Bryan Yoo

Haoyue Zhang, Jennifer S Polson, Kambiz Nael et al.

Treatment of acute ischemic strokes (AIS) is largely contingent upon the time since stroke onset (TSS). However, TSS may not be readily available in up to 25% of patients with unwitnessed AIS. Current clinical guidelines for patients with unknown TSS recommend the use of MRI to determine eligibility for thrombolysis, but radiology assessments have high inter-reader variability. In this work, we present deep learning models that leverage MRI diffusion series to classify TSS based on clinically validated thresholds. We propose an intra-domain task-adaptive transfer learning method, which involves training a model on an easier clinical task (stroke detection) and then refining the model with different binary thresholds of TSS. We apply this approach to both 2D and 3D CNN architectures with our top model achieving an ROC-AUC value of 0.74, with a sensitivity of 0.70 and a specificity of 0.81 for classifying TSS < 4.5 hours. Our pretrained models achieve better classification metrics than the models trained from scratch, and these metrics exceed those of previously published models applied to our dataset. Furthermore, our pipeline accommodates a more inclusive patient cohort than previous work, as we did not exclude imaging studies based on clinical, demographic, or image processing criteria. When applied to this broad spectrum of patients, our deep learning model achieves an overall accuracy of 75.78% when classifying TSS < 4.5 hours, carrying potential therapeutic implications for patients with unknown TSS.

Bilwaj Gaonkar, Joel Beckett, Mark Attiah et al.

Translation of fully automated deep learning based medical image segmentation technologies to clinical workflows face two main algorithmic challenges. The first, is the collection and archival of large quantities of manually annotated ground truth data for both training and validation. The second is the relative inability of the majority of deep learning based segmentation techniques to alert physicians to a likely segmentation failure. Here we propose a novel algorithm, named `Eigenrank' which addresses both of these challenges. Eigenrank can select for manual labeling, a subset of medical images from a large database, such that a U-Net trained on this subset is superior to one trained on a randomly selected subset of the same size. Eigenrank can also be used to pick out, cases in a large database, where deep learning segmentation will fail. We present our algorithm, followed by results and a discussion of how Eigenrank exploits the Von Neumann information to perform both data subset selection and failure prediction for medical image segmentation using deep learning.