; Machine learning ; Stroke ; Artificial intelligence ; Emergency imaging ; Computed tomography, Original Article ; Stroke ; Computed tomography ; Machine learning ; Emergency imaging ; Humans [MeSH] ; Triage [MeSH] ; Ischemic Stroke/diagnostic imaging [MeSH] ; Stroke/diagnostic imaging [MeSH] ; Artificial intelligence ; Retrospective Studies [MeSH] ; Tomography, X-Ray Computed/methods [MeSH], Tomography, X-Ray Computed, Ischemic Stroke, Retrospective Studies, ddc: ddc:

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    popularity
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    Top 10%
    influence
    This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
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    impulse
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selected citations
These citations are derived from selected sources.
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
BIP!Impulse provided by BIP!
3
Top 10%
Average
Average
Green
hybrid