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Verlässlichkeit eines kommerziellen Deep-Learning Algorithmus zur Erkennung intrakranieller Blutungen in notfallmäßigen Computertomographien

  • Background: Highly accurate detection of intracranial hemorrhages (ICH) on head computed tomography (HCT) scans can prove challenging at high-volume centers. This study aimed to determine the number of additional ICHs detected by an artificial intelligence (AI) algorithm and to evaluate reasons for erroneous results at a level I trauma center with teleradiology services. Methods: In a retrospective multi-center cohort study, consecutive emergency non-contrast HCT scans were analyzed by a commercially available ICH detection software (AIDOC, Tel Aviv, Israel). Discrepancies between AI analysis and initial radiology report (RR) were reviewed by a blinded neuroradiologist to determine the number of additional ICHs detected and evaluate reasons leading to errors. Results: 4946 HCT (05/2020-09/2020) from 18 hospitals were included in the analysis. 205 reports (4.1%) were classified as hemorrhages by both radiology report and AI. Out of a total of 162 (3.3%) discrepant reports, 62 were confirmed as hemorrhages by the reference neuroradiologist. 33 ICHs were identified exclusively via RRs. The AI algorithm detected an additional 29 instances of ICH, missed 12.4% of ICH and overcalled 1.9%; RRs missed 10.9% of ICHs and overcalled 0.2%. Many of the ICHs missed by the AI algorithm were located in the subarachnoid space (42.4%) and under the calvaria (48.5%). 85% of ICHs missed by RRs occurred outside of regular working-hours. Calcifications (39.3%), beam-hardening artifacts (18%), tumors (15.7%), and blood vessels (7.9%) were the most common reasons for AI overcalls. ICH size, image quality, and primary examiner experience were not found to be significantly associated with likelihood of incorrect AI results. Conclusion: Complementing human expertise with AI resulted in a 12.2% increase in ICH detection. The AI algorithm overcalled 1.9% HCT. Trial registration: German Clinical Trials Register (DRKS-ID: DRKS00023593).

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Author:Dr. med. Almut Kundisch
Title Additional (English):Deep learning algorithm in detecting intracranial hemorrhages on emergency computed tomographies
Referee:Prof. Dr. med. Karl-Titus Hoffmann, Prof. Dr. med. Sven Mutze
Advisor:Prof. Dr. med. Sven Mutze
Document Type:Doctoral Thesis
Year of Completion:2021
Granting Institution:Universität Greifswald, Universitätsmedizin
Date of final exam:2022/07/07
Release Date:2022/08/10
Tag:Intracranial; hemorrhages
GND Keyword:Deep, Learning, algorithm
Page Number:55
Faculties:Universitätsmedizin / Institut für Diagnostische Radiologie
DDC class:600 Technik, Medizin, angewandte Wissenschaften / 610 Medizin und Gesundheit