Bo Ruting, Xiong Zhi, Huang Ting, Liu Lingling, Chen Zhiqiang
Department of Ultrasound Tianjin Hospital, Tianjin, 300200, People's Republic of China.
Department of Radiology, The First Affiliated Hospital of Hainan Medical University, Haikou, 570102, People's Republic of China.
Int J Gen Med. 2023 Aug 9;16:3393-3402. doi: 10.2147/IJGM.S408725. eCollection 2023.
Hematoma enlargement (HE) is a common complication following acute intracerebral hemorrhage (ICH) and is associated with early deterioration and unfavorable clinical outcomes. This study aimed to evaluate the predictive performance of a computed tomography (CT) based model that utilizes deep learning features in identifying HE.
A total of 408 patients were retrospectively enrolled between January 2015 and December 2020 from our institution. We designed an automatic model that could mask the hematoma area and fusion features of radiomics, clinical data, and convolutional neural network (CNN) in a hybrid model. We assessed the model's performance by using confusion matrix metrics (CM), the area under the receiver operating characteristics curve (AUC), and other statistical indicators.
After automated masking, 408 patients were randomly divided into two cohorts with 204 patients in the training set and 204 patients in the validation set. The first cohort trained the CNN model, from which we then extracted radiomics, clinical data, and CNN features for the second validation cohort. After feature selection by K-highest score, a support vector machines (SVM) model classification was used to predict HE. Our hybrid model exhibited a high AUC of 0.949, and 0.95 of precision, 0.83 of recall, and 0.94 of average precision (AP). The CM found that only 5 cases were misidentified by the model.
The automatic hybrid model we developed is an end-to-end method and can assist in clinical decision-making, thereby facilitating personalized treatment for patients with ICH.
血肿扩大(HE)是急性脑出血(ICH)后的常见并发症,与早期病情恶化及不良临床结局相关。本研究旨在评估一种基于计算机断层扫描(CT)的模型在识别HE时利用深度学习特征的预测性能。
2015年1月至2020年12月期间,我们机构共回顾性纳入了408例患者。我们设计了一种自动模型,该模型可以在混合模型中掩盖血肿区域,并融合影像组学、临床数据和卷积神经网络(CNN)的特征。我们使用混淆矩阵指标(CM)、受试者操作特征曲线下面积(AUC)和其他统计指标来评估该模型的性能。
经过自动掩膜后,408例患者被随机分为两个队列,训练集有204例患者,验证集有204例患者。第一个队列用于训练CNN模型,然后我们从该模型中提取影像组学、临床数据和CNN特征用于第二个验证队列。通过K最高分进行特征选择后,使用支持向量机(SVM)模型分类来预测HE。我们的混合模型表现出较高的AUC,为0.949,精度为0.95,召回率为0.83,平均精度(AP)为0.94。CM发现该模型仅误识别了5例。
我们开发的自动混合模型是一种端到端的方法,可以辅助临床决策,从而促进ICH患者的个性化治疗。