Towards subject-level cerebral infarction classification of CT scans using convolutional networks

PLoS One. 2020 Jul 15;15(7):e0235765. doi: 10.1371/journal.pone.0235765. eCollection 2020.

Abstract

Automatic evaluation of 3D volumes is a topic of importance in order to speed up clinical decision making. We describe a method to classify computed tomography scans on volume level for the presence of non-acute cerebral infarction. This is not a trivial task, as the lesions are often similar to other areas in the brain regarding shape and intensity. A three stage architecture is used for classification: 1) A cranial cavity segmentation network is developed, trained and applied. 2) Region proposals are generated 3) Connected regions are classified using a multi-resolution, densely connected 3D convolutional network. Mean area under curve values for subject level classification are 0.95 for the unstratified test set, 0.88 for stratification by patient age and 0.93 for stratification by CT scanner model. We use a partly segmented dataset of 555 scans of which 186 scans are used in the unstratified test set. Furthermore we examine possible dataset bias for scanner model and patient age parameters. We show a successful application of the proposed three-stage model for full volume classification. In contrast to black-box approaches, the convolutional network's decision can be further assessed by examination of intermediate segmentation results.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Algorithms*
  • Automation
  • Case-Control Studies
  • Cerebral Infarction / classification*
  • Cerebral Infarction / diagnostic imaging
  • Cerebral Infarction / pathology
  • Female
  • Humans
  • Image Processing, Computer-Assisted / methods*
  • Imaging, Three-Dimensional / methods*
  • Male
  • Neural Networks, Computer*
  • Retrospective Studies
  • Tomography, X-Ray Computed / methods*

Grants and funding

FP received a grant (Gottfried Wilhelm Leibniz program) from the DFG (Deutsche Forschungsgemeinschaft, https://www.dfg.de/). FP and DP received a grant (Research Training Group GRK 2274) from the DFG (Deutsche Forschungsgemeinschaft, https://www.dfg.de/). The sponsors did not play any role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript.