Deep learning-based identification and localization of intracranial hemorrhage in patients using a large annotated head computed tomography dataset: A retrospective multicenter study

Background: Accurately identifying and localizing the five subtypes of intracranial hemorrhage (ICH) are crucial steps for subsequent clinical treatment; however, the lack of a large computed tomography (CT) dataset with annotations of the categorization and localization of ICH considerably limits t...

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Main Authors: Jingjing Liu, Weijie Fan, Yi Yang, Qi Peng, Bingjun Ji, Luxing He, Yang Li, Jing Yuan, Wei Li, Xianqi Wang, Yi Wu, Chen Liu, Qingfang Gong, Mi He, Yeqin Fu, Dong Zhang, Si Zhang, Yongjian Nian
Format: Article
Language:English
Published: Elsevier 2025-02-01
Series:Intelligent Medicine
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Online Access:http://www.sciencedirect.com/science/article/pii/S2667102624000895
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author Jingjing Liu
Weijie Fan
Yi Yang
Qi Peng
Bingjun Ji
Luxing He
Yang Li
Jing Yuan
Wei Li
Xianqi Wang
Yi Wu
Chen Liu
Qingfang Gong
Mi He
Yeqin Fu
Dong Zhang
Si Zhang
Yongjian Nian
author_facet Jingjing Liu
Weijie Fan
Yi Yang
Qi Peng
Bingjun Ji
Luxing He
Yang Li
Jing Yuan
Wei Li
Xianqi Wang
Yi Wu
Chen Liu
Qingfang Gong
Mi He
Yeqin Fu
Dong Zhang
Si Zhang
Yongjian Nian
author_sort Jingjing Liu
collection DOAJ
description Background: Accurately identifying and localizing the five subtypes of intracranial hemorrhage (ICH) are crucial steps for subsequent clinical treatment; however, the lack of a large computed tomography (CT) dataset with annotations of the categorization and localization of ICH considerably limits the development of deep learning-based identification and localization methods. We aimed to construct this large dataset and develop a deep learning-based model to identify and localize the five ICH subtypes, including intraventricular hemorrhage (IVH), intraparenchymal hemorrhage (IPH), subdural hemorrhage (SDH), subarachnoid hemorrhage (SAH), and epidural hemorrhage (EDH), in non-contrast head CT scans. Methods: Based on the public Radiological Society of North America (RSNA) 2019 dataset, we constructed a large CT dataset named RSNA 2019+ that was annotated for bleeding localization of the five ICH subtypes by three radiologists. An improved YOLOv8 architecture with the bidirectional feature pyramid network was proposed and trained using the RSNA 2019+ training dataset and evaluated on the RSNA 2019+ test dataset. The public CQ500, and two private datasets collected from the Xinqiao and Sunshine Union Hospitals, respectively, were also annotated to perform multicenter validation. Furthermore, the performance of the deep learning model was compared with that of four radiologists. Multiple performance metrics, including the average precision (AP), precision, recall and F1-score, were used for performance evaluation. The McNemar and chi-squared tests were performed, and the 95% Wilson confidence intervals were given for the precision and recall. Results: There were 175,125; 4,707; 8,259; and 3,104 bounding boxes after annotation on the RSNA 2019+; CQ500+; and the PD 1 and PD 2 datasets, respectively. With an intersection-over-union threshold of 0.5, the APs of IVH, IPH, SAH, SDH and EDH are 0.852, 0.820, 0.574, 0.639, and 0.558, respectively, yielding a mean average precision (mAP) of 0.688 for our proposed deep learning model on the RSNA 2019+ test dataset. For the multicenter validation involving the three external datasets, the mAPs for CQ500, PD1, and PD2 were 0.594, 0.734, and 0.66, respectively, which is comparable to those of radiologist with eight years of experience in head CT interpretation. Conclusion: The deep learning model developed from the constructed RSNA 2019+ dataset exhibited good potential in identifying and localizing the five ICH subtypes in CT slices and has the potential to assist in the clinical diagnosis.
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spelling doaj-art-ac13984e104c48988c20c43a0bc4d4562025-08-20T03:00:32ZengElsevierIntelligent Medicine2667-10262025-02-0151142210.1016/j.imed.2024.11.002Deep learning-based identification and localization of intracranial hemorrhage in patients using a large annotated head computed tomography dataset: A retrospective multicenter studyJingjing Liu0Weijie Fan1Yi Yang2Qi Peng3Bingjun Ji4Luxing He5Yang Li6Jing Yuan7Wei Li8Xianqi Wang9Yi Wu10Chen Liu11Qingfang Gong12Mi He13Yeqin Fu14Dong Zhang15Si Zhang16Yongjian Nian17Department of Digital Medicine, School of Biomedical Engineering and Imaging Medicine, Army Medical University, Chongqing 400038, ChinaDepartment of Radiology, Second Affiliated Hospital, Army Medical University, Chongqing 400037, ChinaDepartment of Digital Medicine, School of Biomedical Engineering and Imaging Medicine, Army Medical University, Chongqing 400038, ChinaDepartment of Digital Medicine, School of Biomedical Engineering and Imaging Medicine, Army Medical University, Chongqing 400038, ChinaRadiotherapy Center, Sunshine Union Hospital, Weifang, Shandong 261061, ChinaDepartment of Digital Medicine, School of Biomedical Engineering and Imaging Medicine, Army Medical University, Chongqing 400038, ChinaDepartment of Radiology, Air Force Hospital of Western Theater Command, Chengdu, Sichuan 610011, ChinaDepartment of Radiology, Army Medical Center, Army Medical University, Chongqing 400037, ChinaDepartment of Radiology, Second Affiliated Hospital, Army Medical University, Chongqing 400037, ChinaDepartment of Radiology, First Affiliated Hospital, Army Medical University, Chongqing 400037, ChinaDepartment of Digital Medicine, School of Biomedical Engineering and Imaging Medicine, Army Medical University, Chongqing 400038, ChinaDepartment of Radiology, First Affiliated Hospital, Army Medical University, Chongqing 400037, ChinaDepartment of Digital Medicine, School of Biomedical Engineering and Imaging Medicine, Army Medical University, Chongqing 400038, ChinaDepartment of Medical Instruments and Metrology, School of Biomedical Engineering and Imaging Medicine, Army Medical University, Chongqing 400038, ChinaDepartment of Digital Medicine, School of Biomedical Engineering and Imaging Medicine, Army Medical University, Chongqing 400038, ChinaDepartment of Radiology, Second Affiliated Hospital, Army Medical University, Chongqing 400037, China; Corresponding authors: Yongjian Nian, Department of Digital Medicine, School of Biomedical Engineering and Imaging Medicine, Army Medical University, Chongqing 400038, China; Si Zhang, Department of Radiology, Second Affiliated Hospital, Army Medical University, Chongqing 400037, China; Dong Zhang, Department of Radiology, Second Affiliated Hospital, Army Medical University, Chongqing 400037, China.Department of Radiology, Second Affiliated Hospital, Army Medical University, Chongqing 400037, China; Corresponding authors: Yongjian Nian, Department of Digital Medicine, School of Biomedical Engineering and Imaging Medicine, Army Medical University, Chongqing 400038, China; Si Zhang, Department of Radiology, Second Affiliated Hospital, Army Medical University, Chongqing 400037, China; Dong Zhang, Department of Radiology, Second Affiliated Hospital, Army Medical University, Chongqing 400037, China.Department of Digital Medicine, School of Biomedical Engineering and Imaging Medicine, Army Medical University, Chongqing 400038, China; Corresponding authors: Yongjian Nian, Department of Digital Medicine, School of Biomedical Engineering and Imaging Medicine, Army Medical University, Chongqing 400038, China; Si Zhang, Department of Radiology, Second Affiliated Hospital, Army Medical University, Chongqing 400037, China; Dong Zhang, Department of Radiology, Second Affiliated Hospital, Army Medical University, Chongqing 400037, China.Background: Accurately identifying and localizing the five subtypes of intracranial hemorrhage (ICH) are crucial steps for subsequent clinical treatment; however, the lack of a large computed tomography (CT) dataset with annotations of the categorization and localization of ICH considerably limits the development of deep learning-based identification and localization methods. We aimed to construct this large dataset and develop a deep learning-based model to identify and localize the five ICH subtypes, including intraventricular hemorrhage (IVH), intraparenchymal hemorrhage (IPH), subdural hemorrhage (SDH), subarachnoid hemorrhage (SAH), and epidural hemorrhage (EDH), in non-contrast head CT scans. Methods: Based on the public Radiological Society of North America (RSNA) 2019 dataset, we constructed a large CT dataset named RSNA 2019+ that was annotated for bleeding localization of the five ICH subtypes by three radiologists. An improved YOLOv8 architecture with the bidirectional feature pyramid network was proposed and trained using the RSNA 2019+ training dataset and evaluated on the RSNA 2019+ test dataset. The public CQ500, and two private datasets collected from the Xinqiao and Sunshine Union Hospitals, respectively, were also annotated to perform multicenter validation. Furthermore, the performance of the deep learning model was compared with that of four radiologists. Multiple performance metrics, including the average precision (AP), precision, recall and F1-score, were used for performance evaluation. The McNemar and chi-squared tests were performed, and the 95% Wilson confidence intervals were given for the precision and recall. Results: There were 175,125; 4,707; 8,259; and 3,104 bounding boxes after annotation on the RSNA 2019+; CQ500+; and the PD 1 and PD 2 datasets, respectively. With an intersection-over-union threshold of 0.5, the APs of IVH, IPH, SAH, SDH and EDH are 0.852, 0.820, 0.574, 0.639, and 0.558, respectively, yielding a mean average precision (mAP) of 0.688 for our proposed deep learning model on the RSNA 2019+ test dataset. For the multicenter validation involving the three external datasets, the mAPs for CQ500, PD1, and PD2 were 0.594, 0.734, and 0.66, respectively, which is comparable to those of radiologist with eight years of experience in head CT interpretation. Conclusion: The deep learning model developed from the constructed RSNA 2019+ dataset exhibited good potential in identifying and localizing the five ICH subtypes in CT slices and has the potential to assist in the clinical diagnosis.http://www.sciencedirect.com/science/article/pii/S2667102624000895Intracranial hemorrhageIdentification and localizationDeep learning modelBounding box
spellingShingle Jingjing Liu
Weijie Fan
Yi Yang
Qi Peng
Bingjun Ji
Luxing He
Yang Li
Jing Yuan
Wei Li
Xianqi Wang
Yi Wu
Chen Liu
Qingfang Gong
Mi He
Yeqin Fu
Dong Zhang
Si Zhang
Yongjian Nian
Deep learning-based identification and localization of intracranial hemorrhage in patients using a large annotated head computed tomography dataset: A retrospective multicenter study
Intelligent Medicine
Intracranial hemorrhage
Identification and localization
Deep learning model
Bounding box
title Deep learning-based identification and localization of intracranial hemorrhage in patients using a large annotated head computed tomography dataset: A retrospective multicenter study
title_full Deep learning-based identification and localization of intracranial hemorrhage in patients using a large annotated head computed tomography dataset: A retrospective multicenter study
title_fullStr Deep learning-based identification and localization of intracranial hemorrhage in patients using a large annotated head computed tomography dataset: A retrospective multicenter study
title_full_unstemmed Deep learning-based identification and localization of intracranial hemorrhage in patients using a large annotated head computed tomography dataset: A retrospective multicenter study
title_short Deep learning-based identification and localization of intracranial hemorrhage in patients using a large annotated head computed tomography dataset: A retrospective multicenter study
title_sort deep learning based identification and localization of intracranial hemorrhage in patients using a large annotated head computed tomography dataset a retrospective multicenter study
topic Intracranial hemorrhage
Identification and localization
Deep learning model
Bounding box
url http://www.sciencedirect.com/science/article/pii/S2667102624000895
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