Nature Communications (Aug 2023)

Deep-learning based detection of vessel occlusions on CT-angiography in patients with suspected acute ischemic stroke

  • Gianluca Brugnara,
  • Michael Baumgartner,
  • Edwin David Scholze,
  • Katerina Deike-Hofmann,
  • Klaus Kades,
  • Jonas Scherer,
  • Stefan Denner,
  • Hagen Meredig,
  • Aditya Rastogi,
  • Mustafa Ahmed Mahmutoglu,
  • Christian Ulfert,
  • Ulf Neuberger,
  • Silvia Schönenberger,
  • Kai Schlamp,
  • Zeynep Bendella,
  • Thomas Pinetz,
  • Carsten Schmeel,
  • Wolfgang Wick,
  • Peter A. Ringleb,
  • Ralf Floca,
  • Markus Möhlenbruch,
  • Alexander Radbruch,
  • Martin Bendszus,
  • Klaus Maier-Hein,
  • Philipp Vollmuth

DOI
https://doi.org/10.1038/s41467-023-40564-8
Journal volume & issue
Vol. 14, no. 1
pp. 1 – 15

Abstract

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Abstract Swift diagnosis and treatment play a decisive role in the clinical outcome of patients with acute ischemic stroke (AIS), and computer-aided diagnosis (CAD) systems can accelerate the underlying diagnostic processes. Here, we developed an artificial neural network (ANN) which allows automated detection of abnormal vessel findings without any a-priori restrictions and in <2 minutes. Pseudo-prospective external validation was performed in consecutive patients with suspected AIS from 4 different hospitals during a 6-month timeframe and demonstrated high sensitivity (≥87%) and negative predictive value (≥93%). Benchmarking against two CE- and FDA-approved software solutions showed significantly higher performance for our ANN with improvements of 25–45% for sensitivity and 4–11% for NPV (p ≤ 0.003 each). We provide an imaging platform ( https://stroke.ccibonn.ai/ ) for online processing of medical imaging data with the developed ANN, including provisions for data crowdsourcing, which will allow continuous refinements and serve as a blueprint to build robust and generalizable AI algorithms.