Abstract
Background and Purpose: Precisely assessing the likelihood of an intracranial aneurysm rupturing is critical for guiding clinical decision-making. The objective of this study is to construct and validate a deep learning framework utilizing point clouds to forecast the likelihood of aneurysm rupturing. Methods: The dataset included in this study consisted of a total of 623 aneurysms, with 211 of them classified as ruptured and 412 as unruptured, which were obtained from two separate projects within the AneuX morphology database. The HUG project, which included 124 ruptured aneurysms and 340 unruptured aneurysms, was used to train and internally validate the model. For external validation, another project named @neurIST was used, which included 87 ruptured and 72 unruptured aneurysms. A standardized method was employed to isolate aneurysms and a segment of their parent vessels from the original 3D vessel models. These models were then converted into a point cloud format using open3d package to facilitate training of the deep learning network. The PointNet++ architecture was utilized to process the models and generate risk scores through a softmax layer. Finally, two models, the dome and cut1 model, were established and then subjected to a comprehensive comparison of statistical indices with the LASSO regression model built by the dataset authors. Results: The cut1 model outperformed the dome model in the 5-fold cross-validation, with the mean AUC values of 0.85 and 0.81, respectively. Furthermore, the cut1 model beat the morphology-based LASSO regression model with an AUC of 0.82. However, as the original dataset authors stated, we observed potential generalizability concerns when applying trained models to datasets with different selection biases. Nevertheless, our method outperformed the LASSO regression model in terms of generalizability, with an AUC of 0.71 versus 0.67. Conclusion: The point cloud, as a 3D visualization technique for intracranial aneurysms, can effectively capture the spatial contour and morphological aspects of aneurysms. More structural features between the aneurysm and its parent vessels can be exposed by keeping a portion of the parent vessels, enhancing the model's performance. The point cloud-based deep learning model exhibited good performance in predicting rupture risk while also facing challenges in generalizability.