Deep learning for liver tumor diagnosis part I: development of a convolutional neural network classifier for multi-phasic MRI

Abstract

Objectives

To develop and validate a proof-of-concept convolutional neural network (CNN)–based deep learning system (DLS) that classifies common hepatic lesions on multi-phasic MRI.

Methods

A custom CNN was engineered by iteratively optimizing the network architecture and training cases, finally consisting of three convolutional layers with associated rectified linear units, two maximum pooling layers, and two fully connected layers. Four hundred ninety-four hepatic lesions with typical imaging features from six categories were utilized, divided into training (n = 434) and test (n = 60) sets. Established augmentation techniques were used to generate 43,400 training samples. An Adam optimizer was used for training. Monte Carlo cross-validation was performed. After model engineering was finalized, classification accuracy for the final CNN was compared with two board-certified radiologists on an identical unseen test set.

Results

The DLS demonstrated a 92% accuracy, a 92% sensitivity (Sn), and a 98% specificity (Sp). Test set performance in a single run of random unseen cases showed an average 90% Sn and 98% Sp. The average Sn/Sp on these same cases for radiologists was 82.5%/96.5%. Results showed a 90% Sn for classifying hepatocellular carcinoma (HCC) compared to 60%/70% for radiologists. For HCC classification, the true positive and false positive rates were 93.5% and 1.6%, respectively, with a receiver operating characteristic area under the curve of 0.992. Computation time per lesion was 5.6 ms.

Conclusion

This preliminary deep learning study demonstrated feasibility for classifying lesions with typical imaging features from six common hepatic lesion types, motivating future studies with larger multi-institutional datasets and more complex imaging appearances.

Key Points

• Deep learning demonstrates high performance in the classification of liver lesions on volumetric multi-phasic MRI, showing potential as an eventual decision-support tool for radiologists.

• Demonstrating a classification runtime of a few milliseconds per lesion, a deep learning system could be incorporated into the clinical workflow in a time-efficient manner.

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Abbreviations

CNN:

Convolutional neural network

CRC:

Colorectal carcinoma

DL:

Deep learning

DLS:

Deep learning system

FNH:

Focal nodular hyperplasia

HCC:

Hepatocellular carcinoma

ICC:

Intrahepatic cholangiocarcinoma

LI-RADS:

Liver Imaging Reporting and Data System

PACS:

Picture archiving and communication system

Sn:

Sensitivity

Sp:

Specificity

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Funding

BL and CW received funding from the Radiological Society of North America (RSNA Research Resident Grant no. RR1731). JD, JC, ML, and CW received funding from the National Institutes of Health (NIH/NCI R01 CA206180).

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Correspondence to Julius Chapiro.

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Guarantor

The scientific guarantor of this publication is Brian Letzen.

Conflict of interest

The authors of this manuscript declare relationships with the following companies: JW: Bracco Diagnostics, Siemens AG; ML: Pro Medicus Limited; JC Koninklijke Philips, Guerbet SA, Eisai Co.

Statistics and biometry

One of the authors has significant statistical expertise.

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Written informed consent was waived by the Institutional Review Board.

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Institutional Review Board approval was obtained.

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• experimental

• performed at one institution

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Hamm, C.A., Wang, C.J., Savic, L.J. et al. Deep learning for liver tumor diagnosis part I: development of a convolutional neural network classifier for multi-phasic MRI. Eur Radiol 29, 3338–3347 (2019). https://doi.org/10.1007/s00330-019-06205-9

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Keywords

  • Liver cancer
  • Deep learning
  • Artificial intelligence