A Cascaded Multi-Task Generative Framework for Detecting Aortic Dissection on 3-D Non-Contrast-Enhanced Computed Tomography

Contrast-enhanced computed tomography (CE-CT) is the gold standard for diagnosing aortic dissection (AD). However, contrast agents can cause allergic reactions or renal failure in some patients. Moreover, AD diagnosis by radiologists using non-contrast-enhanced CT (NCE-CT) images has poor sensitivity. To address this issue, we propose a novel cascaded multi-task generative framework for AD detection using NCE-CT volumes. The framework includes a 3D nnU-Net and a 3D multi-task generative architecture (3D MTGA). Specifically, the 3D nnU-Net was employed to segment aortas from NCE-CT volumes. The 3D MTGA was then employed to simultaneously synthesize CE-CT volumes, segment true & false lumen, and classify the patient as AD or non-AD. A theoretical formulation demonstrated that the 3D MTGA could increase the Jensen-Shannon Divergence (JSD) between AD and non-AD for each NCE-CT volume, thus indirectly improving the AD detection performance. Experiments also showed that the proposed framework could achieve an average accuracy of 0.831, a sensitivity of 0.938, and an F1-score of 0.847 in comparison with seven state-of-the-art classification models used by three radiologists with junior, intermediate, and senior experiences, respectively. The experimental results indicate that the proposed framework obtains superior performance to state-of-the-art models in AD detection. Thus, it has great potential to reduce the misdiagnosis of AD using NCE-CT in clinical practice. The source codes and supplementary materials for our framework are available at https://github.com/yXiangXiong/CMTGF.