Deep Learning–driven classification of external DICOM studies for PACS archiving

OBJECTIVES: Over the course of their treatment, patients often switch hospitals, requiring staff at the new hospital to import external imaging studies to their local database. In this study, the authors present MOdality Mapping and Orchestration (MOMO), a Deep Learning–based approach to automate this mapping process by combining metadata analysis and a neural network ensemble. METHODS: A set of 11,934 imaging series with existing anatomical labels was retrieved from the PACS database of the local hospital to train an ensemble of neural networks (DenseNet-161 and ResNet-152), which process radiological images and predict the type of study they belong to. We developed an algorithm that automatically extracts relevant metadata from imaging studies, regardless of their structure, and combines it with the neural network ensemble, forming a powerful classifier. A set of 843 anonymized external studies from 321 hospitals was hand-labeled to assess performance. We tested several variations of this algorithm. RESULTS: MOMO achieves 92.71% accuracy and 2.63% minor errors (at 99.29% predictive power) on the external study classification task, outperforming both a commercial product (82.86% accuracy, 1.36% minor errors, 96.20% predictive power) and a pure neural network ensemble (72.69% accuracy, 10.3% minor errors, 99.05% predictive power) performing the same task. We find that the highest performance is achieved by an algorithm that combines all information into one vote-based classifier. CONCLUSION: Deep Learning combined with metadata matching is a promising and flexible approach for the automated classification of external DICOM studies for PACS archiving. KEY POINTS: • The algorithm can successfully identify 76 medical study types across seven modalities (CT, X-ray angiography, radiographs, MRI, PET (+CT/MRI), ultrasound, and mammograms). • The algorithm outperforms a commercial product performing the same task by a significant margin (> 9% accuracy gain). • The performance of the algorithm increases through the application of Deep Learning techniques. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s00330-022-08926-w.