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arXiv 1904.03041cs.CV
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利用具有分割置信度的卷积神经网络自动检测多发性硬化的病变负荷变化

Automatic detection of lesion load change in Multiple Sclerosis using convolutional neural networks with segmentation confidence

University of Bern(伯尔尼大学);Inselspital, Bern University Hospital(伯尔尼大学医院 Inselspital);Universitätsklinik Balgrist(巴尔格里斯特大学医院)
Richard McKinley, Lorenz Grunder, Rik Wepfer, Fabian Aschwanden, Tim Fischer, Christoph Friedli, Raphaela Muri, Christian Rummel, Rajeev Verma, Christian Weisst… 展开作者

Richard McKinley, Lorenz Grunder, Rik Wepfer, Fabian Aschwanden, Tim Fischer, Christoph Friedli, Raphaela Muri, Christian Rummel, Rajeev Verma, Christian Weisstanner, Mauricio Reyes, Anke Salmen, Andrew Chan, Roland Wiest, Franca Wagner

摘要:

多发性硬化症中新的或扩大的白质病变的检测是监测接受多发性硬化症疾病改善治疗的患者的重要任务。然而,“新的或扩大的”的定义是不固定的,并且已知病变计数是高度主观的,具有高度的评估者间和评估者内的可变性。用于病变量化的自动化方法具有使新的和扩大的病变的检测一致且可重复的潜力。然而,大多数病变分割算法没有评估其将进展患者与稳定患者分开的能力,尽管这是一个紧迫的临床用例。在本文中,我们表明,改变体积测量病变负荷单独是不是一个很好的方法进行这种分离,即使是高性能的分割方法。相反,我们提出了一种用于识别高确定性病变变化的方法,并在纵向多发性硬化病例的数据集上建立了这种方法能够以非常高的区分度(AUC = 0.99)将进展性与稳定时间点分开,而病变体积的变化则不太能够进行这种分离(AUC = 0.71)。该方法在第二个外部数据集上的验证证实,该方法能够在训练的设置之外进行推广,在分离稳定和渐进时间点方面实现了83%的准确性。病变体积和计数先前已被证明是整个人群中病程的强预测因子。然而,我们证明,对于个别患者,这些措施的变化是不是一个足够的手段,建立没有证据的疾病活动。同时,以高置信度直接检测从非病变到病变变化的组织是用于识别放射活性患者的可行方法。

英文摘要:

The detection of new or enlarged white-matter lesions in multiple sclerosis is a vital task in the monitoring of patients undergoing disease-modifying treatment for multiple sclerosis. However, the definition of 'new or enlarged' is not fixed, and it is known that lesion-counting is highly subjective, with high degree of inter- and intra-rater variability. Automated methods for lesion quantification hold the potential to make the detection of new and enlarged lesions consistent and repeatable. However, the majority of lesion segmentation algorithms are not evaluated for their ability to separate progressive from stable patients, despite this being a pressing clinical use-case. In this paper we show that change in volumetric measurements of lesion load alone is not a good method for performing this separation, even for highly performing segmentation methods. Instead, we propose a method for identifying lesion changes of high certainty, and establish on a dataset of longitudinal multiple sclerosis cases that this method is able to separate progressive from stable timepoints with a very high level of discrimination (AUC = 0.99), while changes in lesion volume are much less able to perform this separation (AUC = 0.71). Validation of the method on a second external dataset confirms that the method is able to generalize beyond the setting in which it was trained, achieving an accuracy of 83% in separating stable and progressive timepoints. Both lesion volume and count have previously been shown to be strong predictors of disease course across a population. However, we demonstrate that for individual patients, changes in these measures are not an adequate means of establishing no evidence of disease activity. Meanwhile, directly detecting tissue which changes, with high confidence, from non-lesion to lesion is a feasible methodology for identifying radiologically active patients.

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