Automated assessment of midline shift in head injury patients
Journal
Clinical Neurology and Neurosurgery
Journal Volume
112
Journal Issue
9
Pages
785-790
Date Issued
2010
Author(s)
Abstract
Objectives: Midline shift (MLS) is an important quantitative feature for evaluating severity of brain compression by various pathologies, including traumatic intracranial hematomas. In this study, we sought to determine the accuracy and the prognostic value of our computer algorithm that automatically measures the MLS of the brain on computed tomography (CT) images in patients with head injury. Patients and methods: Modelling the deformed midline into three segments, we had designed an algorithm to estimate the MLS automatically. We retrospectively applied our algorithm to the initial CT images of 53 patients with head injury to determine the automated MLS (aMLS) and validated it against that measured by human (hMLS). Both measurements were separately used to predict the neurological outcome of the patients. Results: The hMLS ranged from 0 to 30 mm. It was greater than 5 mm in images of 17 patients (32%). In 49 images (92%), the difference between hMLS and aMLS was <1 mm. To detect MLS >5 mm, our algorithm achieved sensitivity of 94% and specificity of 100%. For mortality prediction, aMLS was no worse than hMLS. Conclusion: In summary, automated MLS was accurate and predicted outcome as well as that measured manually. This approach might be useful in constructing a fully automated computer-assisted diagnosis system. ? 2010 Elsevier B.V. All rights reserved.
SDGs
Other Subjects
adolescent; adult; aged; algorithm; article; automation; child; clinical feature; comparative study; computer assisted tomography; computer program; controlled study; diagnostic accuracy; female; head injury; human; major clinical study; male; midline shift; mortality; patient assessment; prognosis; quantitative analysis; school child; sensitivity and specificity; Adolescent; Adult; Aged; Aged, 80 and over; Algorithms; Automation; Cerebral Hemorrhage; Child; Craniocerebral Trauma; Female; Glasgow Coma Scale; Glasgow Outcome Scale; Humans; Image Processing, Computer-Assisted; Male; Middle Aged; Predictive Value of Tests; Prognosis; Retrospective Studies; ROC Curve; Tomography, X-Ray Computed; Treatment Outcome; Young Adult
Type
journal article