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Automated assessment of neonatal internal capsule maturation on T2-weighted MRI across 7T and 3T

Casella, C.; Uus, A.; Dedominicis, L.; Willers Moore, J.; Clayden, B.; Galanides, E.; Bridgen, P.; Di Cio, P.; Tomazinho, I.; Da Costa, C.; Gallo, D.; Arulkumaran, S.; Deprez, M.; Counsell, S. J.; Edwards, A. D.; Hajnal, J. V.; O'Muircheartaigh, J.; Rutherford, M. A.; Malik, S.; Arichi, T.

2026-06-03 radiology and imaging
10.64898/2026.06.02.26354741 medRxiv
Show abstract

Motivation: Quantitative assessment of neonatal internal capsule (IC) maturation remains largely reliant on qual- itative visual evaluation, limiting objectivity and scalability. Approach: We developed a fully automated 3D deep learning framework for anatomically detailed segmentation of IC subregions and PLIC myelin-related signal from structural T2-weighted MRI, trained on both high-resolution 7T and conventional 3T neonatal datasets. Volumetric and intensity-based metrics were derived, and developmental trajectories were modelled using postmenstrual age (PMA) and postnatal age (PNA), with normative modelling used to quantify individual deviations. Results: The pipeline achieved high segmentation accuracy across field strengths (Dice > 0.95, relative volume difference < 5%). IC metrics showed robust age-related changes, with volumetric measures increasing and intensity- based measures decreasing with PMA. PNA effects indicated prematurity-related modulation at equivalent maturational age. These patterns generalized to 3T, where normative modelling revealed significant deviations in preterm infants, particularly for myelin-related intensity measures. Conclusion: Structural T2-weighted MRI, combined with anatomically informed segmentation, enables quantitative and biologically meaningful assessment of neonatal IC maturation. This provides a scalable framework for studying early white matter development and supports potential clinical translation.

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