Deep Learning for Detecting Brain Metastases on MRI: A Systematic Review and Meta-Analysis

Since manual detection of brain metastases (BMs) is time consuming, studies have been conducted to automate this process using deep learning. The purpose of this study was to conduct a systematic review and meta-analysis of the performance of deep learning models that use magnetic resonance imaging (MRI) to detect BMs in cancer patients. A systematic search of MEDLINE, EMBASE, and Web of Science was conducted until 30 September 2022. Inclusion criteria were: patients with BMs; deep learning using MRI images was applied to detect the BMs; sufficient data were present in terms of detective performance; original research articles. Exclusion criteria were: reviews, letters, guidelines, editorials, or errata; case reports or series with less than 20 patients; studies with overlapping cohorts; insufficient data in terms of detective performance; machine learning was used to detect BMs; articles not written in English. Quality Assessment of Diagnostic Accuracy Studies-2 and Checklist for Artificial Intelligence in Medical Imaging was used to assess the quality. Finally, 24 eligible studies were identified for the quantitative analysis. The pooled proportion of patient-wise and lesion-wise detectability was 89%. Articles should adhere to the checklists more strictly. Deep learning algorithms effectively detect BMs. Pooled analysis of false positive rates could not be estimated due to reporting differences.