Usefulness of deep learning-assisted identification of hyperdense MCA sign in acute ischemic stroke: comparison with readers’ performance

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Abstract
Purpose To evaluate the usefulness of deep learning-assisted diagnosis for identifying hyperdense middle cerebral artery sign (HMCAS) on non-contrast computed tomography in comparison with the diagnostic performance of neuroradiologists. Materials and methods We obtained 46 HMCAS-positive and 52 HMCAS-negative test samples extracted using 50-pixel-diameter circular regions of interest. Five neuroradiologists undertook an initial diagnostic performance test by describing the HMCAS-positive prediction rate in each sample. Their diagnostic performance was compared with that of a deep convolutional neural network (DCNN) model that had been trained using another dataset in our previous study. In the second test, readers could reference the prediction rate of the DCNN model in each sample. Results The diagnostic performance of the DCNN for HMCAS showed an accuracy of 81.6% and area under the receiver-operating characteristic curve (AUC) of 0.869, whereas the initial diagnostic performance of neuroradiologists showed an accuracy of 78.8% and AUC of 0.882. The second diagnostic test of neuroradiologists with reference to the results of the DCNN model showed an accuracy of 84.7% and AUC of 0.932. In all readers, AUC values were higher in the second test than the initial test. Conclusion The ability of DCNN to identify HMCAS is comparable with the diagnostic performance of neuroradiologists.

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