School of Biomedical Engineering and Imaging Sciences, King's College London, United Kingdom.
King's College Hospital NHS Foundation Trust, United Kingdom.
Med Image Anal. 2022 May;78:102391. doi: 10.1016/j.media.2022.102391. Epub 2022 Feb 12.
The growing demand for head magnetic resonance imaging (MRI) examinations, along with a global shortage of radiologists, has led to an increase in the time taken to report head MRI scans in recent years. For many neurological conditions, this delay can result in poorer patient outcomes and inflated healthcare costs. Potentially, computer vision models could help reduce reporting times for abnormal examinations by flagging abnormalities at the time of imaging, allowing radiology departments to prioritise limited resources into reporting these scans first. To date, however, the difficulty of obtaining large, clinically-representative labelled datasets has been a bottleneck to model development. In this work, we present a deep learning framework, based on convolutional neural networks, for detecting clinically-relevant abnormalities in minimally processed, hospital-grade axial T2-weighted and axial diffusion-weighted head MRI scans. The models were trained at scale using a Transformer-based neuroradiology report classifier to generate a labelled dataset of 70,206 examinations from two large UK hospital networks, and demonstrate fast (< 5 s), accurate (area under the receiver operating characteristic curve (AUC) > 0.9), and interpretable classification, with good generalisability between hospitals (ΔAUC ≤ 0.02). Through a simulation study we show that our best model would reduce the mean reporting time for abnormal examinations from 28 days to 14 days and from 9 days to 5 days at the two hospital networks, demonstrating feasibility for use in a clinical triage environment.
近年来,由于对头颅磁共振成像(MRI)检查的需求不断增长,而全球放射科医生短缺,导致报告头颅 MRI 扫描的时间增加。对于许多神经疾病,这种延迟可能导致患者预后较差和医疗保健成本增加。潜在地,计算机视觉模型可以通过在成像时标记异常来帮助减少异常检查的报告时间,从而使放射科部门能够优先考虑将这些扫描报告放在首位。然而,到目前为止,获得大型、具有临床代表性的标记数据集的难度一直是模型开发的瓶颈。在这项工作中,我们提出了一个基于卷积神经网络的深度学习框架,用于检测未经处理的医院级轴向 T2 加权和轴向扩散加权头部 MRI 扫描中的临床相关异常。该模型使用基于 Transformer 的神经放射学报告分类器进行了大规模训练,从两个英国大型医院网络中生成了一个包含 70206 次检查的标记数据集,并展示了快速(<5 秒)、准确(接收者操作特征曲线下的面积(AUC)>0.9)和可解释的分类,在医院之间具有良好的泛化能力(ΔAUC≤0.02)。通过模拟研究,我们表明我们的最佳模型将减少两个医院网络中异常检查的平均报告时间,从 28 天减少到 14 天,从 9 天减少到 5 天,证明了在临床分诊环境中的使用可行性。