Construction and evaluation of a gated high-resolution neural network for automatic brain metastasis detection and segmentation

Objectives To construct and evaluate a gated high-resolution convolutional neural network for detecting and segmenting brain metastasis (BM). Methods This retrospective study included craniocerebral MRI scans of 1392 patients with 14,542 BMs and 200 patients with no BM between January 2012 and April 2022. A primary dataset including 1000 cases with 11,686 BMs was employed to construct the model, while an independent dataset including 100 cases with 1069 BMs from other hospitals was used to examine the generalizability. The potential of the model for clinical use was also evaluated by comparing its performance in BM detection and segmentation to that of radiologists, and comparing radiologists’ lesion detecting performances with and without model assistance. Results Our model yielded a recall of 0.88, a dice similarity coefficient (DSC) of 0.90, a positive predictive value (PPV) of 0.93 and a false positives per patient (FP) of 1.01 in the test set, and a recall of 0.85, a DSC of 0.89, a PPV of 0.93, and a FP of 1.07 in dataset from other hospitals. With the model’s assistance, the BM detection rates of 4 radiologists improved significantly, ranging from 5.2 to 15.1% (all p < 0.001), and also for detecting small BMs with diameter ≤ 5 mm (ranging from 7.2 to 27.0%, all p < 0.001). Conclusions The proposed model enables accurate BM detection and segmentation with higher sensitivity and less time consumption, showing the potential to augment radiologists’ performance in detecting BM. Clinical relevance statement This study offers a promising computer-aided tool to assist the brain metastasis detection and segmentation in routine clinical practice for cancer patients. Key Points • The GHR-CNN could accurately detect and segment BM on contrast-enhanced 3D-T1W images. • The GHR-CNN improved the BM detection rate of radiologists, including the detection of small lesions. • The GHR-CNN enabled automated segmentation of BM in a very short time.