Enhancing Acute Bilirubin Encephalopathy Diagnosis with Multi-Modal MRI: A Deep Learning Approach
Source abstract
Abstract
Background: Acute Bilirubin Encephalopathy (ABE) is a major cause of infant mortality and disability, making early detection and treatment essential to prevent further progression and complications. Methods: To enhance the diagnostic capabilities of multi-modal Magnetic Resonance Imaging (MRI) for ABE, we proposed a deep learning model integrating an attention module (AM) with a central network (CentralNet). This model was tested on MRI data from 145 newborns diagnosed with ABE and 140 non-ABE newborns, utilizing both T1-weighted and T2-weighted images. Results: The findings indicated the following: (1) In single-modality experiments, the inclusion of AM significantly improved all the performance metrics compared to the models without AM. Specifically, for T1-weighted MRI, the accuracy was 0.639 ± 0.04, AUC was 0.682 ± 0.037, and sensitivity was 0.688 ± 0.09. For the T2-weighted images, the accuracy was 0.738 ± 0.039 and the AUC was 0.796 ± 0.025. (2) In multi-modal experiments, using T1 + T2 images, our model achieved the best accuracy of 0.845 ± 0.018, AUC of 0.913 ± 0.02, and sensitivity of 0.954 ± 0.069, compared to models without an AM and CentralNet. The specificity remained relatively stable, while the precision and F1 scores significantly increased, reaching 0.792 ± 0.048 and 0.862 ± 0.017, respectively. Conclusions: This study emphasizes the effectiveness of combining attention modules with CentralNet, significantly enhancing the accuracy of multi-modal MRI in classifying ABE. It presents a new perspective and possibility for the clinical application of multi-modal MRI imaging in the diagnosis of ABE.
Source: crossref · Quality: baseline
Research context
OpenAlex topics: Neonatal Health and Biochemistry · Heme Oxygenase-1 and Carbon Monoxide · Neurological and metabolic disorders
SciVX discovery tags are terminology-based. OpenAlex topics are source-provided classifications.
Affiliations
Key Laboratory of Biomedical Engineering of Ministry of Education, Zhejiang University, Hangzhou 310027, China
Funding
Wuxi Health Commission Precision Medicine Key Projects and Funding · Shanxi Provincial Natural Science Basic Research Program
References (34)
Show source-provided references
1. American Academy of Pediatrics Subcommittee on Hyperbilirubinemia (2004). Management of Hyperbilirubinemia in the Newborn Infant 35 or More Weeks of Gestation. Pediatrics, 114, 297–316.10.1542/peds.114.1.297 ↗
2. Olusanya, B.O., Osibanjo, F.B., and Slusher, T.M. (2015). Risk factors for severe neonatal hyperbilirubinemia in low and middle-income countries: A systematic review and meta-analysis. PLoS ONE, 10.10.1371/journal.pone.0117229 ↗
3. Neonatal jaundice: Aetiology, diagnosis and treatment10.12968/hmed.2017.78.12.699 ↗
4. Blood–Brain Barrier and Bilirubin: Clinical Aspects and Experimental Data10.1016/j.arcmed.2014.11.015 ↗
5. Polin, R.A., and Perlman, J.M. (2008). Neonatology: Questions and Controversies Series: Neurology, W.B. Saunders.
6. The Late Clinical Syndrome of Posticteric Encephalopathy10.1016/S0031-3955(16)30979-8 ↗
7. Risk factors for neurotoxicity in newborns with severe neonatal hyperbilirubinemia10.1542/peds.2011-0206 ↗
8. A clinical prediction rule for acute bilirubin encephalopathy in neonates with extreme hyperbilirubinemia: A retrospective cohort study10.1097/MD.0000000000019364 ↗
9. Bilirubin Induced Encephalopathy
10. Changes in the globus pallidus in chronic kernicterus10.4103/1817-1745.57333 ↗
11. Magnetic resonance imaging of bilirubin encephalopathy: Current limitations and future promise10.1053/j.semperi.2014.08.005 ↗
12. Classification of brain tumours in MR images using deep spatiospatial models10.1038/s41598-022-05572-6 ↗
13. Hyperintense globus pallidus on T1-weighted MR imaging in acute kernicterus: Is it common or rare?10.1007/s00330-004-2502-2 ↗
14. Globus pallidus/putamen T1WI signal intensity ratio in grading and predicting prognosis of neonatal acute bilirubin encephalopathy10.3389/fped.2023.1192126 ↗
15. Acute bilirubin encephalopathy and its progression to kernicterus: Current perspectives
16. Kernicterus with abnormal high-signal changes bilaterally in the globus pallidus: A case report
17. The application of magnetic resonance imaging and diffusion-weighted imaging in the diagnosis of hypoxic-ischemic encephalopathy and kernicterus in premature infants10.21037/tp-21-128 ↗
18. Diffusion-weighted imaging of patients with neonatal bilirubin encephalopathy10.1007/s11604-012-0166-4 ↗
19. Imaging of nerve injury in neonatal acute bilirubin encephalopathy using 1H-MRS and Glu-CEST techniques10.3389/fnins.2023.1110349 ↗
20. Brain magnetic resonance imaging and magnetic resonance spectroscopy findings of children with kernicterus10.12659/PJR.892643 ↗
21. Machine Learning Assisted MRI Characterization for Diagnosis of Neonatal Acute Bilirubin Encephalopathy10.3389/fneur.2019.01018 ↗
22. Detecting acute bilirubin encephalopathy in neonates based on multimodal MRI with deep learning10.1038/s41390-021-01560-0 ↗
23. Zhang, H., and Wang, Z. (2022, January 20–22). Feature Fused Attention Network for Acute Bilirubin Encephalopathy Classification. Proceedings of the 2022 7th International Conference on Signal and Image Processing (ICSIP), Suzhou, China.10.1109/ICSIP55141.2022.9886999 ↗
24. Vielzeuf, V., Lechervy, A., Pateux, S., and Jurie, F. (2018, January 8–14). Centralnet: A multilayer approach for multimodal fusion. Proceedings of the European Conference on Computer Vision (ECCV) Workshops, Munich, Germany.10.1007/978-3-030-11024-6_44 ↗
25. Brazelton, T.B., and Nugent, J.K. (1995). Neonatal Behavioral Assessment Scale, Cambridge University Press.
26. Neurological evaluation of the maturity of newborn infants10.1136/adc.43.227.89 ↗
27. SynthStrip: Skull-stripping for any brain image10.1016/j.neuroimage.2022.119474 ↗
28. Woo, S., Park, J., Lee, J.-Y., and Kweon, I.S. (2018, January 8–14). Cbam: Convolutional block attention module. Proceedings of the European Conference on Computer Vision (ECCV), Munich, Germany.10.1007/978-3-030-01234-2_1 ↗
29. Das, S., and van Landeghem, F.K.H. (2019). Clinicopathological Spectrum of Bilirubin Encephalopathy/Kernicterus. Diagnostics, 9.10.3390/diagnostics9010024 ↗
30. Changes in globus pallidus with (pre)term kernicterus10.1542/peds.112.6.1256 ↗
31. Usefulness of (1) H-MRS in differentiating bilirubin encephalopathy from severe hyperbilirubinemia in neonates10.1002/jmri.23995 ↗
32. Magnetic resonance spectroscopy and auditory brain-stem response audiometry as predictors of bilirubin-induced neurologic dysfunction in full-term jaundiced neonates10.1007/s00431-023-05246-z ↗
33. Dosovitskiy, A., Beyer, L., Kolesnikov, A., Weissenborn, D., Zhai, X., Unterthiner, T., Dehghani, M., Minderer, M., Heigold, G., and Gelly, S. (2020). An image is worth 16 × 16 words: Transformers for image recognition at scale. arXiv.
34. A survey on vision transformer10.1109/TPAMI.2022.3152247 ↗