Detection and severity assessment of subdural hematoma is a major step in the evaluation of traumatic brain injuries. This is a retrospective study of 110 computed tomography (CT) scans from patients admitted to the Michigan Medicine Neurological Intensive Care Unit or Emergency Department. A machine learning pipeline was developed to segment and assess the severity of subdural hematoma. First, the probability of each point belonging to the hematoma region was determined using a combination of hand-crafted and deep features. This probability provided the initial state of the segmentation. Next, a 3D post-processing model was applied to evolve the initial state and delineate the hematoma. The recall, precision, and Dice similarity coefficient of the proposed segmentation method were 78.61%, 76.12%, and 75.35%, respectively, for the entire population. The Dice similarity coefficient was 79.97% for clinically significant hematomas, which compared favorably to an inter-rater Dice similarity coefficient. In volume-based severity analysis, the proposed model yielded an F1, recall, and specificity of 98.22%, 98.81%, and 92.31%, respectively, in detecting moderate and severe subdural hematomas based on hematoma volume. These results show that the combination of classical image processing and deep learning can outperform deep learning only methods to achieve greater average performance and robustness. Such a system can aid critical care physicians in reducing time to intervention and thereby improve long-term patient outcomes.
Image segmentation is a common goal in many medical applications, as its use can improve diagnostic capability and outcome prediction. In order to assess the wound healing rate in diabetic foot ulcers, some parameters from the wound area are measured. However, heterogeneity of diabetic skin lesions and the noise present in images captured by digital cameras make wound extraction a difficult task. In this work, a Deep Learning based method for accurate segmentation of wound regions is proposed. In the proposed method, input images are first processed to remove artifacts and then fed into a Convolutional Neural Network (CNN), producing a probability map. Finally, the probability maps are processed to extract the wound region. We also address the
The segmentation of medical and dental images is a fundamental step in automated clinical decision support systems. It supports the entire clinical workflow from diagnosis, therapy planning, intervention, and follow-up. In this paper, we propose a novel tool to accurately process a full-face segmentation in about 5 minutes that would otherwise require an average of 7h of manual work by experienced clinicians. This work focuses on the integration of the state-of-the-art UNEt TRansformers (UNETR) of the Medical Open Network for Artificial Intelligence (MONAI) framework. We trained and tested our models using 618 de-identified Cone-Beam Computed Tomography (CBCT) volumetric images of the head acquired with several parameters from different centers for a generalized clinical application. Our results on a 5-fold cross-validation showed high accuracy and robustness with a Dice score up to 0.962±0.02. Our code is available on our public GitHub repository.
Prognosis of the long-term functional outcome of traumatic brain injury is essential for personalized management of that injury. Nonetheless, accurate prediction remains unavailable. Although machine learning has shown promise in many fields, including medical diagnosis and prognosis, such models are rarely deployed in real-world settings due to a lack of transparency and trustworthiness. To address these drawbacks, we propose a machine learning-based framework that is explainable and aligns with clinical domain knowledge. To build such a framework, additional layers of statistical inference and human expert validation are added to the model, which ensures the predicted risk score’s trustworthiness. Using 831 patients with moderate or severe traumatic brain injury to build a model using the proposed framework, an area under the receiver operating characteristic curve (AUC) and accuracy of 0.8085 and 0.7488 were achieved, respectively, in determining which patients will experience poor functional outcomes. The performance of the machine learning classifier is not adversely affected by the imposition of statistical and domain knowledge “checks and balances”. Finally, through a case study, we demonstrate how the decision made by a model might be biased if it is not audited carefully.
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