Deep learning-assistance significantly increases the detection sensitivity of neurosurgery residents for intracranial aneurysms in subarachnoid hemorrhage

Abstract

Objective

The purpose of this study was to evaluate the effectiveness of a deep learning model (DLM) in improving the sensitivity of neurosurgery residents to detect intracranial aneurysms on CT angiography (CTA) in patients with aneurysmal subarachnoid hemorrhage (aSAH).

Methods

In this diagnostic accuracy study, a set of 104 CTA scans of aSAH patients containing a total of 126 aneurysms were presented to three blinded neurosurgery residents (a first-year, third-year, and fifth-year resident), who individually assessed them for aneurysms. After the initial reading, the residents were given the predictions of a dedicated DLM previously established for automated detection and segmentation of intracranial aneurysms. The detection sensitivities for aneurysms of the DLM and the residents with and without the assistance of the DLM were compared.

Results

The DLM had a detection sensitivity of 85.7%, while the residents showed detection sensitivities of 77.8%, 86.5%, and 87.3% without DLM assistance. After being provided with the DLM’s results, the residents’ individual detection sensitivities increased to 97.6%, 95.2%, and 98.4%, respectively, yielding an average increase of 13.2%. The DLM was particularly useful in detecting small aneurysms. In addition, interrater agreement among residents increased from a Fleiss κ of 0.394 without DLM assistance to 0.703 with DLM assistance.

Conclusions

The results of this pilot study suggest that deep learning models can help neurosurgeons detect aneurysms on CTA and make appropriate treatment decisions when immediate radiological consultation is not possible.