DeepVox and SAVE-CT: a contrast- and dose-independent 3D deep learning approach for thoracic aorta segmentation and aneurysm prediction using computed tomography scans

Thoracic aortic aneurysm (TAA) is a fatal disease which potentially leads to dissection or rupture through progressive enlargement of the aorta. It is usually asymptomatic and screening recommendation are limited. The gold-standard evaluation is performed by computed tomography angiography (CTA) and radiologists time-consuming assessment. Scans for other indications could help on this screening, however if acquired without contrast enhancement or with low dose protocol, it can make the clinical evaluation difficult, besides increasing the scans quantity for the radiologists. In this study, it was selected 587 unique CT scans including control and TAA patients, acquired with low and standard dose protocols, with or without contrast enhancement. A novel segmentation model, DeepVox, exhibited dice score coefficients of 0.932 and 0.897 for development and test sets, respectively, with faster training speed in comparison to models reported in the literature. The novel TAA classification model, SAVE-CT, presented accuracies of 0.930 and 0.922 for development and test sets, respectively, using only the binary segmentation mask from DeepVox as input, without hand-engineered features. These two models together are a potential approach for TAA screening, as they can handle variable number of slices as input, handling thoracic and thoracoabdominal sequences, in a fully automated contrast- and dose-independent evaluation. This may assist to decrease TAA mortality and prioritize the evaluation queue of patients for radiologists.