Classification of cardioembolic stroke based on a deep neural network using chest radiographs.
EBioMedicine
; 69: 103466, 2021 Jul.
Article
em En
| MEDLINE
| ID: mdl-34229276
ABSTRACT
BACKGROUND:
Although chest radiographs have not been utilised well for classifying stroke subtypes, they could provide a plethora of information on cardioembolic stroke. This study aimed to develop a deep convolutional neural network that could diagnose cardioembolic stroke based on chest radiographs.METHODS:
Overall, 4,064 chest radiographs of consecutive patients with acute ischaemic stroke were collected from a prospectively maintained stroke registry. Chest radiographs were randomly partitioned into training/validation (n = 3,255) and internal test (n = 809) datasets in an 82 ratio. A densely connected convolutional network (ASTRO-X) was trained to diagnose cardioembolic stroke based on chest radiographs. The performance of ASTRO-X was evaluated using the area under the receiver operating characteristic curve. Gradient-weighted class activation mapping was used to evaluate the region of focus of ASTRO-X. External testing was performed with 750 chest radiographs of patients with acute ischaemic stroke from 7 hospitals.FINDINGS:
The areas under the receiver operating characteristic curve of ASTRO-X were 0.86 (95% confidence interval [CI], 0.83-0.89) and 0.82 (95% CI, 0.79-0.85) during the internal and multicentre external testing, respectively. The gradient-weighted class activation map demonstrated that ASTRO-X was focused on the area where the left atrium was located. Compared with cases predicted as non-cardioembolism by ASTRO-X, cases predicted as cardioembolism by ASTRO-X had higher left atrial volume index and lower left ventricular ejection fraction in echocardiography.INTERPRETATION:
ASTRO-X, a deep neural network developed to diagnose cardioembolic stroke based on chest radiographs, demonstrated good classification performance and biological plausibility.FUNDING:
Grant No. 14-2020-046 and 08-2016-051 from the Seoul National University Bundang Research Fund and NRF-2020M3E5D9079768 from the National Research Foundation of Korea.Palavras-chave
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Base de dados:
MEDLINE
Assunto principal:
Interpretação de Imagem Radiográfica Assistida por Computador
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AVC Embólico
Idioma:
En
Ano de publicação:
2021
Tipo de documento:
Article