Ultrasound-Based Phenotyping of Lateral Ventricles to Predict Hydrocephalus Outcome in Premature Neonates

IEEE Trans Biomed Eng. 2020 Nov;67(11):3026-3034. doi: 10.1109/TBME.2020.2974650. Epub 2020 Feb 18.

Abstract

Objective: Prediction of post-hemorrhagic hydrocephalus (PHH) outcome-i.e., whether it requires intervention or not-in premature neonates using cranial ultrasound (CUS) images is challenging. In this paper, we present a novel fully-automatic method to perform phenotyping of the brain lateral ventricles and predict PHH outcome from CUS.

Methods: Our method consists of two parts: ventricle quantification followed by prediction of PHH outcome. First, cranial bounding box and brain interhemispheric fissure are detected to determine the anatomical position of ventricles and correct the cranium rotation. Then, lateral ventricles are extracted using a new deep learning-based method by incorporating the convolutional neural network into a probabilistic atlas-based weighted loss function and an image-specific adaption. PHH outcome is predicted using a support vector machine classifier trained using ventricular morphological phenotypes and clinical information.

Results: Experiments demonstrated that our method achieves accurate ventricle segmentation results with an average Dice similarity coefficient of 0.86, as well as very good PHH outcome prediction with accuracy of 0.91.

Conclusion: Automatic CUS-based ventricular phenotyping in premature newborns could objectively and accurately predict the progression to severe PHH.

Significance: Early prediction of severe PHH development in premature newborns could potentially advance criteria for diagnosis and offer an opportunity for early interventions to improve outcome.

MeSH terms

  • Cerebral Hemorrhage / diagnostic imaging
  • Cerebral Ventricles / diagnostic imaging
  • Echoencephalography
  • Humans
  • Hydrocephalus* / diagnostic imaging
  • Infant, Newborn
  • Lateral Ventricles* / diagnostic imaging