A quantitative analysis of the improvement provided by comprehensive annotation on CT lesion detection using deep learning.

Abstract

Data collected from hospitals are usually partially annotated by radiologists due to time constraints. Developing and evaluating deep learning models on these data may result in over or underestimation PURPOSE: We aimed to quantitatively investigate how the percentage of annotated lesions in CT images will influence the performance of universal lesion detection (ULD)algorithms. We trained a multi-view feature pyramid network with position-aware attention (MVP-Net) to perform ULD. Three versions of the DeepLesion dataset were created for training MVP-Net. Original DeepLesion Dataset (OriginalDL) is the publicly available, widely studied DeepLesion dataset that includes 32735 lesions in 4427 patients which were partially labeled during routine clinical practice. Enriched DeepLesion Dataset (EnrichedDL) is an enhanced dataset that features fully labeled at one or more time points for 4145 patients with 34317 lesions. UnionDL is the union of the OriginalDL and EnrichedDL with 54510 labeled lesions in 4427 patients. Each dataset was used separately to train MVP-Net, resulting in the following models: OriginalCNN (replicating the original result), EnrichedCNN (testing the effect of increased annotation), and UnionCNN (featuring the greatest number of annotations). Although the reported mean sensitivity of OriginalCNN was 84.3% using the OriginalDL testing set, the performance fell sharply when tested on the EnrichedDL testing set, yielding mean sensitivities of 56.1%, 66.0%, and 67.8% for OriginalCNN, EnrichedCNN, and UnionCNN, respectively. We also found that increasing the percentage of annotated lesions in the training set increased sensitivity, but the margin of increase in performance gradually diminished according to the powerlaw. We expanded and improved the existing DeepLesion dataset by annotating additional 21775 lesions, and we demonstrated that using fully labeled CT images avoided overestimation of MVP-Net's performance while increasing the algorithm's sensitivity, which may have a huge impact to the future CT lesion detection research. The annotated lesions are at https://github.com/ComputationalImageAnalysisLab/DeepLesionData.