Objective: To objectively evaluate vestibular schwannomas (VSs) and their spatial relationships with the ipsilateral inner ear (IE) in magnetic resonance imaging (MRI) using deep learning.
Study design: Cross-sectional study.
Patients: A total of 490 adults with VS, high-resolution MRI scans, and no previous neurotologic surgery.
Interventions: MRI studies of VS patients were split into training (390 patients) and test (100 patients) sets. A three-dimensional convolutional neural network model was trained to segment VS and IE structures using contrast-enhanced T1-weighted and T2-weighted sequences, respectively. Manual segmentations were used as ground truths. Model performance was evaluated on the test set and on an external set of 100 VS patients from a public data set (Vestibular-Schwannoma-SEG).
Main outcome measures: Dice score, relative volume error, average symmetric surface distance, 95th-percentile Hausdorff distance, and centroid locations.
Results: Dice scores for VS and IE volume segmentations were 0.91 and 0.90, respectively. On the public data set, the model segmented VS tumors with a Dice score of 0.89 ± 0.06 (mean ± standard deviation), relative volume error of 9.8 ± 9.6%, average symmetric surface distance of 0.31 ± 0.22 mm, and 95th-percentile Hausdorff distance of 1.26 ± 0.76 mm. Predicted VS segmentations overlapped with ground truth segmentations in all test subjects. Mean errors of predicted VS volume, VS centroid location, and IE centroid location were 0.05 cm 3 , 0.52 mm, and 0.85 mm, respectively.
Conclusions: A deep learning system can segment VS and IE structures in high-resolution MRI scans with excellent accuracy. This technology offers promise to improve the clinical workflow for assessing VS radiomics and enhance the management of VS patients.
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