Machine learning-based pipeline for automated intracerebral hemorrhage and drain detection, quantification, and classification in non-enhanced CT images (NeuroDrAIn).

<h4>Background and purpose</h4>External drainage represents a well-established treatment option for acute intracerebral hemorrhage. The current standard of practice includes post-operative computer tomography imaging, which is subjectively evaluated. The implementation of an objective, a...

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Main Authors: Samer Elsheikh, Ahmed Elbaz, Alexander Rau, Theo Demerath, Elias Kellner, Ralf Watzlawick, Urs Würtemberger, Horst Urbach, Marco Reisert
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2024-01-01
Series:PLoS ONE
Online Access:https://doi.org/10.1371/journal.pone.0316003
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author Samer Elsheikh
Ahmed Elbaz
Alexander Rau
Theo Demerath
Elias Kellner
Ralf Watzlawick
Urs Würtemberger
Horst Urbach
Marco Reisert
author_facet Samer Elsheikh
Ahmed Elbaz
Alexander Rau
Theo Demerath
Elias Kellner
Ralf Watzlawick
Urs Würtemberger
Horst Urbach
Marco Reisert
author_sort Samer Elsheikh
collection DOAJ
description <h4>Background and purpose</h4>External drainage represents a well-established treatment option for acute intracerebral hemorrhage. The current standard of practice includes post-operative computer tomography imaging, which is subjectively evaluated. The implementation of an objective, automated evaluation of postoperative studies may enhance diagnostic accuracy and facilitate the scaling of research projects. The objective is to develop and validate a fully automated pipeline for intracerebral hemorrhage and drain detection, quantification of intracerebral hemorrhage coverage, and detection of malpositioned drains.<h4>Materials and methods</h4>In this retrospective study, we selected patients (n = 68) suffering from supratentorial intracerebral hemorrhage treated by minimally invasive surgery, from years 2010-2018. These were divided into training (n = 21), validation (n = 3) and testing (n = 44) datasets. Mean age (SD) was 70 (±13.56) years, 32 female. Intracerebral hemorrhage and drains were automatically segmented using a previously published artificial intelligence-based approach. From this, we calculated coverage profiles of the correctly detected drains to quantify the drains' coverage by the intracerebral hemorrhage and classify malpositioning. We used accuracy measures to assess detection and classification results and intraclass correlation coefficient to assess the quantification of the drain coverage by the intracerebral hemorrhage.<h4>Results</h4>In the test dataset, the pipeline showed a drain detection accuracy of 0.97 (95% CI: 0.92 to 0.99), an agreement between predicted and ground truth coverage profiles of 0.86 (95% CI: 0.85 to 0.87) and a drain position classification accuracy of 0.88 (95% CI: 0.77 to 0.95) resulting in area under the receiver operating characteristic curve of 0.92 (95% CI: 0.85 to 0.99).<h4>Conclusion</h4>We developed and statistically validated an automated pipeline for evaluating computed tomography scans after minimally invasive surgery for intracerebral hemorrhage. The algorithm reliably detects drains, quantifies drain coverage by the hemorrhage, and uses machine learning to detect malpositioned drains. This pipeline has the potential to impact the daily clinical workload, as well as to facilitate the scaling of data collection for future research into intracerebral hemorrhage and other diseases.
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spelling doaj-art-802cd5f5f2464f59a8b8c1b276bb46dd2025-01-08T05:32:33ZengPublic Library of Science (PLoS)PLoS ONE1932-62032024-01-011912e031600310.1371/journal.pone.0316003Machine learning-based pipeline for automated intracerebral hemorrhage and drain detection, quantification, and classification in non-enhanced CT images (NeuroDrAIn).Samer ElsheikhAhmed ElbazAlexander RauTheo DemerathElias KellnerRalf WatzlawickUrs WürtembergerHorst UrbachMarco Reisert<h4>Background and purpose</h4>External drainage represents a well-established treatment option for acute intracerebral hemorrhage. The current standard of practice includes post-operative computer tomography imaging, which is subjectively evaluated. The implementation of an objective, automated evaluation of postoperative studies may enhance diagnostic accuracy and facilitate the scaling of research projects. The objective is to develop and validate a fully automated pipeline for intracerebral hemorrhage and drain detection, quantification of intracerebral hemorrhage coverage, and detection of malpositioned drains.<h4>Materials and methods</h4>In this retrospective study, we selected patients (n = 68) suffering from supratentorial intracerebral hemorrhage treated by minimally invasive surgery, from years 2010-2018. These were divided into training (n = 21), validation (n = 3) and testing (n = 44) datasets. Mean age (SD) was 70 (±13.56) years, 32 female. Intracerebral hemorrhage and drains were automatically segmented using a previously published artificial intelligence-based approach. From this, we calculated coverage profiles of the correctly detected drains to quantify the drains' coverage by the intracerebral hemorrhage and classify malpositioning. We used accuracy measures to assess detection and classification results and intraclass correlation coefficient to assess the quantification of the drain coverage by the intracerebral hemorrhage.<h4>Results</h4>In the test dataset, the pipeline showed a drain detection accuracy of 0.97 (95% CI: 0.92 to 0.99), an agreement between predicted and ground truth coverage profiles of 0.86 (95% CI: 0.85 to 0.87) and a drain position classification accuracy of 0.88 (95% CI: 0.77 to 0.95) resulting in area under the receiver operating characteristic curve of 0.92 (95% CI: 0.85 to 0.99).<h4>Conclusion</h4>We developed and statistically validated an automated pipeline for evaluating computed tomography scans after minimally invasive surgery for intracerebral hemorrhage. The algorithm reliably detects drains, quantifies drain coverage by the hemorrhage, and uses machine learning to detect malpositioned drains. This pipeline has the potential to impact the daily clinical workload, as well as to facilitate the scaling of data collection for future research into intracerebral hemorrhage and other diseases.https://doi.org/10.1371/journal.pone.0316003
spellingShingle Samer Elsheikh
Ahmed Elbaz
Alexander Rau
Theo Demerath
Elias Kellner
Ralf Watzlawick
Urs Würtemberger
Horst Urbach
Marco Reisert
Machine learning-based pipeline for automated intracerebral hemorrhage and drain detection, quantification, and classification in non-enhanced CT images (NeuroDrAIn).
PLoS ONE
title Machine learning-based pipeline for automated intracerebral hemorrhage and drain detection, quantification, and classification in non-enhanced CT images (NeuroDrAIn).
title_full Machine learning-based pipeline for automated intracerebral hemorrhage and drain detection, quantification, and classification in non-enhanced CT images (NeuroDrAIn).
title_fullStr Machine learning-based pipeline for automated intracerebral hemorrhage and drain detection, quantification, and classification in non-enhanced CT images (NeuroDrAIn).
title_full_unstemmed Machine learning-based pipeline for automated intracerebral hemorrhage and drain detection, quantification, and classification in non-enhanced CT images (NeuroDrAIn).
title_short Machine learning-based pipeline for automated intracerebral hemorrhage and drain detection, quantification, and classification in non-enhanced CT images (NeuroDrAIn).
title_sort machine learning based pipeline for automated intracerebral hemorrhage and drain detection quantification and classification in non enhanced ct images neurodrain
url https://doi.org/10.1371/journal.pone.0316003
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