Semi-supervised learning for generalizable intracranial hemorrhage detection and segmentation

Purpose: To develop and evaluate a semi-supervised learning model for intracranial hemorrhage detection and segmentation on an out-of-distribution head CT evaluation set. Materials and Methods: This retrospective study used semi-supervised learning to bootstrap performance. An initial "teacher" deep learning model was trained on 457 pixel-labeled head CT scans collected from one US institution from 2010-2017 and used to generate pseudo-labels on a separate unlabeled corpus of 25000 examinations from the RSNA and ASNR. A second "student" model was trained on this combined pixel- and pseudo-labeled dataset. Hyperparameter tuning was performed on a validation set of 93 scans. Testing for both classification (n=481 examinations) and segmentation (n=23 examinations, or 529 images) was performed on CQ500, a dataset of 481 scans performed in India, to evaluate out-of-distribution generalizability. The semi-supervised model was compared with a baseline model trained on only labeled data using area under the receiver operating characteristic curve (AUC), Dice similarity coefficient (DSC), and average precision (AP) metrics. Results: The semi-supervised model achieved statistically significantly higher examination AUC on CQ500 compared with the baseline (0.939 [0.938, 0.940] vs. 0.907 [0.906, 0.908]) (p=0.009). It also achieved a higher DSC (0.829 [0.825, 0.833] vs. 0.809 [0.803, 0.812]) (p=0.012) and Pixel AP (0.848 [0.843, 0.853]) vs. 0.828 [0.817, 0.828]) compared to the baseline. Conclusion: The addition of unlabeled data in a semi-supervised learning framework demonstrates stronger generalizability potential for intracranial hemorrhage detection and segmentation compared with a supervised baseline.