• Charlie A Hamm, Clinton J Wang, Lynn J Savic, Marc Ferrante, Isabel Schobert, Todd Schlachter, MingDe Lin, James S Duncan, Jeffrey C Weinreb, Julius Chapiro, and Brian Letzen.
• Department of Radiology and Biomedical Imaging, Yale School of Medicine, 333 Cedar Street, New Haven, CT, 06520, USA.
• Eur Radiol. 2019 Jul 1; 29 (7): 3338-3347.

ObjectivesTo develop and validate a proof-of-concept convolutional neural network (CNN)-based deep learning system (DLS) that classifies common hepatic lesions on multi-phasic MRI.MethodsA custom CNN was engineered by iteratively optimizing the network architecture and training cases, finally consisting of three convolutional layers with associated rectified linear units, two maximum pooling layers, and two fully connected layers. Four hundred ninety-four hepatic lesions with typical imaging features from six categories were utilized, divided into training (n = 434) and test (n = 60) sets. Established augmentation techniques were used to generate 43,400 training samples. An Adam optimizer was used for training. Monte Carlo cross-validation was performed. After model engineering was finalized, classification accuracy for the final CNN was compared with two board-certified radiologists on an identical unseen test set.ResultsThe DLS demonstrated a 92% accuracy, a 92% sensitivity (Sn), and a 98% specificity (Sp). Test set performance in a single run of random unseen cases showed an average 90% Sn and 98% Sp. The average Sn/Sp on these same cases for radiologists was 82.5%/96.5%. Results showed a 90% Sn for classifying hepatocellular carcinoma (HCC) compared to 60%/70% for radiologists. For HCC classification, the true positive and false positive rates were 93.5% and 1.6%, respectively, with a receiver operating characteristic area under the curve of 0.992. Computation time per lesion was 5.6 ms.ConclusionThis preliminary deep learning study demonstrated feasibility for classifying lesions with typical imaging features from six common hepatic lesion types, motivating future studies with larger multi-institutional datasets and more complex imaging appearances.Key Points• Deep learning demonstrates high performance in the classification of liver lesions on volumetric multi-phasic MRI, showing potential as an eventual decision-support tool for radiologists. • Demonstrating a classification runtime of a few milliseconds per lesion, a deep learning system could be incorporated into the clinical workflow in a time-efficient manner.

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