{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,22]],"date-time":"2026-04-22T02:18:05Z","timestamp":1776824285574,"version":"3.51.2"},"reference-count":41,"publisher":"Public Library of Science (PLoS)","issue":"5","license":[{"start":{"date-parts":[[2025,5,23]],"date-time":"2025-05-23T00:00:00Z","timestamp":1747958400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100010269","name":"Wellcome Trust","doi-asserted-by":"publisher","award":["215010\/Z\/18\/Z"],"award-info":[{"award-number":["215010\/Z\/18\/Z"]}],"id":[{"id":"10.13039\/100010269","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100023312","name":"Wellcome EPSRC Centre for Medical Engineering","doi-asserted-by":"publisher","award":["203148\/Z\/16\/Z"],"award-info":[{"award-number":["203148\/Z\/16\/Z"]}],"id":[{"id":"10.13039\/501100023312","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100010269","name":"Wellcome Trust","doi-asserted-by":"publisher","award":["225167\/Z\/22\/Z"],"award-info":[{"award-number":["225167\/Z\/22\/Z"]}],"id":[{"id":"10.13039\/100010269","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100010269","name":"Wellcome Trust","doi-asserted-by":"publisher","award":["217650\/Z\/19\/Z"],"award-info":[{"award-number":["217650\/Z\/19\/Z"]}],"id":[{"id":"10.13039\/100010269","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100023312","name":"Wellcome EPSRC Centre for Medical Engineering","doi-asserted-by":"publisher","award":["EP\/T022205\/1"],"award-info":[{"award-number":["EP\/T022205\/1"]}],"id":[{"id":"10.13039\/501100023312","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS One"],"abstract":"<jats:sec id=\"sec021\">\n<jats:title>Introduction<\/jats:title>\n<jats:p><jats:italic>Tuberculous meningitis<\/jats:italic> (TBM) leads to high mortality, especially amongst individuals with HIV. Predicting the incidence of disease-related complications is challenging, for which purpose the value of brain magnetic resonance imaging (MRI) has not been well investigated. We used a convolutional neural network (CNN) to explore the complementary contribution of brain MRI to the conventional prognostic determinants.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec022\">\n<jats:title>Methods<\/jats:title>\n<jats:p>We pooled data from two randomised control trials of HIV-positive and HIV-negative adults with clinical TBM in Vietnam to predict the occurrence of death or new neurological complications in the first two months after the subject\u2019s first MRI session. We developed and compared three models: a logistic regression with clinical, demographic and laboratory data as reference, a CNN that utilised only T1-weighted MRI volumes, and a model that fused all available information. All models were fine-tuned using two repetitions of 5-fold cross-validation. The final evaluation was based on a random 70\/30 training\/test split, stratified by the outcome and HIV status. Based on the selected model, we explored the interpretability maps derived from the models.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec023\">\n<jats:title>Results<\/jats:title>\n<jats:p>215 patients were included, with an event prevalence of 22.3%. On the test set our non-imaging model had higher AUC (71.2% <jats:inline-formula id=\"pone.0321655.e001\"><jats:alternatives><jats:graphic xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" id=\"pone.0321655.e001g\" mimetype=\"image\" position=\"anchor\" xlink:href=\"info:doi\/10.1371\/journal.pone.0321655.e001\" xlink:type=\"simple\"\/><mml:math xmlns:mml=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" display=\"inline\" id=\"M1\"><mml:mrow><mml:mi>\u00b1<\/mml:mi><\/mml:mrow><\/mml:math><\/jats:alternatives><\/jats:inline-formula> 1.1%) than the imaging-only model (67.3% <jats:inline-formula id=\"pone.0321655.e002\"><jats:alternatives><jats:graphic xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" id=\"pone.0321655.e002g\" mimetype=\"image\" position=\"anchor\" xlink:href=\"info:doi\/10.1371\/journal.pone.0321655.e002\" xlink:type=\"simple\"\/><mml:math xmlns:mml=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" display=\"inline\" id=\"M2\"><mml:mrow><mml:mi>\u00b1<\/mml:mi><\/mml:mrow><\/mml:math><\/jats:alternatives><\/jats:inline-formula> 2.6%). The fused model was superior to both, with an average AUC = 77.3% <jats:inline-formula id=\"pone.0321655.e003\"><jats:alternatives><jats:graphic xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" id=\"pone.0321655.e003g\" mimetype=\"image\" position=\"anchor\" xlink:href=\"info:doi\/10.1371\/journal.pone.0321655.e003\" xlink:type=\"simple\"\/><mml:math xmlns:mml=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" display=\"inline\" id=\"M3\"><mml:mrow><mml:mi>\u00b1<\/mml:mi><\/mml:mrow><\/mml:math><\/jats:alternatives><\/jats:inline-formula> 4.0% in the test set. The non-imaging variables were more informative in the HIV-positive group, while the imaging features were more predictive in the HIV-negative group. All three models performed better in the HIV-negative cohort. The interpretability maps show the model\u2019s focus on the lateral fissures, the corpus callosum, the midbrain, and peri-ventricular tissues.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec024\">\n<jats:title>Conclusion<\/jats:title>\n<jats:p>Imaging information can provide added value to predict unwanted outcomes of TBM. However, to confirm this finding, a larger dataset is needed.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0321655","type":"journal-article","created":{"date-parts":[[2025,5,23]],"date-time":"2025-05-23T17:38:04Z","timestamp":1748021884000},"page":"e0321655","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":2,"title":["Convolutional neural network using magnetic resonance brain imaging to predict outcome from tuberculosis meningitis"],"prefix":"10.1371","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4281-4929","authenticated-orcid":true,"given":"Trinh Huu Khanh","family":"Dong","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Liane 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