Attention based CNN-LSTM Network for Pulmonary Embolism Prediction on Chest Computed Tomography Pulmonary Angiograms

Abstract: With more than 60,000 deaths annually in the United States, Pulmonary Embolism (PE) is among the most fatal cardiovascular diseases. It is caused by an artery blockage in the lung; confirming its presence is time-consuming and is prone to over-diagnosis. The utilization of automated PE detection systems is critical for diagnostic accuracy and efficiency. In this study we propose a two-stage attention-based CNN-LSTM network for predicting PE, its associated type (chronic, acute) and corresponding location (leftsided, rightsided or central) on computed tomography (CT) examinations. We trained our model on the largest available public Computed Tomography Pulmonary Angiogram PE dataset (RSNA-STR Pulmonary Embolism CT (RSPECT) Dataset, N=7279 CT studies) and tested it on an in-house curated dataset of N=106 studies. Our framework mirrors the radiologic diagnostic process via a multi-slice approach so that the accuracy and pathologic sequela of true pulmonary emboli may be meticulously assessed, enabling physicians to better appraise the morbidity of a PE when present. Our proposed method outperformed a baseline CNN classifier and a single-stage CNN-LSTM network, achieving an AUC of 0.95 on the test set for detecting the presence of PE in the study.