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Updated: Aug 16, 2026

Automated Midline Shift and Intracranial Pressure Estimation based on Brain CT Images
Published on: April 13, 2013
A Deep Learning-Based Automatic Segmentation and 3D Visualization Technique for Intracranial Hemorrhage Detection
Muntakim Mahmud Khan1, Muhammad E H Chowdhury2, A S M Shamsul Arefin1
1Department of Biomedical Physics and Technology, University of Dhaka, Dhaka 1000, Bangladesh.
Insights
This study developed a machine learning algorithm to detect intracranial hemorrhage (ICH) on CT scans, achieving high accuracy in identifying bleeding within the skull for improved patient diagnosis and care.
Area of Science:
- Medical Imaging
- Artificial Intelligence
- Neurosurgery
Background:
- Intracranial hemorrhage (ICH) presents diagnostic challenges due to varied severity and morphology, risking missed diagnoses of small hemorrhages.
- Computed tomography (CT) is the standard for diagnosing ICH, enabling rapid, life-saving interventions.
- Accurate and timely detection of ICH is critical due to high mortality and disability rates.
Purpose of the Study:
- To develop and evaluate a machine learning algorithm for detecting intracranial hemorrhage (ICH) using plain CT images.
- To compare the performance of different deep learning models for hemorrhage segmentation.
Main Methods:
- CT images from 75 patients were preprocessed using brain windowing, skull-stripping, and image inversion.
- Hemorrhage segmentation was performed using U-Net, U-Net++, and Feature Pyramid Network (FPN) models.
- A U-Net model with a DenseNet201 encoder demonstrated superior performance.
Main Results:
- The U-Net model with DenseNet201 achieved the highest Dice Similarity Coefficient (DSC) and Intersection over Union (IoU) scores.
- A 3D brain model was generated to visualize predicted hemorrhages against ground truth.
- Volumetric measurements of hemorrhage size were performed.
Conclusions:
- The developed machine learning algorithm shows promise for accurate ICH detection in clinical practice.
- The U-Net model with DenseNet201 encoder is effective for hemorrhage segmentation on CT scans.
- 3D visualization and volumetric analysis aid in assessing ICH severity.
Abstract:
Intracranial hemorrhage (ICH) occurs when blood leaks inside the skull as a result of trauma to the skull or due to medical conditions. ICH usually requires immediate medical and surgical attention because the disease has a high mortality rate, long-term disability potential, and other potentially life-threatening complications. There are a wide range of severity levels, sizes, and morphologies of ICHs, making accurate identification challenging. Hemorrhages that are small are more likely to be missed, particularly in healthcare systems that experience high turnover when it comes to computed tomography (CT) investigations. Although many neuroimaging modalities have been developed, CT remains the standard for diagnosing trauma and hemorrhage (including non-traumatic ones). A CT scan-based diagnosis can provide time-critical, urgent ICH surgery that could save lives because CT scan-based diagnoses can be obtained rapidly. The purpose of this study is to develop a machine-learning algorithm that can detect intracranial hemorrhage based on plain CT images taken from 75 patients. CT images were preprocessed using brain windowing, skull-stripping, and image inversion techniques. Hemorrhage segmentation was performed using multiple pre-trained models on preprocessed CT images. A U-Net model with DenseNet201 pre-trained encoder outperformed other U-Net, U-Net++, and FPN (Feature Pyramid Network) models with the highest Dice similarity coefficient (DSC) and intersection over union (IoU) scores, which were previously used in many other medical applications. We presented a three-dimensional brain model highlighting hemorrhages from ground truth and predicted masks. The volume of hemorrhage was measured volumetrically to determine the size of the hematoma. This study is essential in examining ICH for diagnostic purposes in clinical practice by comparing the predicted 3D model with the ground truth.
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