Automated Organ-Level Classification of Free-Text Pathology Reports to Support a Radiology Follow-up Tracking Engine

To evaluate the performance of machine learning algorithms on organ-level classification of semistructured pathology reports, to incorporate surgical pathology monitoring into an automated imaging recommendation follow-up engine.

This retrospective study included 2013 pathology reports from patients who underwent abdominal imaging at a large tertiary care center between 2012 and 2018. The reports were labeled by two annotators as relevant to four abdominal organs: liver, kidneys, pancreas and/or adrenal glands, or none. Automated classification methods were compared: simple string matching, random forests, extreme gradient boosting, support vector machines, and two neural network architectures-convolutional neural networks and long short-term memory networks. Three methods from the literature were used to provide interpretability and qualitative validation of the learned network features.

The neural networks performed well on the four-organ classification task (F1 score: 96.3% for convolutional neural network and 96.7% for long short-term memory vs 89.9% for support vector machines, 93.9% for extreme gradient boosting, 82.8% for random forests, and 75.2% for simple string matching). Multiple methods were used to visualize the decision-making process of the network, verifying that the networks used similar heuristics to a human annotator. The neural networks were able to classify, with a high degree of accuracy, pathology reports written in unseen formats, suggesting the networks had learned a generalizable encoding of the salient features.

Neural network-based approaches achieve high performance on organ-level pathology report classification, suggesting that it is feasible to use them within automated tracking systems.© RSNA, 2019Supplemental material is available for this article.See also the commentary by Liu in this issue.