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

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.

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Correspondence to Junghwan Cho.

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This data collection was reviewed and approved by the ethics committee at Kyungpook National University Hospital and Kyungpook National University Hospital Chilgok (KNUH 2017-06-005 and KNUCH 2016-11-050).

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Cho, J., Park, KS., Karki, M. et al. Improving Sensitivity on Identification and Delineation of Intracranial Hemorrhage Lesion Using Cascaded Deep Learning Models. J Digit Imaging 32, 450–461 (2019). https://doi.org/10.1007/s10278-018-00172-1

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Keywords

  • Cascaded deep learning model
  • Lesion segmentation
  • Sensitivity
  • CT window setting
  • Fully convolutional networks
  • Intracranial hemorrhage