Evidence map›Paper›PMID 39521273›Full record

ArticleJournal of neuroradiology = Journal de neuroradiologie2025

Deep learning segmentation-based bone removal from computed tomography of the brain improves subdural hematoma detection.

Masis Isikbay, M Travis Caton, Jared Narvid, Jason Talbott, Soonmee Cha, Evan Calabrese

Abstract read
In one paragraph

Article in Journal of neuroradiology = Journal de neuroradiologie, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Article
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Masis IsikbayDepartment of Radiology and Biomedical Imaging, University of California San Francisco, 505 Parnassus Ave, M-396, San Francisco, CA 94143, USA. Electronic address: masis.isikbay@ucsf.edu.
M Travis CatonCerebrovascular Center, Department of Neurosurgery, Icahn School of Medicine at Mount Sinai, 1450 Madison Ave, New York, NY 10029, USA.
Jared NarvidDepartment of Radiology and Biomedical Imaging, University of California San Francisco, 505 Parnassus Ave, M-396, San Francisco, CA 94143, USA; Department of Radiology, Zuckerberg San Francisco General Hospital and Trauma Center, University of California, San Francisco 94110, USA.
Jason TalbottDepartment of Radiology and Biomedical Imaging, University of California San Francisco, 505 Parnassus Ave, M-396, San Francisco, CA 94143, USA; Department of Radiology, Zuckerberg San Francisco General Hospital and Trauma Center, University of California, San Francisco 94110, USA.
Soonmee ChaDepartment of Radiology and Biomedical Imaging, University of California San Francisco, 505 Parnassus Ave, M-396, San Francisco, CA 94143, USA.
Evan CalabreseDepartment of Radiology and Biomedical Imaging, University of California San Francisco, 505 Parnassus Ave, M-396, San Francisco, CA 94143, USA; Department of Radiology, Division of Neuroradiology, Duke University Medical Center, Box 3808 DUMC Durham, NC 27710, USA; Duke Center for Artificial Intelligence in Radiology (DAIR), Duke University Medical Center, Durham, NC 27710, USA; Center for Intelligent Imaging (Ci2), University of California San Francisco, San Francisco, CA 94143, USA.

Funding

Biomedical Imaging for Clinician ScientistsT32EB001631 · NIBIB · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI THOMAS M LINK · 2005 to 2026
$5.6M
NIBIB NIH HHS T32 EB001631
6 · The paper itself

Abstract

purposeTimely identification of intracranial blood products is clinically impactful, however the detection of subdural hematoma (SDH) on non-contrast CT scans of the head (NCCTH) is challenging given interference from the adjacent calvarium. This work explores the utility of a NCCTH bone removal algorithm for improving SDH detection.

methodsA deep learning segmentation algorithm was designed/trained for bone removal using 100 NCCTH. Segmentation accuracy was evaluated on 15 NCCTH from the same institution and 22 NCCTH from an independent external dataset using quantitative overlap analysis between automated and expert manual segmentations. The impact of bone removal on detecting SDH by junior radiology trainees was evaluated with a reader study comparing detection performance between matched cases with and without bone removal applied.

resultsAverage Dice overlap between automated and manual segmentations from the internal and external test datasets were 0.9999 and 0.9957, which was superior to other publicly available methods. Among trainee readers, SDH detection was statistically improved using NCCTH with and without bone removal applied compared to standard NCCTH alone (P value <0.001). Additionally, 12/14 (86 %) of participating trainees self-reported improved detection of extra axial blood products with bone removal, and 13/14 (93 %) indicated that they would like to have access to NCCTH bone removal in the on-call setting.

conclusionDeep learning segmentation-based NCCTH bone removal is rapid, accurate, and improves detection of SDH among trainee radiologists when used in combination with standard NCCTH. This study highlights the potential of bone removal for improving confidence and accuracy of SDH detection.

Indexed as

Deep LearningHematoma, SubduralTomography, X-Ray ComputedAlgorithmsFemaleHumansMaleRadiographic Image Interpretation, Computer-AssistedSkullArtificial intelligenceBrainDeep learningMachine learningNeurovascularNon-Contrast CT

Identifiers

PMID39521273
PMCPMC11771325

What OpenQuestion holds

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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.