Can deep learning classify cerebral ultrasound images for the detection of brain injury in very preterm infants?

ObjectivesCerebral ultrasound (CUS) is the main imaging screening tool in preterm infants. The aim of this work is to develop deep learning (DL) models that classify normal vs abnormal CUS to serve as a computer-aided detection tool providing timely interpretation of the scans.MethodsA population-based cohort of very preterm infants (220-306 weeks) born between 2004 and 2016 in Nova Scotia, Canada. A set of nine sequential CUS images per infant was retrieved at three specific coronal landmarks at three pre-identified times (first, sixth weeks, and term age). A radiologist manually labeled each image as normal or abnormal. The dataset was split into training/development/test subsets (80:10:10). Different convolutional neural networks were tested, with filtering of the most uncertain prediction. The model's performance was assessed using precision/recall and the receiver operating area under the curve.ResultsSequential CUS retrieved for 538/665 babies (81% of the cohort). Four thousand one hundred eighty images were used to develop and test the model. The model performance was only discrete at the beginning but, through different machine learning strategies was boosted to good levels averaging 0.86 ROC AUC (95% CI: 0.82, 0.90) and 0.87 PR AUC (95% CI: 0.84, 0.90) (model uncertainty estimation filters using normalized entropy threshold = 0.5).ConclusionThis study offers proof of the feasibility of applying DL to CUS. This basic diagnostic model showed good discriminative ability to classify normal versus abnormal CUS. This serves as a CAD and a framework for constructing a prognostic model.Clinical relevance statementThis DL model can serve as a computer-aided detection tool to classify CUS of very preterm babies as either normal or abnormal. This model will also be used as a framework to develop a prognostic model.Key Points...