A Convolutional Neural Network Model for Distinguishing Hemangioblastomas From Other Cerebellar-and-Brainstem Tumors Using Contrast-Enhanced MRI

Background Hemangioblastoma (HB) is a highly vascularized tumor most commonly occurring in the posterior cranial fossa, requiring accurate preoperative diagnosis to avoid accidental intraoperative hemorrhage and even death.Purpose To accurately distinguish HBs from other cerebellar-and-brainstem tumors using a convolutional neural network model based on a contrast-enhanced brain MRI dataset.Study Type Retrospective.Population Four hundred five patients (182 = HBs; 223 = other cerebellar-and brainstem tumors): 305 cases for model training, and 100 for evaluation.Field Strength/Sequence 3 T/contrast-enhanced T1-weighted imaging (T1WI + C).Assessment A CNN-based 2D classification network was trained by using sliced data along the z-axis. To improve the performance of the network, we introduced demographic information, various data-augmentation methods and an auxiliary task to segment tumor region. Then, this method was compared with the evaluations performed by experienced and intermediate-level neuroradiologists, and the heatmap of deep feature, which indicates the contribution of each pixel to model prediction, was visualized by Grad-CAM for analyzing the misclassified cases.Statistical Tests The Pearson chi-square test and an independent t-test were used to test for distribution difference in age and sex. And the independent t-test was exploited to evaluate the performance between experts and our proposed method. P value <0.05 was considered significant.Results The trained network showed a higher accuracy for identifying HBs (accuracy = 0.902 +/- 0.031, F1 = 0.891 +/- 0.035, AUC = 0.926 +/- 0.040) than experienced (accuracy = 0.887 +/- 0.013, F1 = 0.868 +/- 0.011, AUC = 0.881 +/- 0.008) and intermediate-level (accuracy = 0.827 +/- 0.037, F1 = 0.768 +/- 0.068, AUC = 0.810 +/- 0.047) neuroradiologists. The recall values were 0.910 +/- 0.050, 0.659 +/- 0.084, and 0.828 +/- 0.019 for the trained network, intermediate and experienced neuroradiologists, respectively. Additional ablation experiments verified the utility of the introduced demographic information, data augmentation, and the auxiliary-segmentation task.Data Conclusion Our proposed method can successfully distinguish HBs from other cerebellar-and-brainstem tumors and showed diagnostic efficiency comparable to that of experienced neuroradiologists.Evidence Level 3Technical Efficacy Stage 2