Importance Artificial intelligence (AI) based on deep learning has shown promise in adult and pediatric populations in the interpretation of medical imaging to make important diagnostic and management recommendations. However, there has been little work developing new AI methods for neonatal populations.

Objective To develop a novel, deep contrastive learning model to predict a comprehensive set of pathologies from radiographs relevant to neonatal intensive care.

Design, Setting, and Participants We identified a retrospective cohort of infants who obtained a radiograph while admitted to a large neonatal intensive care unit in Boston, MA from January 2008 to December 2023. After collecting radiographs with corresponding reports and relevant demographics for all subjects, we randomized the cohort into three sets: training (80%), validation (10%), and test (10%).

Interventions We developed a deep learning model, NeoCLIP, to identify 15 unique pathologies and 5 medical devices relevant to neonatal intensive care on plain film radiographs. The pathologies were automatically extracted from radiology reports using a custom pipeline based on large language models.

Main Outcomes and Measures We compared the performance of our model, as defined by AUROC, against various baseline methods.

Results We identified 4,629 infants which were randomized into the training (3,731 infants), validation (419 infants), and test (479 infants) sets. In total, we collected 20,154 radiographs with a corresponding 15,795 reports. The AUROC of our model was greater than all baseline methods for every radiographic finding other than portal venous gas. The addition of demographics improved the AUROC of our model for all findings, but the difference was not statistically significant.

Conclusions and Relevance NeoCLIP successfully identified a broad set of pathologies and medical devices on neonatal radiographs, outperforming similar models developed for adult populations. This represents the first such application of advanced AI methodologies to interpret neonatal radiographs.

The authors have declared no competing interest.

Dr. Beam was funded by Chiesi USA, Inc for this study.

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The Beth Israel Deaconess Medical Center Committee on Clinical Investigations has determined that the referenced research project meets the criteria for exempt status under exempt category/categories: 4.

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↵* Denotes co-first authorship

↵** Denotes co-senior authorship

All data produced in the present study are available upon reasonable request to the authors.