U-Net-Based Prediction of Cerebrospinal Fluid Distribution and Ventricular Reflux Grading

Previous work indicates evidence that cerebrospinal fluid (CSF) plays a crucial role in brain waste clearance processes and that altered flow patterns are associated with various diseases of the central nervous system. In this study, we investigate the potential of deep learning to predict the distribution in human brain of a gadolinium-based CSF contrast agent (tracer) administered intrathecal. For this, T1-weighted magnetic resonance imaging (MRI) scans taken at multiple time points before and after injection were utilized. We propose a U-net-based supervised learning model to predict pixel-wise signal increase at its peak after 24 h. Performance is evaluated based on different tracer distribution stages provided during training, including predictions from baseline scans taken before injection. Our findings show that training with imaging data from only the first 2-h postinjection yields tracer flow predictions comparable to models trained with additional later-stage scans. Validation against ventricular reflux gradings from neuroradiologists confirmed alignment with expert evaluations. These results demonstrate that deep learning-based methods for CSF flow prediction deserve more attention, as minimizing MR imaging without compromising clinical analysis could enhance efficiency, improve patient well-being and lower healthcare costs.