Skip to main content

Attention Based CNN-LSTM Network for Pulmonary Embolism Prediction on Chest Computed Tomography Pulmonary Angiograms

  • Conference paper
  • First Online:
Medical Image Computing and Computer Assisted Intervention – MICCAI 2021 (MICCAI 2021)

Abstract

With more than 60,000 deaths annually in the United States, Pulmonary Embolism (PE) is among the most fatal cardiovascular diseases. It is caused by an artery blockage in the lung; confirming its presence is time-consuming and is prone to over-diagnosis. The utilization of automated PE detection systems is critical for diagnostic accuracy and efficiency. In this study we propose a two-stage attention-based CNN-LSTM network for predicting PE, its associated type (chronic, acute) and corresponding location (leftsided, rightsided or central) on computed tomography (CT) examinations. We trained our model on the largest available public Computed Tomography Pulmonary Angiogram PE dataset (RSNA-STR Pulmonary Embolism CT (RSPECT) Dataset, N = 7279 CT studies) and tested it on an in-house curated dataset of N = 106 studies. Our framework mirrors the radiologic diagnostic process via a multi-slice approach so that the accuracy and pathologic sequela of true pulmonary emboli may be meticulously assessed, enabling physicians to better appraise the morbidity of a PE when present. Our proposed method outperformed a baseline CNN classifier and a single-stage CNN-LSTM network, achieving an AUC of 0.95 on the test set for detecting the presence of PE in the study.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 89.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 119.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Similar content being viewed by others

References

  1. RSNA-STR pulmonary embolism CT (RSPECT) dataset, copyright RSNA. https://www.rsna.org/education/ai-resources-and-training/ai-image-challenge/rsna-pe-detection-challenge-2020

  2. Anam, C., Budi, W., Haryanto, F., Fujibuchi, T., Dougherty, G.: A novel multiple-windows blending of CT images in red-green-blue (RGB) color space: phantoms study. Sci. Vis. 11(5) (2019)

    Google Scholar 

  3. Bejnordi, B.E., et al.: Diagnostic assessment of deep learning algorithms for detection of lymph node metastases in women with breast cancer. JAMA 318(22), 2199–2210 (2017)

    Article  Google Scholar 

  4. Colak, E., et al.: The RSNA pulmonary embolism CT dataset. Radiol.: Artif. Intell. 3(2), e200254 (2021)

    Google Scholar 

  5. Coudray, N., et al.: Classification and mutation prediction from non-small cell lung cancer histopathology images using deep learning. Nat. Med. 24(10), 1559–1567 (2018)

    Article  Google Scholar 

  6. Friedman, T., Winokur, R.S., Quencer, K.B., Madoff, D.C.: Patient assessment: clinical presentation, imaging diagnosis, risk stratification, and the role of pulmonary embolism response team. In: Seminars in Interventional Radiology, vol. 35, pp. 116–121. Thieme Medical Publishers (2018)

    Google Scholar 

  7. Ghaye, B., Ghuysen, A., Bruyere, P.J., D’Orio, V., Dondelinger, R.F.: Can CT pulmonary angiography allow assessment of severity and prognosis in patients presenting with pulmonary embolism? What the radiologist needs to know. Radiographics 26(1), 23–39 (2006)

    Article  Google Scholar 

  8. Huang, S.C., et al.: PENet-a scalable deep-learning model for automated diagnosis of pulmonary embolism using volumetric CT imaging. NPJ Digit. Med. 3(1), 1–9 (2020)

    Article  Google Scholar 

  9. Huang, Z., Xu, W., Yu, K.: Bidirectional LSTM-CRF models for sequence tagging. arXiv preprint arXiv:1508.01991 (2015)

  10. Ilse, M., Tomczak, J., Welling, M.: Attention-based deep multiple instance learning. In: International Conference on Machine Learning, pp. 2127–2136. PMLR (2018)

    Google Scholar 

  11. Khorrami, M., et al.: Changes in CT radiomic features associated with lymphocyte distribution predict overall survival and response to immunotherapy in non-small cell lung cancer. Cancer Immunol. Res. 8(1), 108–119 (2020)

    Article  Google Scholar 

  12. Kingma, D.P., Ba, J.: Adam: a method for stochastic optimization. arXiv preprint arXiv:1412.6980 (2014)

  13. Lankeit, M.: Always think of the right ventricle, even in “low-risk” pulmonary embolism (2017)

    Google Scholar 

  14. Liang, J., Bi, J.: Computer aided detection of pulmonary embolism with tobogganing and mutiple instance classification in CT pulmonary angiography. In: Karssemeijer, N., Lelieveldt, B. (eds.) IPMI 2007. LNCS, vol. 4584, pp. 630–641. Springer, Heidelberg (2007). https://doi.org/10.1007/978-3-540-73273-0_52

    Chapter  Google Scholar 

  15. Van der Maaten, L., Hinton, G.: Visualizing data using t-SNE. J. Mach. Learn. Res. 9(11) (2008)

    Google Scholar 

  16. Masutani, Y., MacMahon, H., Doi, K.: Computerized detection of pulmonary embolism in spiral CT angiography based on volumetric image analysis. IEEE Trans. Med. Imaging 21(12), 1517–1523 (2002)

    Article  Google Scholar 

  17. Özkan, H., Osman, O., Şahin, S., Boz, A.F.: A novel method for pulmonary embolism detection in CTA images. Comput. Methods Programs Biomed. 113(3), 757–766 (2014)

    Article  Google Scholar 

  18. Park, S.C., Chapman, B.E., Zheng, B.: A multistage approach to improve performance of computer-aided detection of pulmonary embolisms depicted on CT images: preliminary investigation. IEEE Trans. Biomed. Eng. 58(6), 1519–1527 (2010)

    Article  Google Scholar 

  19. Rajan, D., Beymer, D., Abedin, S., Dehghan, E.: Pi-PE: a pipeline for pulmonary embolism detection using sparsely annotated 3D CT images. In: Machine Learning for Health Workshop, pp. 220–232. PMLR (2020)

    Google Scholar 

  20. Shi, L., Rajan, D., Abedin, S., Yellapragada, M.S., Beymer, D., Dehghan, E.: Automatic diagnosis of pulmonary embolism using an attention-guided framework: a large-scale study. In: Medical Imaging with Deep Learning, pp. 743–754. PMLR (2020)

    Google Scholar 

  21. Singh, G., et al.: Radiomics and radiogenomics in gliomas: a contemporary update. Br. J. Cancer 1–17 (2021)

    Google Scholar 

  22. Sirinukunwattana, K., Raza, S.E.A., Tsang, Y.W., Snead, D.R., Cree, I.A., Rajpoot, N.M.: Locality sensitive deep learning for detection and classification of nuclei in routine colon cancer histology images. IEEE Trans. Med. Imaging 35(5), 1196–1206 (2016)

    Article  Google Scholar 

  23. Tan, M., Le, Q.: Efficientnet: rethinking model scaling for convolutional neural networks. In: International Conference on Machine Learning, pp. 6105–6114. PMLR (2019)

    Google Scholar 

  24. Wittram, C., Maher, M.M., Yoo, A.J., Kalra, M.K., Shepard, J.A.O., McLoud, T.C.: CT angiography of pulmonary embolism: diagnostic criteria and causes of misdiagnosis. Radiographics 24(5), 1219–1238 (2004)

    Article  Google Scholar 

  25. Yang, X., Lin, Y., Su, J., Wang, X., Li, X., Lin, J., Cheng, K.T.: A two-stage convolutional neural network for pulmonary embolism detection from CTPA images. IEEE Access 7, 84849–84857 (2019)

    Article  Google Scholar 

  26. Zhou, B., Khosla, A., Lapedriza, A., Oliva, A., Torralba, A.: Learning deep features for discriminative localization. In: Proceedings of the IEEE Conference on Computer Vision and Pattern Recognition, pp. 2921–2929 (2016)

    Google Scholar 

  27. Zhou, C., et al.: Preliminary investigation of computer-aided detection of pulmonary embolism in threedimensional computed tomography pulmonary angiography images. Acad. Radiol. 12(6), 782 (2005)

    Article  Google Scholar 

Download references

Acknowledgment

Dimitris Samaras was partially supported by the Partner University Fund, the SUNY2020 Infrastructure Transportation Security Center, and a gift from Adobe.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Prateek Prasanna .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2021 Springer Nature Switzerland AG

About this paper

Check for updates. Verify currency and authenticity via CrossMark

Cite this paper

Suman, S. et al. (2021). Attention Based CNN-LSTM Network for Pulmonary Embolism Prediction on Chest Computed Tomography Pulmonary Angiograms. In: de Bruijne, M., et al. Medical Image Computing and Computer Assisted Intervention – MICCAI 2021. MICCAI 2021. Lecture Notes in Computer Science(), vol 12907. Springer, Cham. https://doi.org/10.1007/978-3-030-87234-2_34

Download citation

  • DOI: https://doi.org/10.1007/978-3-030-87234-2_34

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-87233-5

  • Online ISBN: 978-3-030-87234-2

  • eBook Packages: Computer ScienceComputer Science (R0)

Publish with us

Policies and ethics