Two-Dimensional Image-Based Screening Tool for Infants with Positional Cranial Deformities: A Machine Learning Approach.

Cecilia A. Callejas Pastor,Yunseo Ku,Il-Young Jung,Jayoung Choi,Shinhye Seo,Soon Bin Kwon

doi:10.3390/diagnostics10070495

Cecilia A. Callejas Pastor, Yunseo Ku + Show 4 more

Open Access

https://doi.org/10.3390/diagnostics10070495

Copy DOI

Abstract

Positional cranial deformities are relatively common conditions, characterized by asymmetry and changes in skull shape. Although three-dimensional (3D) scanning is the gold standard for diagnosing such deformities, it requires expensive laser scanners and skilled maneuvering. We therefore developed an inexpensive, fast, and convenient screening method to classify cranial deformities in infants, based on single two-dimensional vertex cranial images. In total, 174 measurements from 80 subjects were recorded. Our screening software performs image processing and machine learning-based estimation related to the deformity indices of the cranial ratio (CR) and cranial vault asymmetry index (CVAI) to determine the severity levels of brachycephaly and plagiocephaly. For performance evaluations, the estimated CR and CVAI values were compared to the reference data obtained using a 3D cranial scanner. The CR and CVAI correlation coefficients obtained via support vector regression were 0.85 and 0.89, respectively. When the trained model was evaluated using the unseen test data for the three CR and three CVAI classes, an 86.7% classification accuracy of the proposed method was obtained for both brachycephaly and plagiocephaly. The results showed that our method for screening cranial deformities in infants could aid clinical evaluations and parental monitoring of the progression of deformities at home.

Highlights

Positional cranial deformities occur when an external force or pressure produces asymmetry and flattening of the shape of the skull
We aimed to develop a novel screening tool for evaluating the level of brachycephaly and plagiocephaly that can support a physician’s assessment procedure in the clinic as well as the monitoring conducted by parents at home
We proposed a simple screening method that required only 2D cranial images to assess cranial deformities

Summary

Introduction

Positional cranial deformities occur when an external force or pressure produces asymmetry and flattening of the shape of the skull. A marked increase in the incidence of positional cranial deformities was noted after the “Back to Sleep” campaign that was designed to identify these incidents and prevent sudden infant deaths. Currently, positional cranial deformity is a relatively common problem faced by parents and physicians. In the first few months, cranial deformities in infants have more prevalence on the occipital bone, manifested as unilateral or bilateral flattening [1,2]. According to a prior study, the prevalence of positional skull deformities at the age of 6 weeks is 16%. Decreases to 3.3% by the age of 24 months [3]

Objectives

Methods

Conclusion