J J Heit1, H Coelho2, F O Lima3, M Granja4,5, A Aghaebrahim4,5, R Hanel4,5, K Kwok6, H Haerian7, C W Cereda8, C Venkatasubramanian9, S Dehkharghani10, L A Carbonera11, J Wiener12, K Copeland13, F Mont'Alverne2. 1. From the Department of Radiology, Neuroimaging, and Neurointervention Division (J.J.H.), Stanford University School of Medicine, Stanford, California jheit@stanford.edu. 2. Interventional Radiology Service (H.C., F.M.). 3. Department of Neurology (F.O.L.), Hospital Geral de Fortaleza, R. Ávila Goulart, Fortaleza, Brazil. 4. Baptist Neurological Institute (M.G., A.A., R.H.), Lyerly Neurosurgery/Baptist Health, Jacksonville, Florida. 5. Diagnostic Imaging Department (M.G., A.A., R.H.), Fundación Santa Fe de Bogota University Hospital, Bogotá, Colombia. 6. Department of Radiology (K.K.), Central Valley Imaging Medical Associates, Manteca, California. 7. Department of Radiology (H.H.), LifeBridge Health, Baltimore, Maryland. 8. Department of Neurology (C.W.C.), EOC Ospedale Regionale di Lugano, Lugano, Switzerland. 9. Neurocritical Care and Stroke, Department of Neurology (C.V.), Stanford University, Palo Alto, California. 10. Department of Radiology (S.D.), NY University Langone Health, New York, New York. 11. Hospital das Clínicas de Porto Alegre (L.A.C.), Bairro Santa Cecilia, Brazil. 12. Department of Radiology (J.W.), Boca Raton Regional Hospital, Boca Raton, Florida. 13. Boulder Statistics (K.C.), Steamboat Springs, Colorado.
Abstract
BACKGROUND AND PURPOSE: Intracranial hemorrhage (ICH) is an important event that is diagnosed on head NCCT. Increased NCCT utilization in busy hospitals may limit timely identification of ICH. RAPID ICH is an automated hybrid 2D-3D convolutional neural network application designed to detect ICH that may allow for expedited ICH diagnosis. We determined the accuracy of RAPID ICH for ICH detection and ICH volumetric quantification on NCCT. MATERIALS AND METHODS: NCCT scans were evaluated for ICH by RAPID ICH. Consensus detection of ICH by 3 neuroradiology experts was used as the criterion standard for RAPID ICH comparison. ICH volume was also automatically determined by RAPID ICH in patients with intraparenchymal or intraventricular hemorrhage and compared with manually segmented ICH volumes by a single neuroradiology expert. ICH detection accuracy, sensitivity, specificity, positive predictive value, negative predictive value, and positive and negative likelihood ratios by RAPID ICH were determined. RESULTS: We included 308 studies. RAPID ICH correctly identified 151/158 ICH cases and 143/150 ICH-negative cases, which resulted in high sensitivity (0.956, CI: 0.911-0.978), specificity (0.953, CI: 0.907-0.977), positive predictive value (0.956, CI: 0.911-0.978), and negative predictive value (0.953, CI: 0.907-0.977) for ICH detection. The positive likelihood ratio (20.479, CI 9.928-42.245) and negative likelihood ratio (0.046, CI 0.023-0.096) for ICH detection were similarly favorable. RAPID ICH volumetric quantification for intraparenchymal and intraventricular hemorrhages strongly correlated with expert manual segmentation (correlation coefficient r = 0.983); the median absolute error was 3 mL. CONCLUSIONS: RAPID ICH is highly accurate in the detection of ICH and in the volumetric quantification of intraparenchymal and intraventricular hemorrhages.
BACKGROUND AND PURPOSE: Intracranial hemorrhage (ICH) is an important event that is diagnosed on head NCCT. Increased NCCT utilization in busy hospitals may limit timely identification of ICH. RAPID ICH is an automated hybrid 2D-3D convolutional neural network application designed to detect ICH that may allow for expedited ICH diagnosis. We determined the accuracy of RAPID ICH for ICH detection and ICH volumetric quantification on NCCT. MATERIALS AND METHODS: NCCT scans were evaluated for ICH by RAPID ICH. Consensus detection of ICH by 3 neuroradiology experts was used as the criterion standard for RAPID ICH comparison. ICH volume was also automatically determined by RAPID ICH in patients with intraparenchymal or intraventricular hemorrhage and compared with manually segmented ICH volumes by a single neuroradiology expert. ICH detection accuracy, sensitivity, specificity, positive predictive value, negative predictive value, and positive and negative likelihood ratios by RAPID ICH were determined. RESULTS: We included 308 studies. RAPID ICH correctly identified 151/158 ICH cases and 143/150 ICH-negative cases, which resulted in high sensitivity (0.956, CI: 0.911-0.978), specificity (0.953, CI: 0.907-0.977), positive predictive value (0.956, CI: 0.911-0.978), and negative predictive value (0.953, CI: 0.907-0.977) for ICH detection. The positive likelihood ratio (20.479, CI 9.928-42.245) and negative likelihood ratio (0.046, CI 0.023-0.096) for ICH detection were similarly favorable. RAPID ICH volumetric quantification for intraparenchymal and intraventricular hemorrhages strongly correlated with expert manual segmentation (correlation coefficient r = 0.983); the median absolute error was 3 mL. CONCLUSIONS: RAPID ICH is highly accurate in the detection of ICH and in the volumetric quantification of intraparenchymal and intraventricular hemorrhages.
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