Automated hematoma segmentation and outcome prediction for patients with traumatic brain injury.

Abstract

Traumatic brain injury (TBI) is a major cause of death and disability worldwide. Automated brain hematoma segmentation and outcome prediction for patients with TBI can effectively facilitate patient management. In this study, we propose a novel Multi-view convolutional neural network with a mixed loss to segment total acute hematoma on head CT scans collected within 24 h after the injury. Based on the automated segmentation, the volumetric distribution and shape characteristics of the hematoma were extracted and combined with other clinical observations to predict 6-month mortality. The proposed hematoma segmentation network achieved an average Dice coefficient of 0.697 and an intraclass correlation coefficient of 0.966 between the volumes estimated from the predicted hematoma segmentation and volumes of the annotated hematoma segmentation on the test set. Compared with other published methods, the proposed method has the most accurate segmentation performance and volume estimation. For 6-month mortality prediction, the model achieved an average area under the precision-recall curve (AUCPR) of 0.559 and area under the receiver operating characteristic curve (AUC) of 0.853 using 10-fold cross-validation on a dataset consisting of 828 patients. The average AUCPR and AUC of the proposed model are respectively more than 10% and 5% higher than those of the widely used IMPACT model.