Using a Convolutional Neural Network and Convolutional Long Short-term Memory to Automatically Detect Aneurysms on 2D Digital Subtraction Angiography Images: Framework Development and Validation

JunHua Liao; LunXin Liu; HaiHan Duan; YunZhi Huang; LiangXue Zhou; LiangYin Chen; ChaoHua Wang

doi:10.2196/28880

Using a Convolutional Neural Network and Convolutional Long Short-term Memory to Automatically Detect Aneurysms on 2D Digital Subtraction Angiography Images: Framework Development and Validation

JMIR Med Inform. 2022 Mar 16;10(3):e28880. doi: 10.2196/28880.

Authors

JunHua Liao^#^{1

2}, LunXin Liu^#¹, HaiHan Duan³, YunZhi Huang⁴, LiangXue Zhou¹, LiangYin Chen², ChaoHua Wang¹

Affiliations

¹ Department of Neurosurgery, West China Hospital, Sichuan University, Chengdu, China.
² College of Computer Science, Sichuan University, Chengdu, China.
³ School of Science and Engineering, The Chinese University of Hong Kong, Shenzhen, China.
⁴ School of Automation, Nanjing University of Information Science and Technology, Nanjing, China.

^# Contributed equally.

PMID: 35294371
PMCID: PMC8968557
DOI: 10.2196/28880

Abstract

Background: It is hard to distinguish cerebral aneurysms from overlapping vessels in 2D digital subtraction angiography (DSA) images due to these images' lack of spatial information.

Objective: The aims of this study were to (1) construct a deep learning diagnostic system to improve the ability to detect posterior communicating artery aneurysms on 2D DSA images and (2) validate the efficiency of the deep learning diagnostic system in 2D DSA aneurysm detection.

Methods: We proposed a 2-stage detection system. First, we established the region localization stage to automatically locate specific detection regions of raw 2D DSA sequences. Second, in the intracranial aneurysm detection stage, we constructed a bi-input+RetinaNet+convolutional long short-term memory (C-LSTM) framework to compare its performance for aneurysm detection with that of 3 existing frameworks. Each of the frameworks had a 5-fold cross-validation scheme. The receiver operating characteristic curve, the area under the curve (AUC) value, mean average precision, sensitivity, specificity, and accuracy were used to assess the abilities of different frameworks.

Results: A total of 255 patients with posterior communicating artery aneurysms and 20 patients without aneurysms were included in this study. The best AUC values of the RetinaNet, RetinaNet+C-LSTM, bi-input+RetinaNet, and bi-input+RetinaNet+C-LSTM frameworks were 0.95, 0.96, 0.92, and 0.97, respectively. The mean sensitivities of the RetinaNet, RetinaNet+C-LSTM, bi-input+RetinaNet, and bi-input+RetinaNet+C-LSTM frameworks and human experts were 89% (range 67.02%-98.43%), 88% (range 65.76%-98.06%), 87% (range 64.53%-97.66%), 89% (range 67.02%-98.43%), and 90% (range 68.30%-98.77%), respectively. The mean specificities of the RetinaNet, RetinaNet+C-LSTM, bi-input+RetinaNet, and bi-input+RetinaNet+C-LSTM frameworks and human experts were 80% (range 56.34%-94.27%), 89% (range 67.02%-98.43%), 86% (range 63.31%-97.24%), 93% (range 72.30%-99.56%), and 90% (range 68.30%-98.77%), respectively. The mean accuracies of the RetinaNet, RetinaNet+C-LSTM, bi-input+RetinaNet, and bi-input+RetinaNet+C-LSTM frameworks and human experts were 84.50% (range 69.57%-93.97%), 88.50% (range 74.44%-96.39%), 86.50% (range 71.97%-95.22%), 91% (range 77.63%-97.72%), and 90% (range 76.34%-97.21%), respectively.

Conclusions: According to our results, more spatial and temporal information can help improve the performance of the frameworks. Therefore, the bi-input+RetinaNet+C-LSTM framework had the best performance when compared to that of the other frameworks. Our study demonstrates that our system can assist physicians in detecting intracranial aneurysms on 2D DSA images.

Keywords: cerebral aneurysm; convolutional long short-term memory; convolutional neural network; deep learning.

©JunHua Liao, LunXin Liu, HaiHan Duan, YunZhi Huang, LiangXue Zhou, LiangYin Chen, ChaoHua Wang. Originally published in JMIR Medical Informatics (https://medinform.jmir.org), 16.03.2022.