Yonsei Med J.  2021 Nov;62(11):1052-1061. 10.3349/ymj.2021.62.11.1052.

A Deep Learning Model with High Standalone Performance for Diagnosis of Unruptured Intracranial Aneurysm

• Joo B
• Choi HS
• Ahn SS
• Cha J
• Won SY
• Sohn B
• Kim H
• Han K
• Kim HP
• Choi JM
• Lee SM
• Kim TG
• Lee SK

• KMID: 2521456
• DOI: http://doi.org/10.3349/ymj.2021.62.11.1052

Abstract

Purpose
This study aimed to investigate whether a deep learning model for automated detection of unruptured intracranial aneurysms on time-of-flight (TOF) magnetic resonance angiography (MRA) can achieve a target diagnostic performance comparable to that of human radiologists for approval from the Korean Ministry of Food and Drug Safety as an artificial intelligence-applied software.
Materials and Methods
In this single-center, retrospective, confirmatory clinical trial, the diagnostic performance of the model was evaluated in a predetermined test set. After sample size estimation, the test set consisted of 135 aneurysm-containing examinations with 168 intracranial aneurysms and 197 aneurysm-free examinations. The target sensitivity and specificity were set as 87% and 92%, respectively. The patient-wise sensitivity and specificity of the model were analyzed. Moreover, the lesion-wise sensitivity and false-positive detection rate per case were also investigated.
Results
The sensitivity and specificity of the model were 91.11% [95% confidence interval (CI): 84.99, 95.32] and 93.91% (95% CI: 89.60, 96.81), respectively, which met the target performance values. The lesion-wise sensitivity was 92.26%. The overall falsepositive detection rate per case was 0.123. Of the 168 aneurysms, 13 aneurysms from 12 examinations were missed by the model.
Conclusion
The present deep learning model for automated detection of unruptured intracranial aneurysms on TOF MRA achieved the target diagnostic performance comparable to that of human radiologists. With high standalone performance, this model may be useful for accurate and efficient diagnosis of intracranial aneurysm.

Keyword

Artificial intelligence; deep learning; intracranial aneurysm; magnetic resonance angiography