Abstract

The spleen is one of the most frequently injured organs in blunt abdominal trauma. Computed tomography (CT) is the imaging modality of choice to assess patients with blunt spleen trauma, which may include lacerations, subcapsular or parenchymal hematomas, active hemorrhage, and vascular injuries. While computer-assisted diagnosis systems exist for other conditions assessed using CT scans, the current method to detect spleen injuries involves the manual review of scans by radiologists, which is a time-consuming and repetitive process. In this study, we propose an automated spleen injury detection method using machine learning. CT scans from patients experiencing traumatic injuries were collected from Michigan Medicine and the Crash Injury Research Engineering Network (CIREN) dataset. Ninety-nine scans of healthy and lacerated spleens were split into disjoint training and test sets, with random forest (RF), naive Bayes, SVM, k-nearest neighbors (k-NN) ensemble, and subspace discriminant ensemble models trained via 5-fold cross validation. Of these models, random forest performed the best, achieving an Area Under the receiver operating characteristic Curve (AUC) of 0.91 and an F1 score of 0.80 on the test set. These results suggest that an automated, quantitative assessment of traumatic spleen injury has the potential to enable faster triage and improve patient outcomes.

Highlights

  • Accepted: 22 March 2021Blunt spleen injuries account for up to half of all abdominal solid organ injuries.Common causes include road traffic accidents, falls, physical assaults, and sports-related injuries

  • The type and severity of spleen injuries are commonly described based on the Abbreviated Injury Scale (AIS) or the American Association for Trauma (AAST) Organ

  • computed tomography (CT) scans used in this study were obtained from Michigan Medicine patients who experienced traumatic abdominopelvic injuries under an IRB-approved retrospective study

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Summary

Introduction

Accepted: 22 March 2021Blunt spleen injuries account for up to half of all abdominal solid organ injuries.Common causes include road traffic accidents, falls, physical assaults, and sports-related injuries. Blunt spleen injuries account for up to half of all abdominal solid organ injuries. Multiphasic contrast-enhanced computed tomography (CT) is the standard noninvasive diagnostic tool for injury evaluation of blunt spleen injuries [1], which include lacerations, subcapsular or parenchymal hematomas, active hemorrhage, and vascular injuries. The type and severity of spleen injuries are commonly described based on the Abbreviated Injury Scale (AIS) or the American Association for Trauma (AAST) Organ. Detection and classification of spleen injuries rely on the manual review of radiologists. This manual process is inefficient and subject to variability based on the reviewer [1,2]

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