Introduction: For reliability and ease of use for ICH scoring, we developed a platform, DeepCT, that can quickly and accurately calculate ICH volume, and localize the hematoma from brain CT. This study aim to test the accuracy and practicality of the ICH score by using DeetCT platform.
Methods: We retrospectively included 165 consecutive patients with primary spontaneous intracranial hemorrhage in Keelung CGMH from January 2019 to May 2022. Patient’s characteristics, including of age, initial Glasgow coma scale (GCS) at ER, use of anticoagulant, treatment course (surgery/ medical), and prognosis (mRS, 30-days GOS) were recorded. All non-contrast day one CT scans were analyzed independently by our automatic platform DeepCT, and two neurosurgeons. Patients with different types of ICH were not excluded. For the automatic platform DeepCT, the ICH volume and hematoma location were done using U-Net‘s computational process after segmenting the lesion and brain region. The manually calculated ICH score was done by two independent neurosurgeons blinded to the results of automatic DeepCT calculation. A secondary reviewed by senior neurosurgeon of the CT scan was done if any discrepancy between DeepCT and manual calculation. Overall accuracy, sensitivity, specificity, positive predict value, negative predict value were analysed.
Results: There were 141 patients with pure ICH among 165 patients. The overall accuracy for detection of ICH volume ≥ 30ml, intraventricular hemorrhage, and infratentorial location were 94.3%, 93.1% and 100% in all spontaneous ICH groups. The accuracy increased to 96.5%, 94.3% and 100% in newly onset primary ICH groups. In addition, the ICH volume of 1 cases, IVH of 5 cases and infratentorial location of 1 case were rescored by using this DeepCT automatic software. ICH score calculated by both neurosurgeons and DeepCT were highly correlate to the 30-day GOS (p < 0.001, r = -0.604 and -0.626) and GCS at day 7 (p < 0.001, r = -0.693 and -0.643).
Conclusion : Our study showed the ICH score can be accurately calculated and provide a highly clinical correlation.
