Abstract
OBJECTIVE: To develop deep learning (DL) models applied to neonatal cranial ultrasound (CUS) and clinical variables to predict neurodevelopmental impairment (NDI) in very preterm infants (VPIs) at 3 years of corrected age. PATIENTS AND METHODS: This is a retrospective study of a cohort of VPI (22(0)-30(6) weeks' gestation) born between 2004 and 2016 in Nova Scotia, Canada. Clinical data at hospital discharge and CUS images at 3 time points were used to develop DL models using elastic net (EN) and convolutional neural network (CNN). The models' performances were compared using precision recall area under the curve (PR-AUC) and area under the receiver operation characteristic curve (ROC-AUC) with their 95% ci. RESULTS: Of 665 eligible VPIs, 619 (93%) infants with 4184 CUS images were included. The CNN model combining CUS and clinical variables reported better performance (PR-AUC, 0.75; 95% CI, 072-0.79; ROC-AUC, 0.71; 95% CI, 0.67-0.74) in the prediction of positive NDI outcome compared with the traditional models based solely on clinical predictors (PR-AUC, 0.60; 95% CI, 0.52-0.68; ROC-AUC, 0.72; 95% CI, 0.68-0.75). When analyzed by the CUS plane and acquisition time point, the model using the anterior coronal plane at 6 weeks of age provided the highest predictive accuracy (PR-AUC, 0.81; 95% CI, 0.77-0.91; ROC-AUC, 0.78; 95% CI, 0.66-0.87). CONCLUSION: We developed and internally validated a DL prognostic model using CUS and clinical predictors to predict NDI in VPIs at 3 years of age. Early and accurate identification of infants at risk for NDI enables referral to targeted interventions, which improves functional outcomes.