Deep Learning and Radiomics-Driven Algorithm for Automated Identification of May-Thurner Syndrome in Iliac CTV Imaging

Lufeng Chen Dong-Lin Li Hua-Feng Zheng Chengzhi Qiu ^*

• The Second Affiliated Hospital of Fujian Medical University, Quanzhou, China

Objective: This research aimed to create a dataset of Iliac CTV scans for automated May-Thurner Syndrome (MTS) detection using deep learning and radiomics. In addition, it sought to establish an automated segmentation model for Iliac Vein CTV scans and construct a radiomic signature for MTS diagnosis.We collected a dataset of 490 cases meeting specific inclusion and exclusion criteria, anonymized to comply with HIPAA regulations. Iliac Vein CTV scans were prepared with contrast agent administration, followed by image acquisition and evaluation. A deep learningbased segmentation model, UPerNet, was employed using ten-fold cross-validation. Radiomic features were extracted from the scans and used to construct a diagnostic radiomic signature.Dice values and ROC analysis, was conducted to evaluate segmentation and diagnostic performance. Results: The dataset consisted of 201 positive cases of May-Thurner Syndrome (MTS) and 289 negative cases. The UPerNet segmentation model exhibited remarkable accuracy in identifying MTS regions. A Dice coefficient of 0.925 (95% confidence interval: 0.875-0.961) was observed, indicating the precision and reliability of our segmentation model. Radiomic analysis produced a diagnostic radiomic signature with significant clinical potential. ROC analysis demonstrated promising results, underscoring the efficacy of the developed model in distinguishing MTS cases. The radiomic signature demonstrated strong diagnostic capabilities for MTS. Within the training dataset, it attained a notable area under the curve (AUC) of 0.891, with a 95% confidence interval ranging from 0.825 to 0.956, showcasing its effectiveness. This diagnostic capability extended to the validation dataset, where the AUC remained strong at 0.892 (95% confidence interval: 0.793-0.991). These results highlight the accuracy of our segmentation model and the diagnostic value of our radiomic signature in identifying May-Thurner Syndrome (MTS) cases. Conclusion: This study presents a comprehensive approach to automate MTS detection from Iliac CTV scans, combining deep learning and radiomics. The results suggest the potential clinical utility of the developed model in diagnosing MTS, offering a non-invasive and efficient alternative to traditional methods.