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Published in: Insights into Imaging 1/2019

Open Access 01-12-2019 | Ankle Fracture | Original Article

Structured report data can be used to develop deep learning algorithms: a proof of concept in ankle radiographs

Authors: Daniel Pinto dos Santos, Sebastian Brodehl, Bettina Baeßler, Gordon Arnhold, Thomas Dratsch, Seung-Hun Chon, Peter Mildenberger, Florian Jungmann

Published in: Insights into Imaging | Issue 1/2019

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Abstract

Background

Data used for training of deep learning networks usually needs large amounts of accurate labels. These labels are usually extracted from reports using natural language processing or by time-consuming manual review. The aim of this study was therefore to develop and evaluate a workflow for using data from structured reports as labels to be used in a deep learning application.

Materials and methods

We included all plain anteriorposterior radiographs of the ankle for which structured reports were available. A workflow was designed and implemented where a script was used to automatically retrieve, convert, and anonymize the respective radiographs of cases where fractures were either present or absent from the institution’s picture archiving and communication system (PACS). These images were then used to retrain a pretrained deep convolutional neural network. Finally, performance was evaluated on a set of previously unseen radiographs.

Results

Once implemented and configured, completion of the whole workflow took under 1 h. A total of 157 structured reports were retrieved from the reporting platform. For all structured reports, corresponding radiographs were successfully retrieved from the PACS and fed into the training process. On an unseen validation subset, the model showed a satisfactory performance with an area under the curve of 0.850 (95% CI 0.634–1.000) for detection of fractures.

Conclusion

We demonstrate that data obtained from structured reports written in clinical routine can be used to successfully train deep learning algorithms. This highlights the potential role of structured reporting for the future of radiology, especially in the context of deep learning.
Appendix
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Literature
1.
go back to reference Lakhani P, Gray DL, Pett CR, Nagy P, Shih G (2018) Hello world deep learning in medical imaging. J Digit Imaging 31:283–289CrossRef Lakhani P, Gray DL, Pett CR, Nagy P, Shih G (2018) Hello world deep learning in medical imaging. J Digit Imaging 31:283–289CrossRef
2.
go back to reference Choy G, Khalilzadeh O, Michalski M et al (2018) Current applications and future impact of machine learning in radiology. Radiology. 288:318–328CrossRef Choy G, Khalilzadeh O, Michalski M et al (2018) Current applications and future impact of machine learning in radiology. Radiology. 288:318–328CrossRef
3.
go back to reference Chartrand G, Cheng PM, Vorontsov E et al (2017) Deep learning: a primer for radiologists. Radiographics 37:2113–2131CrossRef Chartrand G, Cheng PM, Vorontsov E et al (2017) Deep learning: a primer for radiologists. Radiographics 37:2113–2131CrossRef
4.
go back to reference Chung SW, Han SS, Lee JW et al (2018) Automated detection and classification of the proximal humerus fracture by using deep learning algorithm. Acta Orthop 89:468–473CrossRef Chung SW, Han SS, Lee JW et al (2018) Automated detection and classification of the proximal humerus fracture by using deep learning algorithm. Acta Orthop 89:468–473CrossRef
5.
go back to reference Urakawa T, Tanaka Y, Goto S, Matsuzawa H, Watanabe K, Endo N (2018) Detecting intertrochanteric hip fractures with orthopedist-level accuracy using a deep convolutional neural network. Skeletal Radiol 41:63–66 Urakawa T, Tanaka Y, Goto S, Matsuzawa H, Watanabe K, Endo N (2018) Detecting intertrochanteric hip fractures with orthopedist-level accuracy using a deep convolutional neural network. Skeletal Radiol 41:63–66
6.
go back to reference Kim DH, MacKinnon T (2018) Artificial intelligence in fracture detection: transfer learning from deep convolutional neural networks. Clin Radiol 73:439–445CrossRef Kim DH, MacKinnon T (2018) Artificial intelligence in fracture detection: transfer learning from deep convolutional neural networks. Clin Radiol 73:439–445CrossRef
7.
go back to reference Wang X, Peng Y, Lu L, Lu Z, Bagheri M, Summers RM (2017) Chestx-ray8: hospital-scale chest x-ray database and benchmarks on weakly-supervised classification and localization of common thorax diseases Available via: https://arxiv.org/abs/1705.02315. Accessed 10 Dec 2018 Wang X, Peng Y, Lu L, Lu Z, Bagheri M, Summers RM (2017) Chestx-ray8: hospital-scale chest x-ray database and benchmarks on weakly-supervised classification and localization of common thorax diseases Available via: https://​arxiv.​org/​abs/​1705.​02315. Accessed 10 Dec 2018
9.
go back to reference Yan K, Wang X, Lu L, Summers RM (2017) DeepLesion: automated deep mining, categorization and detection of significant radiology image findings using large-scale clinical lesion annotations Available via: https://arxiv.org/abs/1710.01766. Accessed 10 Dec 2018 Yan K, Wang X, Lu L, Summers RM (2017) DeepLesion: automated deep mining, categorization and detection of significant radiology image findings using large-scale clinical lesion annotations Available via: https://​arxiv.​org/​abs/​1710.​01766. Accessed 10 Dec 2018
12.
go back to reference Morgan TA, Helibrun ME, Kahn CE Jr (2014) Reporting initiative of the Radiological Society of North America: progress and new directions. Radiology. 273:642–645CrossRef Morgan TA, Helibrun ME, Kahn CE Jr (2014) Reporting initiative of the Radiological Society of North America: progress and new directions. Radiology. 273:642–645CrossRef
13.
go back to reference European Society of Radiology (ESR) (2018) ESR paper on structured reporting in radiology. Insights Imaging 9:1–7 European Society of Radiology (ESR) (2018) ESR paper on structured reporting in radiology. Insights Imaging 9:1–7
14.
go back to reference Ganeshan D, Duong PT, Probyn L et al (2018) Structured reporting in radiology. Acad Radiol 25:66–73CrossRef Ganeshan D, Duong PT, Probyn L et al (2018) Structured reporting in radiology. Acad Radiol 25:66–73CrossRef
17.
go back to reference Pinto dos Santos D, Klos G, Kloeckner R, Oberle R, Dueber C, Mildenberger P (2017) Development of an IHE MRRT-compliant open-source web-based reporting platform. Eur Radiol 27:424–430CrossRef Pinto dos Santos D, Klos G, Kloeckner R, Oberle R, Dueber C, Mildenberger P (2017) Development of an IHE MRRT-compliant open-source web-based reporting platform. Eur Radiol 27:424–430CrossRef
21.
go back to reference Robin X, Turck N, Hainard A et al (2011) pROC: an open-source package for R and S+ to analyze and compare ROC curves. BMC Bioinformatics 12:77 Robin X, Turck N, Hainard A et al (2011) pROC: an open-source package for R and S+ to analyze and compare ROC curves. BMC Bioinformatics 12:77
22.
go back to reference Bosmans JM, Neri E, Ratib O, Kahn CE Jr (2015) Structured reporting: a fusion reactor hungry for fuel. Insights Imaging 6:129–132CrossRef Bosmans JM, Neri E, Ratib O, Kahn CE Jr (2015) Structured reporting: a fusion reactor hungry for fuel. Insights Imaging 6:129–132CrossRef
23.
go back to reference Bosmans JM, Weyler JJ, De Schepper AM, Parizel PM (2011) The radiology report as seen by radiologists and referring clinicians: results of the COVER and ROVER surveys. Radiology. 259:184–195CrossRef Bosmans JM, Weyler JJ, De Schepper AM, Parizel PM (2011) The radiology report as seen by radiologists and referring clinicians: results of the COVER and ROVER surveys. Radiology. 259:184–195CrossRef
24.
go back to reference Plumb AA, Grieve FM, Khan SH (2009) Survey of hospital clinicians' preferences regarding the format of radiology reports. Clin Radiol 64:386–396CrossRef Plumb AA, Grieve FM, Khan SH (2009) Survey of hospital clinicians' preferences regarding the format of radiology reports. Clin Radiol 64:386–396CrossRef
25.
go back to reference Grieve FM, Plumb AA, Khan SH (2010) Radiology reporting: a general practitioner's perspective. Br J Radiol 83:17–22CrossRef Grieve FM, Plumb AA, Khan SH (2010) Radiology reporting: a general practitioner's perspective. Br J Radiol 83:17–22CrossRef
26.
go back to reference Doğan N, Varlibaş ZN, Erpolat OP (2010) Radiological report: expectations of clinicians. Diagn Interv Radiol 16:179–185 Doğan N, Varlibaş ZN, Erpolat OP (2010) Radiological report: expectations of clinicians. Diagn Interv Radiol 16:179–185
27.
go back to reference Lee B, Whitehead MT (2017) Radiology reports: what You think you’re saying and what they think you’re saying. Curr Probl Diagn Radiol 46:186–195CrossRef Lee B, Whitehead MT (2017) Radiology reports: what You think you’re saying and what they think you’re saying. Curr Probl Diagn Radiol 46:186–195CrossRef
28.
go back to reference Schwartz LH, Panicek DM, Berk AR, Li Y, Hricak H (2011) Improving communication of diagnostic radiology findings through structured reporting. Radiology. 260:174–181CrossRef Schwartz LH, Panicek DM, Berk AR, Li Y, Hricak H (2011) Improving communication of diagnostic radiology findings through structured reporting. Radiology. 260:174–181CrossRef
29.
go back to reference Brook OR, Brook A, Vollmer CM, Kent TS, Sanchez N, Pedrosa I (2015) Structured reporting of multiphasic CT for pancreatic cancer: potential effect on staging and surgical planning. Radiology. 274:464–472CrossRef Brook OR, Brook A, Vollmer CM, Kent TS, Sanchez N, Pedrosa I (2015) Structured reporting of multiphasic CT for pancreatic cancer: potential effect on staging and surgical planning. Radiology. 274:464–472CrossRef
30.
go back to reference Nörenberg D, Sommer WH, Thasler W et al (2017) Structured reporting of rectal magnetic resonance imaging in suspected primary rectal cancer: potential benefits for surgical planning and interdisciplinary communication. Invest Radiol 52:232–239CrossRef Nörenberg D, Sommer WH, Thasler W et al (2017) Structured reporting of rectal magnetic resonance imaging in suspected primary rectal cancer: potential benefits for surgical planning and interdisciplinary communication. Invest Radiol 52:232–239CrossRef
31.
go back to reference Nguyen GK, Shetty AS (2018) Artificial intelligence and machine learning: opportunities for radiologists in training. J Am Coll Radiol 15:1320–1321CrossRef Nguyen GK, Shetty AS (2018) Artificial intelligence and machine learning: opportunities for radiologists in training. J Am Coll Radiol 15:1320–1321CrossRef
32.
go back to reference Beam AL, Kohane IS (2018) Big data and machine learning in health care. JAMA. 319:1317–1318CrossRef Beam AL, Kohane IS (2018) Big data and machine learning in health care. JAMA. 319:1317–1318CrossRef
33.
go back to reference Pons E, Braun LM, Hunink MG, Kors JA (2016) Natural language processing in radiology: a systematic review. Radiology. 279:329–343CrossRef Pons E, Braun LM, Hunink MG, Kors JA (2016) Natural language processing in radiology: a systematic review. Radiology. 279:329–343CrossRef
34.
go back to reference Weiss GM, McCarthy K, Zabar B (2017) Cost-sensitive learning vs. sampling: which is best for handling unbalanced classes with unequal error costs? Proceedings of the 2007 international conference on data mining Weiss GM, McCarthy K, Zabar B (2017) Cost-sensitive learning vs. sampling: which is best for handling unbalanced classes with unequal error costs? Proceedings of the 2007 international conference on data mining
35.
go back to reference Chawla NV, Bowyer KW, O’Hall L, Kegelmeyer WP (2002) SMOTE: synthetic minority over-sampling technique. J Artif Intell Res 16:321–357CrossRef Chawla NV, Bowyer KW, O’Hall L, Kegelmeyer WP (2002) SMOTE: synthetic minority over-sampling technique. J Artif Intell Res 16:321–357CrossRef
36.
go back to reference He H, Bai Y, Garcia EA, Li S (2008) ADASYN: adaptive synthetic sampling approach for imbalanced learning. 2008 IEEE International Joint Conference on Neural Networks, Hong Kong, 1322–1328 He H, Bai Y, Garcia EA, Li S (2008) ADASYN: adaptive synthetic sampling approach for imbalanced learning. 2008 IEEE International Joint Conference on Neural Networks, Hong Kong, 1322–1328
38.
go back to reference Langlotz CP, Allen B, Erickson BJ et al (2019) A roadmap for foundational research on artificial intelligence in medical imaging: from the 2018 NIH/RSNA/ACR/the academy workshop. Radiology. 291:781–791CrossRef Langlotz CP, Allen B, Erickson BJ et al (2019) A roadmap for foundational research on artificial intelligence in medical imaging: from the 2018 NIH/RSNA/ACR/the academy workshop. Radiology. 291:781–791CrossRef
39.
go back to reference Rubin DL (2008) Creating and curating a terminology for radiology: ontology modeling and analysis. J Digit Imaging 21:355–362CrossRef Rubin DL (2008) Creating and curating a terminology for radiology: ontology modeling and analysis. J Digit Imaging 21:355–362CrossRef
Metadata
Title
Structured report data can be used to develop deep learning algorithms: a proof of concept in ankle radiographs
Authors
Daniel Pinto dos Santos
Sebastian Brodehl
Bettina Baeßler
Gordon Arnhold
Thomas Dratsch
Seung-Hun Chon
Peter Mildenberger
Florian Jungmann
Publication date
01-12-2019
Publisher
Springer Berlin Heidelberg
Keyword
Ankle Fracture
Published in
Insights into Imaging / Issue 1/2019
Electronic ISSN: 1869-4101
DOI
https://doi.org/10.1186/s13244-019-0777-8

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