Infection diagnosis in hydrocephalus CT images: a domain enriched attention learning approach.

Journal: Journal of neural engineering
Published Date:

Abstract

. Hydrocephalus is the leading indication for pediatric neurosurgical care worldwide. Identification of postinfectious hydrocephalus (PIH) verses non-postinfectious hydrocephalus, as well as the pathogen involved in PIH is crucial for developing an appropriate treatment plan. Accurate identification requires clinical diagnosis by neuroscientists and microbiological analysis, which are time-consuming and expensive. In this study, we develop a domain enriched AI method for computerized tomography (CT)-based infection diagnosis in hydrocephalic imagery. State-of-the-art (SOTA) convolutional neural network (CNN) approaches form an attractive neural engineering solution for addressing this problem as pathogen-specific features need discovery. Yet black-box deep networks often need unrealistic abundant training data and are not easily interpreted.. In this paper, a novel brain attention regularizer is proposed, which encourages the CNN to put more focus inside brain regions in its feature extraction and decision making. Our approach is then extended to a hybrid 2D/3D network that mines inter-slice information. A new strategy of regularization is also designed for enabling collaboration between 2D and 3D branches.. Our proposed method achieves SOTA results on a CURE Children's Hospital of Uganda dataset with an accuracy of 95.8% in hydrocephalus classification and 84% in pathogen classification. Statistical analysis is performed to demonstrate that our proposed methods obtain significant improvements over the existing SOTA alternatives.. Such attention regularized learning has particularly pronounced benefits in regimes where training data may be limited, thereby enhancing generalizability. To the best of our knowledge, our findings are unique among early efforts in interpretable AI-based models for classification of hydrocephalus and underlying pathogen using CT scans.

Authors

  • Mingzhao Yu
    School of Electrical Engineering and Computer Science, The Pennsylvania State University, University Park, PA, USA.
  • Mallory R Peterson
    Center for Neural Engineering, the Pennsylvania State University, University Park, PA 16801, United States of America.
  • Venkateswararao Cherukuri
    School of Electrical Engineering and Computer Science, The Pennsylvania State University, University Park, PA, USA.
  • Christine Hehnly
    College of Medicine, the Pennsylvania State University, University Park, PA 16801, United States of America.
  • Edith Mbabazi-Kabachelor
    The CURE Children's Hospital of Uganda, Uganda.
  • Ronnie Mulondo
    CURE Children's Hospital of Uganda, Mbale, Uganda.
  • Brian Nsubuga Kaaya
    CURE Children's Hospital of Uganda, Mbale, Uganda.
  • James R Broach
    College of Medicine, the Pennsylvania State University, University Park, PA 16801, United States of America.
  • Steven J Schiff
    Center for Neural Engineering, Department of Engineering Science and Mechanics, The Pennsylvania State University, University Park, PA, USA; Departments of Neurosurgery, and Physics, The Pennsylvania State University, University Park, PA, USA. Electronic address: steven.j.schiff@gmail.com.
  • Vishal Monga