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AJNR Awards, New Junior Editors, and more. Read the latest AJNR updates

Research ArticleArtificial Intelligence

Identifying Patients with CSF-Venous Fistula Using Brain MRI: A Deep Learning Approach

Shahriar Faghani, Mana Moassefi, Ajay A. Madhavan, Ian T. Mark, Jared T. Verdoorn, Bradley J. Erickson and John C. Benson
American Journal of Neuroradiology April 2024, 45 (4) 439-443; DOI: https://doi.org/10.3174/ajnr.A8173
Shahriar Faghani
aFrom the Radiology Informatics Lab, Department of Radiology, Mayo Clinic, Rochester, Minnesota
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Mana Moassefi
aFrom the Radiology Informatics Lab, Department of Radiology, Mayo Clinic, Rochester, Minnesota
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Ajay A. Madhavan
bDepartment of Radiology, Mayo Clinic, Rochester, Minnesota.
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Ian T. Mark
bDepartment of Radiology, Mayo Clinic, Rochester, Minnesota.
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Jared T. Verdoorn
bDepartment of Radiology, Mayo Clinic, Rochester, Minnesota.
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Bradley J. Erickson
aFrom the Radiology Informatics Lab, Department of Radiology, Mayo Clinic, Rochester, Minnesota
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John C. Benson
bDepartment of Radiology, Mayo Clinic, Rochester, Minnesota.
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  • FIG 1.
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    FIG 1.

    Schematic illustration of the preprocessing, data augmentation, and model training pipeline. A, 3D contrast-enhanced T1 input volume. B, Preprocessed and augmented CET1 to mitigate overfitting. C, 3D-DenseNet model. D, Prediction of absence or presence of CSF leak.

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    FIG 2.

    Receiver operating characteristic (ROC) curves for 5-fold cross-validation. Each curve represents the performance of the model on a distinct validation fold. The curves demonstrate the model’s ability to distinguish between the absence and presence of CSF leaks from brain MR imaging scans.

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    FIG 3.

    Three-part representation of the regions that are crucial to the model’s decision-making process in detecting CSF leaks. A, Sagittal view of contrast-enhanced T1 brain MR imaging. B, Occlusion mask overlaid on the original contrast-enhanced T1 image, highlighting the regions that significantly influence the model’s predictions. C, Occlusion mask generated to identify regions of interest.

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    Table 1:

    Participant characteristics and Bern score status

    Subject CharacteristicsAll Subjects (n = 129)
    Median age in years (interquartile range)54 (20)
    Age range in years23–87
    Female84 (65.12%)
    Male45 (34.48%)
    Bern score
     Low risk (Bern score 0–2)47 (36.43%)
     Intermediate risk (Bern score 3–4)26 (20.15%)
     High risk (Bern score >4)56 (43.42%)
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    Table 2:

    Summary of classifier performance per validation fold

    Fold NumberAUROC
    10.8988
    20.8284
    30.8580
    40.8580
    50.8910
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American Journal of Neuroradiology: 45 (4)
American Journal of Neuroradiology
Vol. 45, Issue 4
1 Apr 2024
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Cite this article
Shahriar Faghani, Mana Moassefi, Ajay A. Madhavan, Ian T. Mark, Jared T. Verdoorn, Bradley J. Erickson, John C. Benson
Identifying Patients with CSF-Venous Fistula Using Brain MRI: A Deep Learning Approach
American Journal of Neuroradiology Apr 2024, 45 (4) 439-443; DOI: 10.3174/ajnr.A8173

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CSF-Venous Fistula Detection with Deep Learning
Shahriar Faghani, Mana Moassefi, Ajay A. Madhavan, Ian T. Mark, Jared T. Verdoorn, Bradley J. Erickson, John C. Benson
American Journal of Neuroradiology Apr 2024, 45 (4) 439-443; DOI: 10.3174/ajnr.A8173
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This article has been cited by the following articles in journals that are participating in Crossref Cited-by Linking.

  • Spinal CSF Leaks: The Neuroradiologist Transforming Care
    Mark D. Mamlouk, Andrew L. Callen, Ajay A. Madhavan, Niklas Lützen, Lalani Carlton Jones, Ian T. Mark, Waleed Brinjikji, John C. Benson, Jared T. Verdoorn, D.K. Kim, Timothy J. Amrhein, Linda Gray, William P. Dillon, Marcel M. Maya, Thien J. Huynh, Vinil N. Shah, Tomas Dobrocky, Eike I. Piechowiak, Joseph Levi Chazen, Michael D. Malinzak, Jessica L. Houk, Peter G. Kranz
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