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In Journal of medical Internet research ; h5-index 88.0

BACKGROUND : Liver cancer is a substantial disease burden in China. As one of the primary diagnostic tools for detecting liver cancer, dynamic contrast-enhanced computed tomography provides detailed evidences for diagnosis that are recorded in free-text radiology reports.

OBJECTIVE : The aim of our study was to apply a deep learning model and rule-based natural language processing (NLP) method to identify evidences for liver cancer diagnosis automatically.

METHODS : We proposed a pretrained, fine-tuned BERT (Bidirectional Encoder Representations from Transformers)-based BiLSTM-CRF (Bidirectional Long Short-Term Memory-Conditional Random Field) model to recognize the phrases of APHE (hyperintense enhancement in the arterial phase) and PDPH (hypointense in the portal and delayed phases). To identify more essential diagnostic evidences, we used the traditional rule-based NLP methods for the extraction of radiological features. APHE, PDPH, and other extracted radiological features were used to design a computer-aided liver cancer diagnosis framework by random forest.

RESULTS : The BERT-BiLSTM-CRF predicted the phrases of APHE and PDPH with an F1 score of 98.40% and 90.67%, respectively. The prediction model using combined features had a higher performance (F1 score, 88.55%) than those using APHE and PDPH (84.88%) or other extracted radiological features (83.52%). APHE and PDPH were the top 2 essential features for liver cancer diagnosis.

CONCLUSIONS : This work was a comprehensive NLP study, wherein we identified evidences for the diagnosis of liver cancer from Chinese radiology reports, considering both clinical knowledge and radiology findings. The BERT-based deep learning method for the extraction of diagnostic evidence achieved state-of-the-art performance. The high performance proves the feasibility of the BERT-BiLSTM-CRF model in information extraction from Chinese radiology reports. The findings of our study suggest that the deep learning-based method for automatically identifying evidences for diagnosis can be extended to other types of Chinese clinical texts.

Liu Honglei, Zhang Zhiqiang, Xu Yan, Wang Ni, Huang Yanqun, Yang Zhenghan, Jiang Rui, Chen Hui


BERT, BiLSTM-CRF, computer-aided diagnosis, information extraction, natural language processing, radiology reports