Weifang Liu1,2, Min Liu3, Xiaojuan Guo4, Peiyao Zhang2, Ling Zhang2, Rongguo Zhang5, Han Kang5, Zhenguo Zhai6, Xincao Tao6, Jun Wan6, Sheng Xie7. 1. Peking University Health Science Center, Beijing, 100871, China. 2. Department of Radiology, China-Japan Friendship Hospital, 2 Yinghua Dong Street, Hepingli, Chao Yang District, Beijing, 100029, China. 3. Department of Radiology, China-Japan Friendship Hospital, 2 Yinghua Dong Street, Hepingli, Chao Yang District, Beijing, 100029, China. drradiology@163.com. 4. Department of Radiology, Beijing Chaoyang Hospital of Capital Medical University, Beijing, 100019, China. 5. Artificial Intelligence Scholar Center, Infervision, Beijing, 100025, China. 6. Department of Pulmonary and Critical Care Medicine, China-Japan Friendship Hospital, Beijing, 100029, China. 7. Department of Radiology, China-Japan Friendship Hospital, 2 Yinghua Dong Street, Hepingli, Chao Yang District, Beijing, 100029, China. xs_mri@126.com.
Abstract
OBJECTIVES: To take advantage of the deep learning algorithms to detect and calculate clot burden of acute pulmonary embolism (APE) on computed tomographic pulmonary angiography (CTPA). MATERIALS AND METHODS: The training set in this retrospective study consisted of 590 patients (460 with APE and 130 without APE) who underwent CTPA. A fully deep learning convolutional neural network (DL-CNN), called U-Net, was trained for the segmentation of clot. Additionally, an in-house validation set consisted of 288 patients (186 with APE and 102 without APE). In this study, we set different probability thresholds to test the performance of U-Net for the clot detection and selected sensitivity, specificity, and area under the curve (AUC) as the metrics of performance evaluation. Furthermore, we investigated the relationship between the clot burden assessed by the Qanadli score, Mastora score, and other imaging parameters on CTPA and the clot burden calculated by the DL-CNN model. RESULTS: There was no statistically significant difference in AUCs with the different probability thresholds. When the probability threshold for segmentation was 0.1, the sensitivity and specificity of U-Net in detecting clot respectively were 94.6% and 76.5% while the AUC was 0.926 (95% CI 0.884-0.968). Moreover, this study displayed that the clot burden measured with U-Net was significantly correlated with the Qanadli score (r = 0.819, p < 0.001), Mastora score (r = 0.874, p < 0.001), and right ventricular functional parameters on CTPA. CONCLUSIONS: DL-CNN achieved a high AUC for the detection of pulmonary emboli and can be applied to quantitatively calculate the clot burden of APE patients, which may contribute to reducing the workloads of clinicians. KEY POINTS: • Deep learning can detect APE with a good performance and efficiently calculate the clot burden to reduce the physicians' workload. • Clot burden measured with deep learning highly correlates with Qanadli and Mastora scores of CTPA. • Clot burden measured with deep learning correlates with parameters of right ventricular function on CTPA.
OBJECTIVES: To take advantage of the deep learning algorithms to detect and calculate clot burden of acute pulmonary embolism (APE) on computed tomographic pulmonary angiography (CTPA). MATERIALS AND METHODS: The training set in this retrospective study consisted of 590 patients (460 with APE and 130 without APE) who underwent CTPA. A fully deep learning convolutional neural network (DL-CNN), called U-Net, was trained for the segmentation of clot. Additionally, an in-house validation set consisted of 288 patients (186 with APE and 102 without APE). In this study, we set different probability thresholds to test the performance of U-Net for the clot detection and selected sensitivity, specificity, and area under the curve (AUC) as the metrics of performance evaluation. Furthermore, we investigated the relationship between the clot burden assessed by the Qanadli score, Mastora score, and other imaging parameters on CTPA and the clot burden calculated by the DL-CNN model. RESULTS: There was no statistically significant difference in AUCs with the different probability thresholds. When the probability threshold for segmentation was 0.1, the sensitivity and specificity of U-Net in detecting clot respectively were 94.6% and 76.5% while the AUC was 0.926 (95% CI 0.884-0.968). Moreover, this study displayed that the clot burden measured with U-Net was significantly correlated with the Qanadli score (r = 0.819, p < 0.001), Mastora score (r = 0.874, p < 0.001), and right ventricular functional parameters on CTPA. CONCLUSIONS:DL-CNN achieved a high AUC for the detection of pulmonary emboli and can be applied to quantitatively calculate the clot burden of APEpatients, which may contribute to reducing the workloads of clinicians. KEY POINTS: • Deep learning can detect APE with a good performance and efficiently calculate the clot burden to reduce the physicians' workload. • Clot burden measured with deep learning highly correlates with Qanadli and Mastora scores of CTPA. • Clot burden measured with deep learning correlates with parameters of right ventricular function on CTPA.
Authors: Hongxia Zhang; Yan Cheng; Zhenbo Chen; Xinying Cong; Han Kang; Rongguo Zhang; Xiaojuan Guo; Min Liu Journal: Quant Imaging Med Surg Date: 2022-01
Authors: Connor Tice; Matthew Seigerman; Paul Fiorilli; Steven C Pugliese; Sameer Khandhar; Jay Giri; Taisei Kobayashi Journal: Curr Cardiovasc Risk Rep Date: 2020-10-06