Evidence map›Paper›PMID 40183966›Full record

ArticleNeuroradiology2025

Towards clinical implementation of automated segmentation of vestibular schwannomas: a reliability study comparing AI and human performance.

Stefan Cornelissen, Sammy M Schouten, Patrick P J H Langenhuizen, Henricus P M Kunst, Jeroen B Verheul, Peter H N De With

Abstract readComparative Study
In one paragraph

Article in Neuroradiology, 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
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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.

Stefan CornelissenGamma Knife Center, Department of Neurosurgery, Elisabeth-TweeSteden Hospital, Tilburg, Netherlands. stefan.cornelissen@etz.nl.
Sammy M SchoutenGamma Knife Center, Department of Neurosurgery, Elisabeth-TweeSteden Hospital, Tilburg, Netherlands.
Patrick P J H LangenhuizenGamma Knife Center, Department of Neurosurgery, Elisabeth-TweeSteden Hospital, Tilburg, Netherlands.
Henricus P M KunstDepartment of Otolaryngology, Radboud University Medical Center, Nijmegen, Netherlands.
Jeroen B VerheulGamma Knife Center, Department of Neurosurgery, Elisabeth-TweeSteden Hospital, Tilburg, Netherlands.
Peter H N De WithDepartment of Electrical Engineering, Eindhoven University of Technology, Eindhoven, Netherlands.

Funding

ZonMw 10070012010006
6 · The paper itself

Abstract

purposeTo evaluate the clinimetric reliability of automated vestibular schwannoma (VS) segmentations by a comparison with human inter-observer variability on T1-weighted contrast-enhanced MRI scans.

methodsThis retrospective study employed MR images, including follow-up, from 1,015 patients (median age: 59, 511 men), resulting in 1,856 unique scans. Two nnU-Net models were trained using fivefold cross-validation to create a single-center segmentation model, along with a multi-center model using additional publicly available data. Geometric-based segmentation metrics (e.g. the Dice score) were used to evaluate model performance. To quantitatively assess the clinimetric reliability of the models, automated tumor volumes from a separate test set were compared to human inter-observer variability using the limits of agreement with the mean (LOAM) procedure. Additionally, new agreement limits that include automated annotations are calculated.

resultsBoth models performed comparable to current state-of-the-art VS segmentation models, with median Dice scores of 91.6% and 91.9% for the single and multi-center models, respectively. There is a stark difference in clinimetric performance between both models: automated tumor volumes of the multi-center model fell within human agreement limits in 73% of the cases, compared to 44% for the single-center model. Newly calculated agreement limits including the single-center model, resulted in very high and wide limits. For the multi-center model, the new agreement limits were comparable to human inter-observer variability.

conclusionModels with excellent geometric-based metrics do not necessarily imply high clinimetric reliability, demonstrating the need to clinimetrically evaluate models as part of the clinical implementation process. The multi-center model displayed high reliability, warranting its possible future use in clinical practice. However, caution should be exercised when employing the model for small tumors, as the reliability was found to be volume-dependent.

Indexed as

Artificial IntelligenceImage Interpretation, Computer-AssistedMagnetic Resonance ImagingNeuroma, AcousticAdultAgedContrast MediaFemaleHumansMaleMiddle AgedObserver VariationReproducibility of ResultsRetrospective StudiesTumor BurdenContrast MediaAutomatic segmentationClinimetric reliabilityInter-observer variabilityMRIVestibular schwannoma

Identifiers

PMID40183966
PMCPMC12040986

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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.