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AI / informaticsAJNR. American journal of neuroradiology · 2026

Two-Step Semiautomated Classification of Choroidal Metastases on MRI: Orbit Localization via Bounding Boxes Followed by Binary Classification via Evolutionary Strategies.

Jeffrey S Shi, Bala McRae-Posani, Sofia Haque … Joseph Stember

OphthalmologyAI / informatics

AI classifier distinguished choroidal metastases from normal orbits on brain MRI with high accuracy

Two-Step Semiautomated Classification of Choroidal Metastases on MRI: Orbit Localization via Bounding Boxes Followed by Binary Classification via Evolutionary Strategies.

Jeffrey S Shi … Joseph Stember

AJNR. American journal of neuroradiology · 2026

Background

The choroid of the eye is a rare site for metastatic tumor spread, and as small lesions on the periphery of brain MRI studies, these choroidal metastases are often missed.

Purpose

To improve their detection, we aimed to use artificial intelligence to distinguish between brain MRI scans containing normal orbits and choroidal metastases.

Methods

In step 1, we trained a localization network on 386 T2-weighted brain MRI axial slices from 97 patients.

n = 97 patients

Results

Area under curve of 0.93; 1.0 is perfect discrimination, 0.5 is chance

AUC 0.93 (95% CI 0.83 to 1.03)

CI excludes the null - significant

More results

Our orbit localization model identified globes with 100% accuracy and a mean average precision (mAP) of intersection over union thresholds of 0.5-0.95 [mAP(0.5:0.95)] of 0.47 on held-out testing data.

More results

Similarly, the model generalized well to our step 2 data set, which included orbits demonstrating pathologies, achieving 100% accuracy and mAP(0.5:0.95) of 0.44. mAP(0.5:0.95) appeared low because the model could not distinguish left and right orbits.

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Conclusion · 1 of 2

The semiautomated pipeline from brain MRI slices to choroidal metastasis classification demonstrates the utility of a sequential localization and classification approach, and clinical relevance for identifying small, "corner-of-the-image," easily overlooked lesions.

Conclusion · 2 of 2

Artificial Intelligence Level of Evidence: 5B.

Post

Two-Step Semiautomated Classification of Choroidal Metastases on MRI: Orbit Localization via Bounding Boxes Followed by Binary Classification via Evolutionary Strategies.

AI classifier distinguished choroidal metastases from normal orbits on brain MRI with high accuracy

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