Abstract WMP60: Eliminating False Positive Detections Of Intracranial Hemorrhage (ICH) Using RAPID ICH 3

Abstract

Introduction: Prompt detection of intracranial hemorrhage (ICH) on a non-contrast head CT (NCCT) is critical to initial patient triage. Several ICH detection and notification programs now exist, but none presently generate locations or segmentations of suspected ICH, and false-positive notifications are not easily identified. We investigated an enhanced ICH detection tool with heightened immunity to false-positive diagnosis. Methods: NCCT scans from 3 large databases were evaluated for the presence of an ICH (IPH, IVH, SAH or SDH) of >0.4 ml by the automated RAPID ICH 3.0 software module and compared to a consensus detection from 3 neuroradiology experts. Scans were excluded for (1) severe CT acquisition artifacts, (2) prior neurosurgical procedures or (3) intravenous contrast administration. ICH detection accuracy, sensitivity, specificity, positive predictive value, negative predictive value, and positive and negative likelihood ratios by RAPID ICH 3 were determined. Results: A total of 790 studies were included. RAPID ICH 3.0 correctly identified 399/411 ICH-positive cases and 378/379 ICH-negative cases, resulting in a sensitivity of 98.08% and specificity 99.74%, positive predictive value 99.75%, and negative predictive value 96.92% for ICH detection. The positive and negative likelihood ratios for ICH detection were similarly favorable at 367.93 and 0.03 respectively. Mean processing time was <40 seconds. Conclusions: In this large data set of nearly 800 patients, the RAPID ICH 3.0 automated software maintained a high sensitivity for detection of ICH, while essentially eliminating false positive identifications, leading to very high positive predictive value.