Artificial Intelligence Outcome Prediction in Neonates with Encephalopathy (AI-OPiNE).

Journal: Radiology. Artificial intelligence
PMID: 38984984

Abstract

Purpose To develop a deep learning algorithm to predict 2-year neurodevelopmental outcomes in neonates with hypoxic-ischemic encephalopathy using MRI and basic clinical data. Materials and Methods In this study, MRI data of term neonates with encephalopathy in the High-dose Erythropoietin for Asphyxia and Encephalopathy (HEAL) trial (ClinicalTrials.gov: NCT02811263), who were enrolled from 17 institutions between January 25, 2017, and October 9, 2019, were retrospectively analyzed. The harmonized MRI protocol included T1-weighted, T2-weighted, and diffusion tensor imaging. Deep learning classifiers were trained to predict the primary outcome of the HEAL trial (death or any neurodevelopmental impairment at 2 years) using multisequence MRI and basic clinical variables, including sex and gestational age at birth. Model performance was evaluated on test sets comprising 10% of cases from 15 institutions (in-distribution test set, = 41) and 10% of cases from two institutions (out-of-distribution test set, = 41). Model performance in predicting additional secondary outcomes, including death alone, was also assessed. Results For the 414 neonates (mean gestational age, 39 weeks ± 1.4 [SD]; 232 male, 182 female), in the study cohort, 198 (48%) died or had any neurodevelopmental impairment at 2 years. The deep learning model achieved an area under the receiver operating characteristic curve (AUC) of 0.74 (95% CI: 0.60, 0.86) and 63% accuracy in the in-distribution test set and an AUC of 0.77 (95% CI: 0.63, 0.90) and 78% accuracy in the out-of-distribution test set. Performance was similar or better for predicting secondary outcomes. Conclusion Deep learning analysis of neonatal brain MRI yielded high performance for predicting 2-year neurodevelopmental outcomes. Convolutional Neural Network (CNN), Prognosis, Pediatrics, Brain, Brain Stem Clinical trial registration no. NCT02811263 © RSNA, 2024 See also commentary by Rafful and Reis Teixeira in this issue.

Authors

  • Christopher O Lew
    From the Department of Radiology, Division of Neuroradiology, Alzheimer Disease Imaging Research Laboratory (C.O.L., J.R.P.), and Neurocognitive Disorders Program, Departments of Psychiatry and Medicine (P.M.D.), Duke University Medical Center, DUMC-Box 3808, Durham, NC 27710-3808; and Duke Institute for Brain Sciences (P.M.D.) and Department of Electrical and Computer Engineering, Department of Computer Science, Department of Biostatistics and Bioinformatics (L.Z., M.A.M.), Duke University, Durham, NC.
  • Evan Calabrese
    Department of Radiology and Biomedical Imaging, University of California At San Francisco, 350 Parnassus Ave, Suite 307H, San Francisco, CA, 94143-0628, USA. evan.calabrese@ucsf.edu.
  • Joshua V Chen
    From the Department of Radiology, Duke University Medical Center, 2301 Erwin Rd, Box 3808, Durham, NC 27710 (C.O.L., E.C, A.L., J.F.); Department of Radiology (J.V.C., F.T., G.C., A.R., Y.L.) and Weill Institute for Neurosciences (Y.W.W.), University of California San Francisco, San Francisco, Calif; Department of Pediatrics, University of Washington, Seattle, Wash (S.J.); Department of Pediatrics, Saint Louis University, St Louis, Mo (A.M.); Mallinckrodt Institute of Radiology, Washington University School of Medicine, St Louis, Mo (R.C.M.); and Children's Hospital Los Angeles, University of Southern California, Los Angeles, Calif (J.L.W.).
  • Felicia Tang
    From the Department of Radiology, Duke University Medical Center, 2301 Erwin Rd, Box 3808, Durham, NC 27710 (C.O.L., E.C, A.L., J.F.); Department of Radiology (J.V.C., F.T., G.C., A.R., Y.L.) and Weill Institute for Neurosciences (Y.W.W.), University of California San Francisco, San Francisco, Calif; Department of Pediatrics, University of Washington, Seattle, Wash (S.J.); Department of Pediatrics, Saint Louis University, St Louis, Mo (A.M.); Mallinckrodt Institute of Radiology, Washington University School of Medicine, St Louis, Mo (R.C.M.); and Children's Hospital Los Angeles, University of Southern California, Los Angeles, Calif (J.L.W.).
  • Gunvant Chaudhari
    From the School of Medicine (J.V.C., G.C.) and Department of Radiology and Biomedical Imaging (C.P.H., O.A.G., L.P.S., A.M.R., Y.L.), University of California, San Francisco, 505 Parnassus Avenue, M-391, San Francisco, CA 94143-0628.
  • Amanda Lee
    From the Department of Radiology, Duke University Medical Center, 2301 Erwin Rd, Box 3808, Durham, NC 27710 (C.O.L., E.C, A.L., J.F.); Department of Radiology (J.V.C., F.T., G.C., A.R., Y.L.) and Weill Institute for Neurosciences (Y.W.W.), University of California San Francisco, San Francisco, Calif; Department of Pediatrics, University of Washington, Seattle, Wash (S.J.); Department of Pediatrics, Saint Louis University, St Louis, Mo (A.M.); Mallinckrodt Institute of Radiology, Washington University School of Medicine, St Louis, Mo (R.C.M.); and Children's Hospital Los Angeles, University of Southern California, Los Angeles, Calif (J.L.W.).
  • John Faro
    From the Department of Radiology, Duke University Medical Center, 2301 Erwin Rd, Box 3808, Durham, NC 27710 (C.O.L., E.C, A.L., J.F.); Department of Radiology (J.V.C., F.T., G.C., A.R., Y.L.) and Weill Institute for Neurosciences (Y.W.W.), University of California San Francisco, San Francisco, Calif; Department of Pediatrics, University of Washington, Seattle, Wash (S.J.); Department of Pediatrics, Saint Louis University, St Louis, Mo (A.M.); Mallinckrodt Institute of Radiology, Washington University School of Medicine, St Louis, Mo (R.C.M.); and Children's Hospital Los Angeles, University of Southern California, Los Angeles, Calif (J.L.W.).
  • Sandra Juul
    From the Department of Radiology, Duke University Medical Center, 2301 Erwin Rd, Box 3808, Durham, NC 27710 (C.O.L., E.C, A.L., J.F.); Department of Radiology (J.V.C., F.T., G.C., A.R., Y.L.) and Weill Institute for Neurosciences (Y.W.W.), University of California San Francisco, San Francisco, Calif; Department of Pediatrics, University of Washington, Seattle, Wash (S.J.); Department of Pediatrics, Saint Louis University, St Louis, Mo (A.M.); Mallinckrodt Institute of Radiology, Washington University School of Medicine, St Louis, Mo (R.C.M.); and Children's Hospital Los Angeles, University of Southern California, Los Angeles, Calif (J.L.W.).
  • Amit Mathur
    From the Department of Radiology, Duke University Medical Center, 2301 Erwin Rd, Box 3808, Durham, NC 27710 (C.O.L., E.C, A.L., J.F.); Department of Radiology (J.V.C., F.T., G.C., A.R., Y.L.) and Weill Institute for Neurosciences (Y.W.W.), University of California San Francisco, San Francisco, Calif; Department of Pediatrics, University of Washington, Seattle, Wash (S.J.); Department of Pediatrics, Saint Louis University, St Louis, Mo (A.M.); Mallinckrodt Institute of Radiology, Washington University School of Medicine, St Louis, Mo (R.C.M.); and Children's Hospital Los Angeles, University of Southern California, Los Angeles, Calif (J.L.W.).
  • Robert C McKinstry
    Department of Pediatrics, Washington University School of Medicine, Saint Louis, Missouri; Department of Radiology, Washington University School of Medicine, Saint Louis, Missouri.
  • Jessica L Wisnowski
    From the Department of Radiology, Duke University Medical Center, 2301 Erwin Rd, Box 3808, Durham, NC 27710 (C.O.L., E.C, A.L., J.F.); Department of Radiology (J.V.C., F.T., G.C., A.R., Y.L.) and Weill Institute for Neurosciences (Y.W.W.), University of California San Francisco, San Francisco, Calif; Department of Pediatrics, University of Washington, Seattle, Wash (S.J.); Department of Pediatrics, Saint Louis University, St Louis, Mo (A.M.); Mallinckrodt Institute of Radiology, Washington University School of Medicine, St Louis, Mo (R.C.M.); and Children's Hospital Los Angeles, University of Southern California, Los Angeles, Calif (J.L.W.).
  • Andreas Rauschecker
    From the Department of Radiology, Duke University Medical Center, 2301 Erwin Rd, Box 3808, Durham, NC 27710 (C.O.L., E.C, A.L., J.F.); Department of Radiology (J.V.C., F.T., G.C., A.R., Y.L.) and Weill Institute for Neurosciences (Y.W.W.), University of California San Francisco, San Francisco, Calif; Department of Pediatrics, University of Washington, Seattle, Wash (S.J.); Department of Pediatrics, Saint Louis University, St Louis, Mo (A.M.); Mallinckrodt Institute of Radiology, Washington University School of Medicine, St Louis, Mo (R.C.M.); and Children's Hospital Los Angeles, University of Southern California, Los Angeles, Calif (J.L.W.).
  • Yvonne W Wu
    Department of Neurology, UCSF, San Francisco, California.
  • Yi Li
    Wuhan Zoncare Bio-Medical Electronics Co., Ltd, Wuhan, China.

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