Automatic quantification of ischemic injury on diffusion-weighted MRI of neonatal hypoxic ischemic encephalopathy.
A fully automatic method for detection and quantification of ischemic lesions in diffusion-weighted MR images of neonatal hypoxic ischemic encephalopathy (HIE) is presented. Ischemic lesions are manually segmented by two independent observers in 1.5 T data from 20 subjects and an automatic algorithm using a random forest classifier is developed and trained on the annotations of observer 1. The algorithm obtains a median sensitivity and specificity of 0.72 and 0.99 respectively. F1-scores are calculated per subject for algorithm performance (median = 0.52) and observer 2 performance (median = 0.56). A paired t-test on the F1-scores shows no statistical difference between the algorithm and observer 2 performances. The method is applied to a larger dataset including 54 additional subjects scanned at both 1.5 T and 3.0 T. The algorithm findings are shown to correspond well with the injury pattern noted by clinicians in both 1.5 T and 3.0 T data and to have a strong relationship with outcome. The results of the automatic method are condensed to a single score for each subject which has significant correlation with an MR score assigned by experienced clinicians (p < 0.0001). This work represents a quantitative method of evaluating diffusion-weighted MR images in neonatal HIE and a first step in the development of an automatic system for more in-depth analysis and prognostication.
Irish Centre for Fetal and Neonatal Translational Research, Dept. of Paediatrics and Child Health, University College Cork, Cork, Ireland.
Keelin
K
Murphy
Dept of Neonatology, Wilhelmina Children's Hospital, University Medical Center, Utrecht, The Netherlands.
Niek E
NE
van der Aa
Dept of Neonatology, Wilhelmina Children's Hospital, University Medical Center, Utrecht, The Netherlands; Dept of Molecular and Developmental Medicine, University of Siena, Italy.
Simona
S
Negro
Dept of Neonatology, Wilhelmina Children's Hospital, University Medical Center, Utrecht, The Netherlands.
Floris
F
Groenendaal
Dept of Neonatology, Wilhelmina Children's Hospital, University Medical Center, Utrecht, The Netherlands.
Linda S
LS
de Vries
Image Sciences Institute, University Medical Center, Utrecht, The Netherlands.
Max A
MA
Viergever
Irish Centre for Fetal and Neonatal Translational Research, Dept. of Paediatrics and Child Health, University College Cork, Cork, Ireland.
Geraldine B
GB
Boylan
Dept of Neonatology, Wilhelmina Children's Hospital, University Medical Center, Utrecht, The Netherlands.
Manon J N L
MJ
Benders
Image Sciences Institute, University Medical Center, Utrecht, The Netherlands.
Ivana
I
Išgum
D000465:Algorithms; D001921:Brain / Q000000981:diagnostic imaging*; D002545:Brain Ischemia / Q000000981:diagnostic imaging*; D001931:Brain Mapping; D015331:Cohort Studies; D038524:Diffusion Magnetic Resonance Imaging / Q000379:methods*; D005189:False Positive Reactions; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D007231:Infant, Newborn; D008297:Male
Automatic quantification; Diffusion-weighted lesions; HIE; MRI; Neonatal hypoxic ischemic encephalopathy; Segmentation