Leveraging open dataset and transfer learning for accurate recognition of chronic pulmonary embolism from CT angiogram maximum intensity projection images

European Radiology Experimental

Original Article

Marko Kangasniemi¹  Tuomas Vainio¹  Anssi Arkko¹  Teemu Mäkelä²  Sauli Savolainen² 

[1]Radiology, HUS Medical Imaging Center, University of Helsinki and Helsinki University Hospital, 00290, Helsinki, Finland

[2]Radiology, HUS Medical Imaging Center, University of Helsinki and Helsinki University Hospital, 00290, Helsinki, Finland

[3]Department of Physics, University of Helsinki, Helsinki, Finland

关键词: Artificial intelligence;    Computed tomography angiography;    Deep learning;    Neural networks (computer);    Pulmonary embolism;   

DOI  :  10.1186/s41747-023-00346-9

 received in 2022-12-19, accepted in 2023-04-14,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundEarly diagnosis of the potentially fatal but curable chronic pulmonary embolism (CPE) is challenging. We have developed and investigated a novel convolutional neural network (CNN) model to recognise CPE from CT pulmonary angiograms (CTPA) based on the general vascular morphology in two-dimensional (2D) maximum intensity projection images.MethodsA CNN model was trained on a curated subset of a public pulmonary embolism CT dataset (RSPECT) with 755 CTPA studies, including patient-level labels of CPE, acute pulmonary embolism (APE), or no pulmonary embolism. CPE patients with right-to-left-ventricular ratio (RV/LV) < 1 and APE patients with RV/LV ≥ 1 were excluded from the training. Additional CNN model selection and testing were done on local data with 78 patients without the RV/LV-based exclusion. We calculated area under the receiver operating characteristic curves (AUC) and balanced accuracies to evaluate the CNN performance.ResultsWe achieved a very high CPE versus no-CPE classification AUC 0.94 and balanced accuracy 0.89 on the local dataset using an ensemble model and considering CPE to be present in either one or both lungs.ConclusionsWe propose a novel CNN model with excellent predictive accuracy to differentiate chronic pulmonary embolism with RV/LV ≥ 1 from acute pulmonary embolism and non-embolic cases from 2D maximum intensity projection reconstructions of CTPA.Relevance statementA DL CNN model identifies chronic pulmonary embolism from CTA with an excellent predictive accuracy.Key points• Automatic recognition of CPE from computed tomography pulmonary angiography was developed.• Deep learning was applied on two-dimensional maximum intensity projection images.• A large public dataset was used for training the deep learning model.• The proposed model showed an excellent predictive accuracy.Graphical Abstract

【 授权许可】

CC BY   
© The Author(s) 2023

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