Goertz Lukas, Jünger Stephanie T, Reinecke David, von Spreckelsen Niklas, Shahzad Rahil, Thiele Frank, Laukamp Kai Roman, Timmer Marco, Gertz Roman Johannes, Gietzen Carsten, Kaya Kenan, Grunz Jan-Peter, Schlamann Marc, Kabbasch Christoph, Borggrefe Jan, Pennig Lenhard
Institute for Diagnostic and Interventional Radiology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany; Center for Neurosurgery, Department of General Neurosurgery, University of Cologne, Faculty of Medicine and University Hospital, Cologne, Germany.
Center for Neurosurgery, Department of General Neurosurgery, University of Cologne, Faculty of Medicine and University Hospital, Cologne, Germany.
J Clin Neurosci. 2025 Feb;132:110971. doi: 10.1016/j.jocn.2024.110971. Epub 2024 Dec 13.
The purpose of this study was to evaluate the effectiveness of a deep learning model (DLM) in improving the sensitivity of neurosurgery residents to detect intracranial aneurysms on CT angiography (CTA) in patients with aneurysmal subarachnoid hemorrhage (aSAH).
In this diagnostic accuracy study, a set of 104 CTA scans of aSAH patients containing a total of 126 aneurysms were presented to three blinded neurosurgery residents (a first-year, third-year, and fifth-year resident), who individually assessed them for aneurysms. After the initial reading, the residents were given the predictions of a dedicated DLM previously established for automated detection and segmentation of intracranial aneurysms. The detection sensitivities for aneurysms of the DLM and the residents with and without the assistance of the DLM were compared.
The DLM had a detection sensitivity of 85.7%, while the residents showed detection sensitivities of 77.8%, 86.5%, and 87.3% without DLM assistance. After being provided with the DLM's results, the residents' individual detection sensitivities increased to 97.6%, 95.2%, and 98.4%, respectively, yielding an average increase of 13.2%. The DLM was particularly useful in detecting small aneurysms. In addition, interrater agreement among residents increased from a Fleiss κ of 0.394 without DLM assistance to 0.703 with DLM assistance.
The results of this pilot study suggest that deep learning models can help neurosurgeons detect aneurysms on CTA and make appropriate treatment decisions when immediate radiological consultation is not possible.
本研究旨在评估深度学习模型(DLM)在提高神经外科住院医师对动脉瘤性蛛网膜下腔出血(aSAH)患者CT血管造影(CTA)上颅内动脉瘤检测敏感性方面的有效性。
在这项诊断准确性研究中,向三名不知情的神经外科住院医师(一名一年级、一名三年级和一名五年级住院医师)展示了一组104例aSAH患者的CTA扫描图像,这些图像共包含126个动脉瘤,住院医师分别对其进行动脉瘤评估。在初始阅片后,向住院医师提供先前建立的用于颅内动脉瘤自动检测和分割的专用DLM的预测结果。比较了DLM以及有无DLM协助时住院医师对动脉瘤的检测敏感性。
DLM的检测敏感性为85.7%,而住院医师在无DLM协助时的检测敏感性分别为77.8%、86.5%和87.3%。在获得DLM的结果后,住院医师的个人检测敏感性分别提高到97.6%、95.2%和98.4%,平均提高了13.2%。DLM在检测小动脉瘤方面特别有用。此外,住院医师之间的评分者间一致性从无DLM协助时的Fleiss κ值0.394提高到有DLM协助时的0.703。
这项初步研究的结果表明,深度学习模型可以帮助神经外科医生在无法立即进行放射学会诊时,在CTA上检测动脉瘤并做出适当的治疗决策。