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Zhuang X, Jin K, Lin H, Li J, Yin Y, Dong X. Can radiomics be used to detect hypoxic-ischemic encephalopathy in neonates without magnetic resonance imaging abnormalities? Pediatr Radiol 2023; 53:1927-1940. [PMID: 37183229 PMCID: PMC10421781 DOI: 10.1007/s00247-023-05680-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Revised: 04/12/2023] [Accepted: 04/13/2023] [Indexed: 05/16/2023]
Abstract
BACKGROUND No study has assessed normal magnetic resonance imaging (MRI) findings to predict potential brain injury in neonates with hypoxic-ischemic encephalopathy (HIE). OBJECTIVE We aimed to evaluate the efficacy of MRI-based radiomics models of the basal ganglia, thalami and deep medullary veins to differentiate between HIE and the absence of MRI abnormalities in neonates. MATERIALS AND METHODS In this study, we included 38 full-term neonates with HIE and normal MRI findings and 89 normal neonates. Radiomics features were extracted from T1-weighted images, T2-weighted images, diffusion-weighted imaging and susceptibility-weighted imaging (SWI). The different models were evaluated using receiver operating characteristic curve analysis. Clinical utility was evaluated using decision curve analysis. RESULTS The SWI model exhibited the best performance among the seven single-sequence models. For the training and validation cohorts, the area under the curves (AUCs) of the SWI model were 1.00 and 0.98, respectively. The combined nomogram model incorporating SWI Rad-scores and independent predictors of clinical characteristics was not able to distinguish HIE in patients without MRI abnormalities from the control group (AUC, 1.00). A high degree of fitting and favorable clinical utility was detected using the calibration curve with the Hosmer-Lemeshow test. Decision curve analysis was used for the SWI, clinical and combined nomogram models. The decision curve showed that the SWI and combined nomogram models had better predictive performance than the clinical model. CONCLUSIONS HIE can be detected in patients without MRI abnormalities using an MRI-based radiomics model. The SWI model performed better than the other models.
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Affiliation(s)
- Xiamei Zhuang
- Department of Radiology, Hunan Children's Hospital, 86 Ziyuan Road, Yuhua District, Changsha, 410007, China
| | - Ke Jin
- Department of Radiology, Hunan Children's Hospital, 86 Ziyuan Road, Yuhua District, Changsha, 410007, China.
| | - Huashan Lin
- Department of Pharmaceutical Diagnosis, GE Healthcare, Changsha, 410005, China
| | - Junwei Li
- Department of Radiology, Hunan Children's Hospital, 86 Ziyuan Road, Yuhua District, Changsha, 410007, China
| | - Yan Yin
- Department of Radiology, Hunan Children's Hospital, 86 Ziyuan Road, Yuhua District, Changsha, 410007, China
| | - Xiao Dong
- Department of Radiology, Hunan Children's Hospital, 86 Ziyuan Road, Yuhua District, Changsha, 410007, China
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Tian T, Gan T, Chen J, Lu J, Zhang G, Zhou Y, Li J, Shao H, Liu Y, Zhu H, Wu D, Jiang C, Shao J, Shi J, Yang W, Zhu W. Graphic Intelligent Diagnosis of Hypoxic-Ischemic Encephalopathy Using MRI-Based Deep Learning Model. Neonatology 2023; 120:441-449. [PMID: 37231912 DOI: 10.1159/000530352] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Accepted: 03/20/2023] [Indexed: 05/27/2023]
Abstract
INTRODUCTION Heterogeneous MRI manifestations restrict the efficiency and consistency of neuroradiologists in diagnosing hypoxic-ischemic encephalopathy (HIE) due to complex injury patterns. This study aimed to develop and validate an intelligent HIE identification model (termed as DLCRN, deep learning clinical-radiomics nomogram) based on conventional structural MRI and clinical characteristics. METHODS In this retrospective case-control study, full-term neonates with HIE and healthy controls were collected in two different medical centers from January 2015 to December 2020. Multivariable logistic regression analysis was implemented to establish the DLCRN model based on conventional MRI sequences and clinical characteristics. Discrimination, calibration, and clinical applicability were used to evaluate the model in the training and validation cohorts. Grad-class activation map algorithm was implemented to visualize the DLCRN. RESULTS 186 HIE patients and 219 healthy controls were assigned to the training, internal validation, and independent validation cohorts. Birthweight was incorporated with deep radiomics signatures to create the final DLCRN model. The DLCRN model achieved better discriminatory power than simple radiomics models, with an area under the curve (AUC) of 0.868, 0.813, and 0.798 in the training, internal validation, and independent validation cohorts, respectively. The DLCRN model was well calibrated and has clinical potential. Visualization of the DLCRN highlighted the lesion areas that conformed to radiological identification. CONCLUSION Visualized DLCRN may be a useful tool in the objective and quantitative identification of HIE. Scientific application of the optimized DLCRN model may save time for screening early mild HIE, improve the consistency of HIE diagnosis, and guide timely clinical management.
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Affiliation(s)
- Tian Tian
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Tongjia Gan
- Medical Imaging Center, Wuhan Children's Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | | | - Jun Lu
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Department of CT and MRI, The First Affiliated Hospital, College of Medicine, Shihezi University, Shihezi, China
| | - Guiling Zhang
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yiran Zhou
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Jia Li
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Haoyue Shao
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yufei Liu
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Hongquan Zhu
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Di Wu
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Chengcheng Jiang
- Department of Radiology, Maternal and Child Health Hospital of Hubei Province, Wuhan, China
| | - Jianbo Shao
- Medical Imaging Center, Wuhan Children's Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Jingjing Shi
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Wenzhong Yang
- Department of Radiology, Maternal and Child Health Hospital of Hubei Province, Wuhan, China
| | - Wenzhen Zhu
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
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Zhuang X, Lin H, Li J, Yin Y, Dong X, Jin K. Radiomics based of deep medullary veins on susceptibility-weighted imaging in infants: predicting the severity of brain injury of neonates with perinatal asphyxia. Eur J Med Res 2023; 28:9. [PMID: 36609425 PMCID: PMC9817267 DOI: 10.1186/s40001-022-00954-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Accepted: 12/14/2022] [Indexed: 01/09/2023] Open
Abstract
OBJECTIVE This study aimed to apply radiomics analysis of the change of deep medullary veins (DMV) on susceptibility-weighted imaging (SWI), and to distinguish mild hypoxic-ischemic encephalopathy (HIE) from moderate-to-severe HIE in neonates. METHODS A total of 190 neonates with HIE (24 mild HIE and 166 moderate-to-severe HIE) were included in this study. All of them were born at 37 gestational weeks or later. The DMVs were manually included in the regions of interest (ROI). For the purpose of identifying optimal radiomics features and to construct Rad-scores, 1316 features were extracted. LASSO regression was used to identify the optimal radiomics features. Using the Red-score and the clinical independent factor, a nomogram was constructed. In order to evaluate the performance of the different models, receiver operating characteristic (ROC) curve analysis was applied. Decision curve analysis (DCA) was implemented to evaluate the clinical utility. RESULTS A total of 15 potential predictors were selected and contributed to Red-score construction. Compared with the radiomics model, the nomogram combined model incorporating Red-score and urea nitrogen did not better distinguish between the mild HIE and moderate-to-severe HIE group. For the training cohort, the AUC of the radiomics model and the combined nomogram model was 0.84 and 0.84. For the validation cohort, the AUC of the radiomics model and the combined nomogram model was 0.80 and 0.79, respectively. The addition of clinical characteristics to the nomogram failed to distinguish mild HIE from moderate-to-severe HIE group. CONCLUSION We developed a radiomics model and combined nomogram model as an indicator to distinguish mild HIE from moderate-to-severe HIE group.
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Affiliation(s)
- Xiamei Zhuang
- grid.440223.30000 0004 1772 5147Department of Radiology, Hunan Children’s Hospital, 86 Ziyuan Road, Yuhua District, Changsha, China
| | - Huashan Lin
- Department of Pharmaceutical Diagnosis, GE Healthcare, Changsha, 410005 China
| | - Junwei Li
- grid.440223.30000 0004 1772 5147Department of Radiology, Hunan Children’s Hospital, 86 Ziyuan Road, Yuhua District, Changsha, China
| | - Yan Yin
- grid.440223.30000 0004 1772 5147Department of Radiology, Hunan Children’s Hospital, 86 Ziyuan Road, Yuhua District, Changsha, China
| | - Xiao Dong
- grid.440223.30000 0004 1772 5147Department of Radiology, Hunan Children’s Hospital, 86 Ziyuan Road, Yuhua District, Changsha, China
| | - Ke Jin
- grid.440223.30000 0004 1772 5147Department of Radiology, Hunan Children’s Hospital, 86 Ziyuan Road, Yuhua District, Changsha, China
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