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      Deep-learning model for diagnostic clue: detecting the dural tail sign for meningiomas on contrast-enhanced T1 weighted images

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          Abstract

          Background

          Meningiomas are the most common primary central nervous system tumors, and magnetic resonance imaging (MRI), especially contrast-enhanced T1 weighted image (CE T1WI), is used as a fundamental imaging modality for the detection and analysis of the tumors. In this study, we propose an automated deep-learning model for meningioma detection using the dural tail sign.

          Methods

          The dataset included 123 patients with 3,824 dural tail signs on sagittal CE T1WI. The dataset was divided into training and test datasets based on specific time point, and 78 and 45 patients were comprised for the training and test dataset, respectively. To compensate for the small sample size of the training dataset, 39 additional patients with 69 dural tail signs from the open dataset were appended to the training dataset. A You Only Look Once (YOLO) v4 network was trained with sagittal CE T1WI to detect dural tail signs. The normal group dataset, comprised of 51 patients with no abnormal finding on MRI, was employed to evaluate the specificity of the trained model.

          Results

          The sensitivity and false positive average were 82.22% and 29.73, respectively, in the test dataset. The specificity and false positive average were 17.65% and 3.16, respectively, in the normal dataset. Most of the false-positive cases in the test dataset were enhancing vessels, misinterpreted as dural thickening.

          Conclusions

          The proposed model demonstrates an automated detection system for the dural tail sign to identify meningioma in general screening MRI. Our model can facilitate and alleviate radiologists’ reading process by notifying the possibility of incidental dural mass based on dural tail sign detection.

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          Most cited references38

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          The Cancer Imaging Archive (TCIA): maintaining and operating a public information repository.

          The National Institutes of Health have placed significant emphasis on sharing of research data to support secondary research. Investigators have been encouraged to publish their clinical and imaging data as part of fulfilling their grant obligations. Realizing it was not sufficient to merely ask investigators to publish their collection of imaging and clinical data, the National Cancer Institute (NCI) created the open source National Biomedical Image Archive software package as a mechanism for centralized hosting of cancer related imaging. NCI has contracted with Washington University in Saint Louis to create The Cancer Imaging Archive (TCIA)-an open-source, open-access information resource to support research, development, and educational initiatives utilizing advanced medical imaging of cancer. In its first year of operation, TCIA accumulated 23 collections (3.3 million images). Operating and maintaining a high-availability image archive is a complex challenge involving varied archive-specific resources and driven by the needs of both image submitters and image consumers. Quality archives of any type (traditional library, PubMed, refereed journals) require management and customer service. This paper describes the management tasks and user support model for TCIA.
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            CBTRUS Statistical Report: Primary Brain and Other Central Nervous System Tumors Diagnosed in the United States in 2014–2018

            The Central Brain Tumor Registry of the United States (CBTRUS), in collaboration with the Centers for Disease Control and Prevention (CDC) and National Cancer Institute (NCI), is the largest population-based cancer registry focused exclusively on primary brain and other central nervous system (CNS) tumors in the United States (US) and represents the entire US population. This report contains the most up-to-date population-based data on primary brain tumors available and supersedes all previous reports in terms of completeness and accuracy and is the first CBTRUS Report to provide the distribution of molecular markers for selected brain and CNS tumor histologies. All rates are age-adjusted using the 2000 US standard population and presented per 100,000 population. The average annual age-adjusted incidence rate (AAAIR) of all malignant and non-malignant brain and other CNS tumors was 24.25 (Malignant AAAIR=7.06, Non-malignant AAAIR=17.18). This overall rate was higher in females compared to males (26.95 versus 21.35) and non-Hispanics compared to Hispanics (24.68 versus 22.12). The most commonly occurring malignant brain and other CNS tumor was glioblastoma (14.3% of all tumors and 49.1% of malignant tumors), and the most common non-malignant tumor was meningioma (39.0% of all tumors and 54.5% of non-malignant tumors). Glioblastoma was more common in males, and meningioma was more common in females. In children and adolescents (age 0–19 years), the incidence rate of all primary brain and other CNS tumors was 6.21. An estimated 88,190 new cases of malignant and non-malignant brain and other CNS tumors are expected to be diagnosed in the US population in 2021 (25,690 malignant and 62,500 non-malignant). There were 83,029 deaths attributed to malignant brain and other CNS tumors between 2014 and 2018. This represents an average annual mortality rate of 4.43 per 100,000 and an average of 16,606 deaths per year. The five-year relative survival rate following diagnosis of a malignant brain and other CNS tumor was 35.6%, for a non-malignant brain and other CNS tumors the five-year relative survival rate was 91.8%.
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              Current Applications and Future Impact of Machine Learning in Radiology.

              Recent advances and future perspectives of machine learning techniques offer promising applications in medical imaging. Machine learning has the potential to improve different steps of the radiology workflow including order scheduling and triage, clinical decision support systems, detection and interpretation of findings, postprocessing and dose estimation, examination quality control, and radiology reporting. In this article, the authors review examples of current applications of machine learning and artificial intelligence techniques in diagnostic radiology. In addition, the future impact and natural extension of these techniques in radiology practice are discussed.
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                Author and article information

                Journal
                Quant Imaging Med Surg
                Quant Imaging Med Surg
                QIMS
                Quantitative Imaging in Medicine and Surgery
                AME Publishing Company
                2223-4292
                2223-4306
                03 November 2023
                01 December 2023
                : 13
                : 12
                : 8132-8143
                Affiliations
                [1]deptDepartment of Radiology, Kyung Hee University Hospital , Kyung Hee University College of Medicine , Seoul, Republic of Korea
                Author notes

                Contributions: (I) Conception and design: KM Lee, H Kim; (II) Administrative support: KM Lee, HG Kim; (III) Provision of study materials or patients: HG Kim, KM Lee; (IV) Collection and assembly of data: HG Kim, JH Oh; (V) Data analysis and interpretation: H Kim, JH Oh; (VI) Manuscript writing: All authors; (VII) Final approval of manuscript: All authors.

                [#]

                These authors contributed equally to this work.

                Correspondence to: Kyung Mi Lee, MD, PhD; Jang-Hoon Oh, PhD. Department of Radiology, Kyung Hee University Hospital, Kyung Hee University College of Medicine, #23 Kyungheedae-ro, Dongdaemun-gu, Seoul 02447, Republic of Korea. Email: bandilee@ 123456khu.ac.kr ; roineri5@ 123456gmail.com .
                Article
                qims-13-12-8132
                10.21037/qims-23-114
                10722041
                38106283
                2fdd9f1f-98ad-468b-b70a-c298e8fe5dfd
                2023 Quantitative Imaging in Medicine and Surgery. All rights reserved.

                Open Access Statement: This is an Open Access article distributed in accordance with the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License (CC BY-NC-ND 4.0), which permits the non-commercial replication and distribution of the article with the strict proviso that no changes or edits are made and the original work is properly cited (including links to both the formal publication through the relevant DOI and the license). See: https://creativecommons.org/licenses/by-nc-nd/4.0.

                History
                : 30 January 2023
                : 06 September 2023
                Funding
                Funded by: the National Research Foundation of Korea (NRF) grant funded by the Government of South Korea (Ministry of Science and ICT, MSIT)
                Award ID: NRF-2020R1C1C1006623
                Award ID: NRF-2021R1F1A1050515
                Categories
                Original Article

                meningioma,dural tail sign,magnetic resonance imaging (mri),convolutional neural networks (cnns),deep learning

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