Deep Learning-based Assessment of Oncologic Outcomes from Natural Language Processing of Structured Radiology Reports.

Purpose: To train a deep natural language processing (NLP) model, using data mined structured oncology reports (SOR), for rapid tumor response category (TRC) classification from free-text oncology reports (FTOR) and to compare its performance with human readers and conventional NLP algorithms. Materials and Methods: In this retrospective study, databases of three independent radiology departments were queried for SOR and FTOR dated from March 2018 to August 2021. An automated data mining and curation pipeline was developed to extract Response Evaluation Criteria in Solid Tumors-related TRCs for SOR for ground truth definition. The deep NLP bidirectional encoder representations from transformers (BERT) model and three feature-rich algorithms were trained on SOR to predict TRCs in FTOR. Models' F1 scores were compared against scores of radiologists, medical students, and radiology technologist students. Lexical and semantic analyses were conducted to investigate human and model performance on FTOR. Results: Oncologic findings and TRCs were accurately mined from 9653 of 12 833 (75.2%) queried SOR, yielding oncology reports from 10 455 patients (mean age, 60 years ± 14 [SD]; 5303 women) who met inclusion criteria. On 802 FTOR in the test set, BERT achieved better TRC classification results (F1, 0.70; 95% CI: 0.68, 0.73) than the best-performing reference linear support vector classifier (F1, 0.63; 95% CI: 0.61, 0.66) and technologist students (F1, 0.65; 95% CI: 0.63, 0.67), had similar performance to medical students (F1, 0.73; 95% CI: 0.72, 0.75), but was inferior to radiologists (F1, 0.79; 95% CI: 0.78, 0.81). Lexical complexity and semantic ambiguities in FTOR influenced human and model performance, revealing maximum F1 score drops of -0.17 and -0.19, respectively. Conclusion: The developed deep NLP model reached the performance level of medical students but not radiologists in curating oncologic outcomes from radiology FTOR.Keywords: Neural Networks, Computer Applications-Detection/Diagnosis, Oncology, Research Design, Staging, Tumor Response, Comparative Studies, Decision Analysis, Experimental Investigations, Observer Performance, Outcomes Analysis Supplemental material is available for this article. © RSNA, 2022.

MOOD 2020: A Public Benchmark for Out-of-Distribution Detection and Localization on Medical Images.

Detecting Out-of-Distribution (OoD) data is one of the greatest challenges in safe and robust deployment of machine learning algorithms in medicine. When the algorithms encounter cases that deviate from the distribution of the training data, they often produce incorrect and over-confident predictions. OoD detection algorithms aim to catch erroneous predictions in advance by analysing the data distribution and detecting potential instances of failure. Moreover, flagging OoD cases may support human readers in identifying incidental findings. Due to the increased interest in OoD algorithms, benchmarks for different domains have recently been established. In the medical imaging domain, for which reliable predictions are often essential, an open benchmark has been missing. We introduce the Medical-Out-Of-Distribution-Analysis-Challenge (MOOD) as an open, fair, and unbiased benchmark for OoD methods in the medical imaging domain. The analysis of the submitted algorithms shows that performance has a strong positive correlation with the perceived difficulty, and that all algorithms show a high variance for different anomalies, making it yet hard to recommend them for clinical practice. We also see a strong correlation between challenge ranking and performance on a simple toy test set, indicating that this might be a valuable addition as a proxy dataset during anomaly detection algorithm development.

Arthroscopic mobilization of the hip joint in children with aseptic necrosis of the femur head.

The purpose of the study was to evaluate the ability of arthroscopic mobilization of the hip to improve restricted range of motion after failed conservative therapy (level IV) of patient with aseptic necrosis of the femoral head. We examined 11 patients (eight male, three female). The average age at follow-up was 13 years (8-17 years). All 11 patients suffered from idiopathic femur head necrosis (M. Perthes). A minimum 1-year follow-up revealed an average increase of hip motion of 20 degrees of flexion, 15 degrees of abduction (P=0.007), 30 degrees of adduction (P=0.03), 15 degrees of external rotation, and 20 degrees of internal rotation. Arthroscopic hydraulic hip distension with postoperative physiotherapy in a brace under epidural anesthesia of the hip joint leads to an increased range of motion of the affected hip and allows additional intraarticular assessment of the joint. Whether the arthroscopic findings will alter the treatment and prognosis of future patients has to be established with further studies.