Image Thresholding Improves 3-Dimensional Convolutional Neural Network Diagnosis of Different Acute Brain Hemorrhages on Computed Tomography Scans

Intracranial hemorrhage is a medical emergency that requires urgent diagnosis and immediate treatment to improve patient outcome. Machine learning algorithms can be used to perform medical image classification and assist clinicians in diagnosing radiological scans. In this paper, we apply 3-dimensional convolutional neural networks (3D CNN) to classify computed tomography (CT) brain scans into normal scans (N) and abnormal scans containing subarachnoid hemorrhage (SAH), intraparenchymal hemorrhage (IPH), acute subdural hemorrhage (ASDH) and brain polytrauma hemorrhage (BPH). The dataset used consists of 399 volumetric CT brain images representing approximately 12,000 images from the National Neuroscience Institute, Singapore. We used a 3D CNN to perform both 2-class (normal versus a specific abnormal class) and 4-class classification (between normal, SAH, IPH, ASDH). We apply image thresholding at the image pre-processing step, that improves 3D CNN classification accuracy and performance by accentuating the pixel intensities that contribute most to feature discrimination. For 2-class classification, the F1 scores for various pairs of medical diagnoses ranged from 0.706 to 0.902 without thresholding. With thresholding implemented, the F1 scores improved and ranged from 0.919 to 0.952. Our results are comparable to, and in some cases, exceed the results published in other work applying 3D CNN to CT or magnetic resonance imaging (MRI) brain scan classification. This work represents a direct application of a 3D CNN to a real hospital scenario involving a medically emergent CT brain diagnosis.