An anomaly detection approach to identify chronic brain infarcts on MRI

van Hespen, Kees M, Zwanenburg, Jaco J M, Dankbaar, Jan W, Geerlings, Mirjam I, Hendrikse, Jeroen, Kuijf, Hugo J


Scientific Reports 11 (1),


The performance of current machine learning methods to detect heterogeneous pathology is limited by the quantity and quality of pathology in medical images. A possible solution is anomaly detection; an approach that can detect all abnormalities by learning how 'normal' tissue looks like. In this work, we propose an anomaly detection method using a neural network architecture for the detection of chronic brain infarcts on brain MR images. The neural network was trained to learn the visual appearance of normal appearing brains of 697 patients. We evaluated its performance on the detection of chronic brain infarcts in 225 patients, which were previously labeled. Our proposed method detected 374 chronic brain infarcts (68% of the total amount of brain infarcts) which represented 97.5% of the total infarct volume. Additionally, 26 new brain infarcts were identified that were originally missed by the radiologist during radiological reading. Our proposed method also detected white matter hyperintensities, anomalous calcifications, and imaging artefacts. This work shows that anomaly detection is a powerful approach for the detection of multiple brain abnormalities, and can potentially be used to improve the radiological workflow efficiency by guiding radiologists to brain anomalies which otherwise remain unnoticed.