Format

Send to

Choose Destination
EBioMedicine. 2019 Feb;40:636-642. doi: 10.1016/j.ebiom.2018.12.043. Epub 2018 Dec 29.

Machine learning for detecting moyamoya disease in plain skull radiography using a convolutional neural network.

Author information

1
Department of Neurosurgery, Seoul National University Bundang Hospital, 82, Gumi-ro 173 Beon-gil, Bundang-gu, Seongnam-si, Gyeonggi-do 13620, Republic of Korea.
2
Department of Applied Statistics, The University of Suwon, 17, Wauan-gil, Bongdam-eup, Hwaseong-si, Gyeonggi-do 18323, Republic of Korea.
3
Department of Neurosurgery, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 56, Dongsu-ro, Bupyeong-gu, Incheon, 21431, Republic of Korea.
4
Department of Radiology, Seoul National University Bundang Hospital, 82, Gumi-ro 173 Beon-gil, Bundang-gu, Seongnam-si, Gyeonggi-do 13620, Republic of Korea.
5
Department of Emergency Medicine, Seoul National University Bundang Hospital, 82, Gumi-ro 173 Beon-gil, Bundang-gu, Seongnam-si, Gyeonggi-do 13620, Republic of Korea.
6
Division of Cardiology, Department of Internal Medicine, Seoul National University Bundang Hospital, 82, Gumi-ro 173 Beon-gil, Bundang-gu, Seongnam-si, Gyeonggi-do 13620, Republic of Korea.
7
Department of Ophthalmology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, 82, Gumi-ro 173 Beon-gil, Bundang-gu, Seongnam-si, Gyeonggi-do 13620, Republic of Korea.
8
Department of Neurosurgery, Seoul National University Bundang Hospital, 82, Gumi-ro 173 Beon-gil, Bundang-gu, Seongnam-si, Gyeonggi-do 13620, Republic of Korea; Department of Neurosurgery, Seoul National University College of Medicine, 101 Daehak-Ro Jongno-Gu, Seoul 03080, Republic of Korea.
9
Department of Neurosurgery, Seoul National University Bundang Hospital, 82, Gumi-ro 173 Beon-gil, Bundang-gu, Seongnam-si, Gyeonggi-do 13620, Republic of Korea; Department of Neurosurgery, Seoul National University College of Medicine, 101 Daehak-Ro Jongno-Gu, Seoul 03080, Republic of Korea. Electronic address: wanoh@snu.ac.kr.

Abstract

BACKGROUND:

Recently, innovative attempts have been made to identify moyamoya disease (MMD) by focusing on the morphological differences in the head of MMD patients. Following the recent revolution in the development of deep learning (DL) algorithms, we designed this study to determine whether DL can distinguish MMD in plain skull radiograph images.

METHODS:

Three hundred forty-five skull images were collected as an MMD-labeled dataset from patients aged 18 to 50 years with definite MMD. As a control-labeled data set, 408 skull images of trauma patients were selected by age and sex matching. Skull images were partitioned into training and test datasets at a 7:3 ratio using permutation. A total of six convolution layers were designed and trained. The accuracy and area under the receiver operating characteristic (AUROC) curve were evaluated as classifier performance. To identify areas of attention, gradient-weighted class activation mapping was applied. External validation was performed with a new dataset from another hospital.

FINDINGS:

For the institutional test set, the classifier predicted the true label with 84·1% accuracy. Sensitivity and specificity were both 0·84. AUROC was 0·91. MMD was predicted by attention to the lower face in most cases. Overall accuracy for external validation data set was 75·9%.

INTERPRETATION:

DL can distinguish MMD cases within specific ages from controls in plain skull radiograph images with considerable accuracy and AUROC. The viscerocranium may play a role in MMD-related skull features. FUND: This work was supported by grant no. 18-2018-029 from the Seoul National University Bundang Hospital Research Fund.

KEYWORDS:

Convolutional neural network; Deep learning; Moyamoya; Skull

PMID:
30598372
PMCID:
PMC6413674
DOI:
10.1016/j.ebiom.2018.12.043
[Indexed for MEDLINE]
Free PMC Article

Supplemental Content

Full text links

Icon for Elsevier Science Icon for PubMed Central
Loading ...
Support Center