International Journal of Computer Assisted Radiology and Surgery

Comparison of statistical learning approaches for cerebral aneurysm rupture assessment

Felicitas J. Detmer, Daniel Lückehe, Fernando Mut, Martin Slawski, Sven Hirsch, Philippe Bijlenga,
Gabriele von Voigt, Juan R. Cebral

Corresponding Author:
Felicitas J. Detmer
Bioengineering Department
Volgenau School of Engineering
George Mason University
4400 University Drive
Fairfax, VA 22030, USA
Email: fdetmer@gmu.edu
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Table 1 Values of grid of tuning parameters for cross-validation

Classifier Tuning parameter Values of grid for cross-validation

Group Strength of regularization of “group 0.398,0.316,0.251,0.199,0.158,0.126,0.1,0.079,0.0
Lasso norm” of fitted coefficients 63,0.05,0.04,0.032,0.025,0.02,0.016,0.013,0.01
Linear 0.00001, 0.0001, 0.001, 0.01, 0.1, 1, 10, 100, 1000,
Cost parameter C
SVM 10000, 10000
0.00001, 0.0001, 0.001, 0.01, 0.1, 1, 10, 100, 1000,
Cost parameter C
10000, 10000
RBF-SVM
0.000001, 0.00001, 0.0001, 0.001, 0.01, 0.1, 1, 10,
γ-parameter of kernel function
100, 1000, 10000
number of neighboring patterns
kNN 1, 2, 3, 4, … ,48, 49
used for classification k
Decision
Maximum depth of tree 1, 2, 3, 4, … ,29, 30
Tree
Random Maximum depth of trees 1, 2, 3, 4, … , 13, 14
Forest Number of trees 5, 10, 15, 20, … , 195, 200

Table 2 Results of pairwise comparisons of AUCs for different classifiers evaluated in test data based on DeLong et al.’s exact
method [15]. Significantly different AUCs (p-value < 0.05) are highlighted in italic

SVM_RBF SVM_linear kNN DT RF MLP

grplasso 0.1606 0.0206 0.0067 <0.001 0.0968 0.9698
SVM_RBF - 0.1159 0.0232 0.0015 0.2548 0.7624
SVM_linear - - 0.0525 0.0039 0.4333 0.635
kNN - - - 0.1011 0.1441 0.1212
DT - - - - 0.0024 0.0109
RF - - - - - 0.3807

Table 3 Comparison of relative importances for the group lasso model, linear SVM, and random forest ordered by the
importance based on the group lasso (relative selection frequency in repeated nested cross-validation). For the SVM and RF,
the values were normalized by the maximum value of the weight and Gini importance, respectively

Type Description Group lasso SVM RF

age Patient Patient age 1 -0.22 0.33
NSI Shape Non-sphericity index 1 0.21 0.99
position_ACA Location Anterior cerebral artery 1 0.11 0.01
position_ACOM Location Anterior communicating artery 1 1 0.67
position_BA-DIST- Location Basilar artery other than 1 -0.3 0.01
PROX tip
position_BA-TIP Location Tip of basilar artery 1 0.04 0.01
position_ICA-ACHOR Location Internal carotid artery – anterior choroidal 1 -0.12 0.01
position_ICA-BIF Location Internal carotid artery bifurcation 1 -0.34 0.01
position_ICA-CAV Location Cavernous internal carotid 1 -0.46 0.07
artery
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position_ICA-OPH Location Internal carotid artery – ophthalmic 1 -0.32 0.21

position_ICA-SHYP Location Superior hypophyseal segment internal 1 -0.15 0.02
carotid artery
position_MCA-BIF Location Middle cerebral artery bifurcation 1 -0.11 0.02
position_MCA-DIST- Location Middle cerebral artery other than 1 -0.32 0.01
PROX bifurcation
position_PCOM Location Posterior communicating artery 1 0.6 0.12
position_VA Location Vertebral artery 1 0.37 0.01
sex_F Patient Female patient 1 -0.15 0.05
sex_M Patient Male patient 1 0.15 0.05
Vdiam Shape Vessel diameter: Diameter of nearest 1 -0.06 0.36
vessel from aneurysm neck
Awidth Shape Max. diameter of aneurysm slices parallel 1 -0.32 0.23
to aneurysm neck
MLN Shape L2-Norm of mean aneurysm surface 1 0.41 0.65
curvature
OSImax Hem. Maximum oscillatory shear index 1 0.12 0.16
LSA Hem. Low shear area 1 -0.11 0.15
KE Hem. Mean kinetic energy 0.99 0.23 0.13
GLN Shape L2-Norm of Gaussian curvature 0.99 0.18 0.88
BL Shape Bulge location = Distance of plane with 0.95 0.06 0.15
largest diameter from neck/height
VOR Shape Volume to ostium ratio = Aneurysm 0.93 -0.38 0.27
volume/Area of neck
Vmax Hem. Peak Velocity 0.93 0.3 0.31
WSSmin Hem. Minimum wall shear stress over space and 0.93 0.02 0.23
time
GAA Shape Area weighted average of Gaussian 0.9 -0.26 0.15
aneurysm surface curvature
HWR Shape Height to width ratio = aneurysm 0.87 0.09 0.52
height/aneurysm width
SCI Hem. Shear concentration index 0.87 -0.1 0.14
Narea Shape Area of the neck surface 0.69 -0.3 0.23
WSSnorm Hem. Normalized WSS = WSSmean/WSSves 0.67 -0.24 0.13
Ndiam Shape Equivalent diameter of neck = 4 x 0.67 -0.27 0.24
area/perimeter
corelen Hem. Vortex core line length (flow complexity) 0.64 0.01 0.25
MWSSnorm Hem. Maximum normalized WSS = 0.49 0.02 0.18
WSSmax/WSSves
AR Shape Aspect ratio = aneurysm depth/neck 0.45 0.31 0.51
diameter
ICI Hem. Inflow concentration index 0.44 0.22 0.13
WSSves Hem. Mean wall shear stress in parent vessel 0.4 -0.11 0.19
VD Hem. Mean viscous dissipation 0.37 -0.18 0.19
WSSmax Hem. Maximum wall shear stress over space and 0.33 0 0.28
time
EI Shape Ellipticity index 0.31 0.06 0.56
Nsize Shape Max. distance between any two points on 0.25 -0.01 0.17
the neck surface
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OSImean Hem. Mean oscillatory shear index 0.23 -0.01 0.18

MAA Shape Area weighted average of mean curvature 0.17 0.18 0.3
podenum Hem. Proper orthogonal decomposition – 0.16 -0.03 0.01
number of modes to account for 95%
of total energy (flow stability)
podent Hem. Proper orthogonal decomposition (POD) 0.15 0.01 0.12
entropy (flow stability)
Aheight Shape Max. normal distance of all points on 0.14 -0.12 0.21
aneurysm dome from aneurysm neck
Aspect Shape Aspect ratio 2 = aneurysm height/neck 0.13 -0.28 0.39
diameter
Asize Shape Max. distance between any two points on 0.13 0.36 0.17
the aneurysm surface
VO Hem. Mean vorticity 0.11 0.09 0.15
VE Hem. Mean velocity 0.08 -0.09 0.12
VmaxMean Hem. Time average of maximum velocity in space 0.08 -0.18 0.28
CR Shape Convexity ratio = Aneurysm 0.08 -0.2 0.34
volume/Volume of aneurysm’s convex hull
SizeR Shape Size ratio = Aneurysm size/Vessel diameter 0.07 0.12 0.67
Q Hem. Mean inflow rate into aneurysm 0.07 0.13 0.13
Avol Shape Aneurysm volume 0.07 0.24 0.22
BF Shape Bottle neck factor = aneurysm width/neck 0.07 0.11 0.26
diameter
IPR Shape Isoperimetric ratio 0.07 -0.12 1
WSSmean Hem. Time average of spatially-averaged WSS 0.05 -0.06 0.13
Aarea Shape Aneurysm area 0.05 -0.18 0.21
SR Hem. Mean shear rate 0.03 0.09 0.16
depth Shape Max. distance of all points on aneurysm 0.02 0.04 0.29
dome from aneurysm neck

Table 4 Mean and standard deviation of Gini importance as variable importance measure based on random forest with 100
repetitions trained on whole dataset

Feature Mean Gini Standard Deviation

Importance
IPR 0.0652 0.0071
NSI 0.0645 0.0065
GLN 0.0573 0.0079
SizeR 0.044 0.0068
position_ACOM 0.0434 0.0047
MLN 0.0426 0.0061
EI 0.0368 0.0043
HWR 0.0338 0.0044
AR 0.0331 0.0051
Aspect 0.0255 0.0046
Vdiam 0.0235 0.0025
CR 0.022 0.0025
age 0.0212 0.0021
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Vmax 0.02 0.0025

MAA 0.0193 0.0024
depth 0.0187 0.0035
WSSmax 0.0182 0.0024
VmaxMean 0.0181 0.0024
VOR 0.0176 0.0036
BF 0.0168 0.0026
corelen 0.0162 0.0029
Ndiam 0.0158 0.002
Narea 0.0152 0.0019
Awidth 0.015 0.002
WSSmin 0.0148 0.0021
Avol 0.0143 0.0021
Aheight 0.0138 0.0027
Aarea 0.0138 0.0023
position_ICA-OPH 0.0134 0.0025
WSSves 0.0125 0.0014
VD 0.0122 0.0015
MWSSnorm 0.012 0.0014
OSImean 0.0115 0.0016
Nsize 0.0114 0.0016
Asize 0.0112 0.0022
SR 0.0107 0.0013
OSImax 0.0107 0.0017
BL 0.01 0.0011
GAA 0.0099 0.0015
LSA 0.0097 0.0013
VO 0.0097 0.0013
SCI 0.0093 0.0014
ICI 0.0088 0.0011
WSSnorm 0.0087 0.0011
KE 0.0087 0.0012
WSSmean 0.0086 0.0011
Q 0.0085 0.0011
VE 0.0081 0.001
position_PCOM 0.0081 0.0017
podent 0.0077 0.001
position_ICA-CAV 0.0043 0.001
sex_F 0.003 0.0007
sex_M 0.003 0.0007
position_ICA-SHYP 0.0015 0.0004
position_MCA-BIF 0.0014 0.0004
position_ICA-BIF 0.0009 0.0004
podenum 0.0009 0.0003
position_BA-TIP 0.0007 0.0003
position_MCA-DIST-PROX 0.0007 0.0003
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position_BA-DIST-PROX 0.0006 0.0003

position_VA 0.0006 0.0003
position_ACA 0.0004 0.0002
position_ICA-ACHOR 0.0004 0.0002