Multi-parameter-based Radiological Diagnosis of Chiari Malformation
using Machine Learning Technology
Abstract
Background: The known primary radiological diagnosis of Chiari
Malformation-I (CM-I) is based on the degree of tonsillar herniation (
TH) below the Foramen Magnum (FM). However, recent data also shows the
association of such malformation with smaller posterior cranial fossa
(PCF) volume and the anatomical issues regarding the Odontoid. This
study presents the achieved result regarding some detected potential
radiological findings that may aid CM-I diagnosis using several machine
learning (ML) algorithms. Materials and Methods: Between 2011 and 2020,
radiological examinations of 100 clinically/radiologically proved
symptomatic CM-I cases and 100 control were evaluated by matching age
and gender. A team of Neuroradiologists had reviewed the MR images of
the study population. A total of 11 different radiological parameters
were assessed for CM-I diagnosis. The parameters were defined and
examined in 5 designed different ML algorithms. Statistical analysis was
conducted for data analysis. Results: The mean age of patients was
29.92 ± 15.03 years. The primary presenting symptoms were headaches
(62%). Syringomyelia and retrocurved-odontoid were detected in 34% and
8% of patients, respectively. All of the morphometric measures were
significantly different between the groups, except for the distance from
the dens axis to the posterior margin of FM. The Radom Forest model is
found to have the best 1.0 (14 of 14) ratio of accuracy in regard to 14
different combinations of morphometric features. Conclusion: This study
indicates the potential usefulness of ML-guided PCF measurements, other
than TH, that may be used to predict and diagnose CM-I accurately. Our
results support the view of TH as a single radiological parameter may
fail during the diagnosis of CM-I. Combining two or three preferable
osseous structure-based parameters may increase the accuracy of
radiological diagnosis of CM-I.