scholarly journals Clinically Applicable Deep Learning for Intracranial Aneurysm Detection in Computed Tomography Angiography Images: A Comprehensive Multicohort Study

2020 ◽  
Author(s):  
Zhao Shi ◽  
Chongchang Miao ◽  
Chengwei Pan ◽  
Xue Chai ◽  
Xiu Li Li ◽  
...  
Keyword(s):  
Deep Learning ◽  
Intracranial Aneurysm ◽  
High Confidence ◽  
Common Life ◽  
Bone Removal ◽  
Life Threatening ◽  
Diagnosis Tool ◽  
Aneurysm Detection ◽  
A Prospective Study ◽  
Human Burden

AbstractIntracranial aneurysm is a common life-threatening disease. CTA is recommended as a standard diagnosis tool, while the interpretation is time-consuming and challenging. We presented a novel deep-learning-based framework trained on 1,177 DSA verified bone-removal CTA cases. The framework had excellent tolerance to the influence of occult cases of CTA-negative but DSA-positive aneurysms, image quality, and manufacturers. Simulated real-world studies were conducted in consecutive internal and external cohorts, achieving improved sensitivity and negative predictive value than radiologists. A specific cohort of suspected acute ischemic stroke was employed and found 96.8% predicted-negative cases can be trusted with high confidence, leading to reducing in human burden. A prospective study is warranted to determine whether the algorithm could improve patients’ care in comparison to radiologists’ assessment.

scholarly journals A clinically applicable deep-learning model for detecting intracranial aneurysm in computed tomography angiography images

2020 ◽  
Vol 11 (1) ◽  
Author(s):  
Zhao Shi ◽  
Chongchang Miao ◽  
U. Joseph Schoepf ◽  
Rock H. Savage ◽  
Danielle M. Dargis ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Deep Learning ◽  
Intracranial Aneurysm ◽  
Computed Tomography Angiography ◽  
Good Tolerance ◽  
Common Life ◽  
Life Threatening ◽  
Lesion Level ◽  
A Prospective Study ◽  
Deep Learning Model

AbstractIntracranial aneurysm is a common life-threatening disease. Computed tomography angiography is recommended as the standard diagnosis tool; yet, interpretation can be time-consuming and challenging. We present a specific deep-learning-based model trained on 1,177 digital subtraction angiography verified bone-removal computed tomography angiography cases. The model has good tolerance to image quality and is tested with different manufacturers. Simulated real-world studies are conducted in consecutive internal and external cohorts, in which it achieves an improved patient-level sensitivity and lesion-level sensitivity compared to that of radiologists and expert neurosurgeons. A specific cohort of suspected acute ischemic stroke is employed and it is found that 99.0% predicted-negative cases can be trusted with high confidence, leading to a potential reduction in human workload. A prospective study is warranted to determine whether the algorithm could improve patients’ care in comparison to clinicians’ assessment.

Using convolutional neural network and long short time memory to automatically detect aneurysm on 2D DSA images (Preprint)

2021 ◽  
Author(s):  
JunHua Liao ◽  
LunXin Liu ◽  
HaiHan Duan ◽  
YunZhi Huang ◽  
LiangXue Zhou ◽  
...  
Keyword(s):  
Deep Learning ◽  
Intracranial Aneurysm ◽  
Spatial Information ◽  
Diagnostic System ◽  
Two Stage ◽  
Regional Localization ◽  
Detection Stage ◽  
Aneurysm Detection ◽  
Sensitivity Specificity ◽  
Computation Load

BACKGROUND It is hard to distinguish cerebral aneurysm from overlap vessels based on the 2D DSA images, for its lack the spatial information. OBJECTIVE The aim of this study is to construct a deep learning diagnostic system to improve the ability of detecting the PCoA aneurysm on 2D-DSA images and validate the efficiency of deep learning diagnostic system in 2D-DSA aneurysm detecting. METHODS We proposed a two stage detecting system. First, we established the regional localization stage (RLS) to automatically locate specific detection region of raw 2D-DSA sequences. And then, in the intracranial aneurysm detection stage (IADS) ,we build three different frames, RetinaNet, RetinaNet+LSTM, Bi-input+RetinaNet+LSTM, to detect the aneurysms. Each of the frame had fivefold cross-validation scheme. The area under curve (AUC), the receiver operating characteristic (ROC) curve, and mean average precision (mAP) were used to validate the efficiency of different frames. The sensitivity, specificity and accuracy were used to identify the ability of different frames. RESULTS 255 patients with PCoA aneurysms and 20 patients without aneurysm were included in this study. The best results of AUC of the RetinaNet, RetinaNet+LSTM, and Bi-input+RetinaNet+LSTM were 0.95, 0.96, and 0.97, respectively. The sensitivity of the RetinaNet, RetinaNet+LSTM, and Bi-input+RetinaNet+LSTM were 81.65% (59.40% to 94.76%), 87.91% (64.24% to 98.27%), 84.50% (69.57% to 93.97%), respectively. The specificity of the RetinaNet, RetinaNet+LSTM, and Bi-input+RetinaNet+LSTM were 88.89% (66.73% to 98.41%), 88.12% (66.06% to 98.08%), and 88.50% (74.44% to 96.39%), respectively. The accuracy of the RetinaNet, RetinaNet+LSTM, and Bi-input+RetinaNet+LSTM were 92.71% (71.29% to 99.54%), 89.42% (68.13% to 98.49%), and 91.00% (77.63% to 97.72%), respectively. CONCLUSIONS Two stage aneurysm detecting system can reduce time cost and the computation load. According to our results, more spatial and temporal information can help improve the performance of the frames, so that Bi-input+RetinaNet+LSTM has the best performance compared to other frames. And our study can demonstrate that our system was feasible to assist doctor to detect intracranial aneurysm on 2D-DSA images.

scholarly journals Ectopic Pregnancy, Still A Life Threatening Emergency - A Clinical Study Of 100 Cases

2014 ◽  
Vol 2 (1) ◽  
Author(s):  
Kavitha B ◽  
Geetha L ◽  
Usha Rani T ◽  
Rama Devi A ◽  
Madhuri K ◽  
...  
Keyword(s):  
Risk Factors ◽  
Ectopic Pregnancy ◽  
Case Fatality ◽  
Common Life ◽  
Ectopic Gestation ◽  
Child Bearing ◽  
Life Threatening ◽  
Common Risk Factors ◽  
A Prospective Study ◽  
Urine Pregnancy Test

Ectopic pregnancy is still a major challenge & its incidence is on the rise due to changes in lifestyle & advances in medical practice. The objective was to study incidence, clinical presentation, risk factors & management of cases that presented in our hospital over a four -year period. A Prospective study of 100 cases presenting as ectopic pregnancy from 15-1-2010 to 15-1-2014.During this period total of 3176 deliveries & 1347 gynaecological surgeries were recorded. 100 patients had ectopic gestations accounting for 3.1% of all deliveries & 7.4% of gynaecological surgeries. Peak age group was 20-29y in 59cases(59%). Gestational age at presentation was 6-8weeks for most of the cases (62%). 59 cases (59%) were multiparous & 41(41%) were nulliparous. All had symptoms suggestive of ectopic pregnancy (amenorrhea, abdominal pain, giddiness, bleeding pervaginum). Diagnosis was confirmed by urine pregnancy test & USG. Common risk factors present were previous surgery ie LSCS-30(30%), Tubectomy-19(19%); Abortions-32(32%); Infertility-36(36%); PID-16(16%).Out of 100cases, 93 (93%) were ruptured & 7(7%) unruptured. Unruptured cases were treated medically using Methotrexate. Laparotomy was done for ruptured cases. Commonest site of Ectopic was ampulla (60%). Salpingectomy was done for most cases (73%).Although case-fatality has decreased, ruptured Ectopic gestation continues to be a common life-threatening emergency making tubal conservation inapplicable. This is of concern in a society with high premium on child-bearing.

scholarly journals A deep learning algorithm may automate intracranial aneurysm detection on MR angiography with high diagnostic performance

2020 ◽  
Vol 30 (11) ◽  
pp. 5785-5793 ◽  
Author(s):  
Bio Joo ◽  
Sung Soo Ahn ◽  
Pyeong Ho Yoon ◽  
Sohi Bae ◽  
Beomseok Sohn ◽  
...  
Keyword(s):  
Deep Learning ◽  
Intracranial Aneurysm ◽  
Mr Angiography ◽  
Diagnostic Performance ◽  
Learning Algorithm ◽  
Deep Learning Algorithm ◽  
Aneurysm Detection

Clinical Case: Complications after Endovascular Treatment of Intracranial Aneurysm in a Patient after Subarachnoid Hemorrhage

2020 ◽  
Vol 8 (1) ◽  
pp. 9-15
Author(s):  
Petrov Nikolay ◽  
◽  
Marinova R. ◽  
Odiseeva Ev.
Keyword(s):  
Intracranial Aneurysm ◽  
Endovascular Treatment ◽  
Clinical Case ◽  
Endovascular Coiling ◽  
Published Data ◽  
Military Medical Academy ◽  
Life Threatening ◽  
Arachnoid Hemorrhage ◽  
The Right ◽  
Brain Artery

Abstract: Intracranial aneurysm is one of the most common neurovascular complications. During the recent years the accepted treatment of enraptured cranial aneurysm is noninvasive endovascular coiling. This technique is modern but it is not without complications which can be serious and life-threatening. A clinical case of a patient admitted to the ICU of Military Medical Academy - Sofia with sub arachnoid hemorrhage is described. After a positive clinical course, the check-up magnetic resonance showed intracranial aneurism of the right carotid artery. The patient underwent angiographic endovascular treatment. Vasospasm of the middle and right brain artery and thrombosis were detected during the procedure. Attempt of thromboaspiration was made without success. This article reviews published data on broad-spectrum researches concerning complications of endovascular coiling of intracranial aneurysms and the ways to prevent and reduce them.

LAPAROSCOPIC CHOLECYSTECTOMY IN ACUTE CHOLECYSTITIS: A PROSPECTIVE STUDY.

2019 ◽  
Author(s):  
Madan Goyal ◽  
R K Goel
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Acute Cholecystitis ◽  
Open Cholecystectomy ◽  
Critical View Of Safety ◽  
Recent Onset ◽  
Conversion To Open Cholecystectomy ◽  
Threatening Condition ◽  
Life Threatening ◽  
Fluid Collections ◽  
A Prospective Study

Acute cholecystitis (AC) is a potentially life-threatening condition. LC was initially considered to be a relative contraindication for laparoscopic cholecystectomy (LC), but with increase in general expertise, early LC was recommended in selected patients1. Aprospective study of LC in grade 1 and 2 AC patients with mild to moderate inflammatory changes in the gallbladder and no significant organ dysfunction, was performed during October 2016 to July 2019. A total of 78 patients, out of 408 cholecystectomies performed during this period, were included in this study. Criteria for diagnosing AC was, recent onset of pain in right hypochondrium, fever, leucocytosis, pericholecystic fluid collections, subserosal oedema on ultrasound, pyocele and other pathological evidence of AC. Patients presented and operated within 4 days of onset of symptoms showed better results as compared to those who could be operated after 4 days and within 14 days. Five patients required conversion to open cholecystectomy because of complex adhesions in 2, critical view of safety was unachievable in 2 and in 1 for troublesome bleeding.

scholarly journals The OSMR Gene Is Involved in Hirschsprung Associated Enterocolitis Susceptibility through an Altered Downstream Signaling

2021 ◽  
Vol 22 (8) ◽  
pp. 3831
Author(s):  
Tiziana Bachetti ◽  
Francesca Rosamilia ◽  
Martina Bartolucci ◽  
Giuseppe Santamaria ◽  
Manuela Mosconi ◽  
...  
Keyword(s):  
Immune Response ◽  
Oncostatin M ◽  
Common Life ◽  
Downstream Signaling ◽  
Whole Exome ◽  
Gut Homeostasis ◽  
Life Threatening ◽  
Infection And Inflammation ◽  
Susceptibility Variant ◽  
Oncostatin M Receptor

Hirschsprung (HSCR) Associated Enterocolitis (HAEC) is a common life-threatening complication in HSCR. HAEC is suggested to be due to a loss of gut homeostasis caused by impairment of immune system, barrier defense, and microbiome, likely related to genetic causes. No gene has been claimed to contribute to HAEC occurrence, yet. Genetic investigation of HAEC by Whole-Exome Sequencing (WES) on 24 HSCR patients affected (HAEC) or not affected (HSCR-only) by enterocolitis and replication of results on a larger panel of patients allowed the identification of the HAEC susceptibility variant p.H187Q in the Oncostatin-M receptor (OSMR) gene (14.6% in HAEC and 5.1% in HSCR-only, p = 0.0024). Proteomic analysis on the lymphoblastoid cell lines from one HAEC patient homozygote for this variant and one HAEC patient not carrying the variant revealed two well distinct clusters of proteins significantly up or downregulated upon OSM stimulation. A marked enrichment in immune response pathways (q < 0.0001) was shown in the HAEC H187 cell line, while proteins upregulated in the HAEC Q187 lymphoblasts sustained pathways likely involved in pathogen infection and inflammation. In conclusion, OSMR p.H187Q is an HAEC susceptibility variant and perturbates the downstream signaling cascade necessary for the gut immune response and homeostasis maintenance.

scholarly journals Metabolic disturbances of the vitamin A pathway in human diaphragmatic hernia

2015 ◽  
Vol 308 (2) ◽  
pp. L147-L157 ◽  
Author(s):  
Karen Coste ◽  
Leonardus W. J. E. Beurskens ◽  
Pierre Blanc ◽  
Denis Gallot ◽  
Amélie Delabaere ◽  
...  
Keyword(s):  
Diaphragmatic Hernia ◽  
Perinatal Death ◽  
Single Gene ◽  
Gene Mutations ◽  
Transcriptional Analysis ◽  
Metabolic Disturbances ◽  
Common Life ◽  
Retinoid Signaling ◽  
Life Threatening ◽  
Surgically Induced

Congenital diaphragmatic hernia (CDH) is a common life-threatening congenital anomaly resulting in high rates of perinatal death and neonatal respiratory distress. Some of the nonisolated forms are related to single-gene mutations or genomic rearrangements, but the genetics of the isolated forms (60% of cases) still remains a challenging issue. Retinoid signaling (RA) is critical for both diaphragm and lung development, and it has been hypothesized that subtle disruptions of this pathway could contribute to isolated CDH etiology. Here we used time series of normal and CDH lungs in humans, in nitrofen-exposed rats, and in surgically induced hernia in rabbits to perform a systematic transcriptional analysis of the RA pathway key components. The results point to CRPBP2, CY26B1, and ALDH1A2 as deregulated RA signaling genes in human CDH. Furthermore, the expression profile comparisons suggest that ALDH1A2 overexpression is not a primary event, but rather a consequence of the CDH-induced lung injury. Taken together, these data show that RA signaling disruption is part of CDH pathogenesis, and also that dysregulation of this pathway should be considered organ specifically.

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