Automated Detection of Endoleaks in CT Angiography Using a Single Deep Learning Model.

Abstract

Aim: Detecting endoleaks on post-EVAR CT scans, especially in the presence of artifacts caused by embolic agents like Onyx, is a challenging but critical task. In this study, we propose a deep learning-based method for endoleak detection using a single object detection model.

Materials and methods: A retrospective dataset comprising 249 CT scans was used, divided into training (129 scans) and test (120 scans) datasets. Ground truth annotations were obtained through 3D manual segmentation, and a preprocessing pipeline was applied. The model was trained on slices extracted from the training dataset and validated using standard metrics, including sensitivity, specificity, and AUC.

Results: The model achieved high performance at both the per-slice and per-series levels. Per-slice detection yielded a ROC AUC of 96%, with a sensitivity of 91%, specificity of 93%, PPV of 55%, and NPV of 99%. At the per-series level, sensitivity and specificity were 93% and 95%, respectively. Notably, our method introduces a per-slice detection metric, which was not reported in previous studies, and uses a single model, making it computationally efficient and easy to train.

Conclusion: This study demonstrates the feasibility of using deep learning for endoleak detection, offering a robust and efficient tool for clinical practice. Future work could focus on expanding the dataset and integrating additional predictive capabilities, such as endoleak classification and localization.