RESUMEN
OBJECTIVES: We aimed to evaluate the ability of feed-forward neural networks (fNNs) to predict the neurodevelopmental outcome (NDO) of very preterm neonates (VPIs) at 12 months corrected age by using biomarkers of cerebral MR proton spectroscopy (1H-MRS) and diffusion tensor imaging (DTI) at term-equivalent age (TEA). METHODS: In this prospective study, 300 VPIs born before 32 gestational weeks received an MRI scan at TEA between September 2013 and December 2017. Due to missing or poor-quality spectroscopy data and missing neurodevelopmental tests, 173 VPIs were excluded. Data sets consisting of 103 and 115 VPIs were considered for prediction of motor and cognitive developmental delay, respectively. Five metabolite ratios and two DTI characteristics in six different areas of the brain were evaluated. A feature selection algorithm was developed for receiving a subset of characteristics prevalent for the VPIs with a developmental delay. Finally, the predictors were constructed employing multiple fNNs and fourfold cross-validation. RESULTS: By employing the constructed fNN predictors, we were able to predict cognitive delays of VPIs with 85.7% sensitivity, 100% specificity, 100% positive predictive value (PPV) and 99.1% negative predictive value (NPV). For the prediction of motor delay, we achieved a sensitivity of 76.9%, a specificity of 98.9%, a PPV of 90.9% and an NPV of 96.7%. CONCLUSION: FNNs might be able to predict motor and cognitive development of VPIs at 12 months corrected age when employing biomarkers of cerebral 1H-MRS and DTI quantified at TEA. KEY POINTS: ⢠A feed-forward neuronal network is a promising tool for outcome prediction in premature infants. ⢠Cerebral proton magnetic resonance spectroscopy and diffusion tensor imaging can be used for the construction of early prognostic biomarkers. ⢠Premature infants that would most benefit from early intervention services can be spotted at the time of optimal neuroplasticity.
Asunto(s)
Encéfalo/diagnóstico por imagen , Discapacidades del Desarrollo/diagnóstico , Imagen de Difusión Tensora/métodos , Interpretación de Imagen Asistida por Computador/métodos , Enfermedades del Prematuro/diagnóstico , Espectroscopía de Resonancia Magnética/métodos , Redes Neurales de la Computación , Encéfalo/fisiopatología , Discapacidades del Desarrollo/fisiopatología , Femenino , Humanos , Lactante , Recién Nacido , Recien Nacido Prematuro , Enfermedades del Prematuro/fisiopatología , Masculino , Valor Predictivo de las Pruebas , Pronóstico , Estudios Prospectivos , Sensibilidad y EspecificidadRESUMEN
In this paper we present a new scheme of a kernel-based regularization learning algorithm, in which the kernel and the regularization parameter are adaptively chosen on the base of previous experience with similar learning tasks. The construction of such a scheme is motivated by the problem of prediction of the blood glucose levels of diabetic patients. We describe how the proposed scheme can be used for this problem and report the results of the tests with real clinical data as well as comparing them with existing literature.