Assessing clinical progression from subjective cognitive decline to mild cognitive impairment with incomplete multi-modal neuroimages

MGIML: Cancer Grading With Incomplete Radiology-Pathology Data via Memory Learning and Gradient Homogenization

Taking advantage of multi-modal radiology-pathology data with complementary clinical information for cancer grading is helpful for doctors to improve diagnosis efficiency and accuracy. However, radiology and pathology data have distinct acquisition difficulties and costs, which leads to incomplete-modality data being common in applications. In this work, we propose a Memory- and Gradient-guided Incomplete Modal-modal Learning (MGIML) framework for cancer grading with incomplete radiology-pathology data. Firstly, to remedy missing-modality information, we propose a Memory-driven Hetero-modality Complement (MH-Complete) scheme, which constructs modal-specific memory banks constrained by a coarse-grained memory boosting (CMB) loss to record generic radiology and pathology feature patterns, and develops a cross-modal memory reading strategy enhanced by a fine-grained memory consistency (FMC) loss to take missing-modality information from well-stored memories. Secondly, as gradient conflicts exist between missing-modality situations, we propose a Rotation-driven Gradient Homogenization (RG-Homogenize) scheme, which estimates instance-specific rotation matrices to smoothly change the feature-level gradient directions, and computes confidence-guided homogenization weights to dynamically balance gradient magnitudes. By simultaneously mitigating gradient direction and magnitude conflicts, this scheme well avoids the negative transfer and optimization imbalance problems. Extensive experiments on CPTAC-UCEC and CPTAC-PDA datasets show that the proposed MGIML framework performs favorably against state-of-the-art multi-modal methods on missing-modality situations.

Triplet-constrained deep hashing for chest X-ray image retrieval in COVID-19 assessment

Radiology images of the chest, such as computer tomography scans and X-rays, have been prominently used in computer-aided COVID-19 analysis. Learning-based radiology image retrieval has attracted increasing attention recently, which generally involves image feature extraction and finding matches in extensive image databases based on query images. Many deep hashing methods have been developed for chest radiology image search due to the high efficiency of retrieval using hash codes. However, they often overlook the complex triple associations between images; that is, images belonging to the same category tend to share similar characteristics and vice versa. To this end, we develop a triplet-constrained deep hashing (TCDH) framework for chest radiology image retrieval to facilitate automated analysis of COVID-19. The TCDH consists of two phases, including (a) feature extraction and (b) image retrieval. For feature extraction, we have introduced a triplet constraint and an image reconstruction task to enhance discriminative ability of learned features, and these features are then converted into binary hash codes to capture semantic information. Specifically, the triplet constraint is designed to pull closer samples within the same category and push apart samples from different categories. Additionally, an auxiliary image reconstruction task is employed during feature extraction to help effectively capture anatomical structures of images. For image retrieval, we utilize learned hash codes to conduct searches for medical images. Extensive experiments on 30,386 chest X-ray images demonstrate the superiority of the proposed method over several state-of-the-art approaches in automated image search. The code is now available online.

Joint learning framework of cross-modal synthesis and diagnosis for Alzheimer's disease by mining underlying shared modality information

Alzheimer's disease (AD) is one of the most common neurodegenerative disorders presenting irreversible progression of cognitive impairment. How to identify AD as early as possible is critical for intervention with potential preventive measures. Among various neuroimaging modalities used to diagnose AD, functional positron emission tomography (PET) has higher sensitivity than structural magnetic resonance imaging (MRI), but it is also costlier and often not available in many hospitals. How to leverage massive unpaired unlabeled PET to improve the diagnosis performance of AD from MRI becomes rather important. To address this challenge, this paper proposes a novel joint learning framework of unsupervised cross-modal synthesis and AD diagnosis by mining underlying shared modality information, improving the AD diagnosis from MRI while synthesizing more discriminative PET images. We mine underlying shared modality information in two aspects: diversifying modality information through the cross-modal synthesis network and locating critical diagnosis-related patterns through the AD diagnosis network. First, to diversify the modality information, we propose a novel unsupervised cross-modal synthesis network, which implements the inter-conversion between 3D PET and MRI in a single model modulated by the AdaIN module. Second, to locate shared critical diagnosis-related patterns, we propose an interpretable diagnosis network based on fully 2D convolutions, which takes either 3D synthesized PET or original MRI as input. Extensive experimental results on the ADNI dataset show that our framework can synthesize more realistic images, outperform the state-of-the-art AD diagnosis methods, and have better generalization on external AIBL and NACC datasets.

GMRLNet: A Graph-Based Manifold Regularization Learning Framework for Placental Insufficiency Diagnosis on Incomplete Multimodal Ultrasound Data

Multimodal analysis of placental ultrasound (US) and microflow imaging (MFI) could greatly aid in the early diagnosis and interventional treatment of placental insufficiency (PI), ensuring a normal pregnancy. Existing multimodal analysis methods have weaknesses in multimodal feature representation and modal knowledge definitions and fail on incomplete datasets with unpaired multimodal samples. To address these challenges and efficiently leverage the incomplete multimodal dataset for accurate PI diagnosis, we propose a novel graph-based manifold regularization learning (MRL) framework named GMRLNet. It takes US and MFI images as input and exploits their modality-shared and modality-specific information for optimal multimodal feature representation. Specifically, a graph convolutional-based shared and specific transfer network (GSSTN) is designed to explore intra-modal feature associations, thus decoupling each modal input into interpretable shared and specific spaces. For unimodal knowledge definitions, graph-based manifold knowledge is introduced to describe the sample-level feature representation, local inter-sample relations, and global data distribution of each modality. Then, an MRL paradigm is designed for inter-modal manifold knowledge transfer to obtain effective cross-modal feature representations. Furthermore, MRL transfers the knowledge between both paired and unpaired data for robust learning on incomplete datasets. Experiments were conducted on two clinical datasets to validate the PI classification performance and generalization of GMRLNet. State-of-the-art comparisons show the higher accuracy of GMRLNet on incomplete datasets. Our method achieves 0.913 AUC and 0.904 balanced accuracy (bACC) for paired US and MFI images, as well as 0.906 AUC and 0.888 bACC for unimodal US images, illustrating its application potential in PI CAD systems.

Predicting mild cognitive impairments from cognitively normal brains using a novel brain age estimation model based on structural magnetic resonance imaging

Brain age prediction is a practical method used to quantify brain aging and detect neurodegenerative diseases such as Alzheimer's disease (AD). However, very few studies have considered brain age prediction as a biomarker for the conversion of cognitively normal (CN) to mild cognitive impairment (MCI). In this study, we developed a novel brain age prediction model using brain volume and cortical thickness features. We calculated an acceleration of brain age (ABA) derived from the suggested model to estimate different diagnostic groups (CN, MCI, and AD) and to classify CN to MCI and MCI to AD conversion groups. We observed a strong association between ABA and the 3 diagnostic groups. Additionally, the classification models for CN to MCI conversion and MCI to AD conversion exhibited acceptable and robust performances, with area under the curve values of 0.66 and 0.76, respectively. We believe that our proposed model provides a reliable estimate of brain age for elderly individuals and can identify those at risk of progressing from CN to MCI. This model has great potential to reveal a diagnosis associated with a change in cognitive decline.

Recent contributions to the field of subjective cognitive decline in aging: A literature review

Subjective cognitive decline (SCD) is defined as self-experienced, persistent concerns of decline in cognitive capacity in the context of normal performance on objective cognitive measures. Although SCD was initially thought to represent the "worried well," these concerns can be linked to subtle brain changes prior to changes in objective cognitive performance and, therefore, in some individuals, SCD may represent the early stages of an underlying neurodegenerative disease process (e.g., Alzheimer's disease). The field of SCD research has expanded rapidly over the years, and this review aims to provide an update on new advances in, and contributions to, the field of SCD in key areas and themes identified by researchers in this field as particularly important and impactful. First, we highlight recent studies examining sociodemographic and genetic risk factors for SCD, including explorations of SCD across racial and ethnic minoritized groups, and examinations of sex and gender considerations. Next, we review new findings on relationships between SCD and in vivo markers of pathophysiology, utilizing neuroimaging and biofluid data, as well as associations between SCD and objective cognitive tests and neuropsychiatric measures. Finally, we summarize recent work on interventions for SCD and areas of future growth in the field of SCD.

Hybrid Multimodality Fusion with Cross-Domain Knowledge Transfer to Forecast Progression Trajectories in Cognitive Decline

Magnetic resonance imaging (MRI) and positron emission tomography (PET) are increasingly used to forecast progression trajectories of cognitive decline caused by preclinical and prodromal Alzheimer's disease (AD). Many existing studies have explored the potential of these two distinct modalities with diverse machine and deep learning approaches. But successfully fusing MRI and PET can be complex due to their unique characteristics and missing modalities. To this end, we develop a hybrid multimodality fusion (HMF) framework with cross-domain knowledge transfer for joint MRI and PET representation learning, feature fusion, and cognitive decline progression forecasting. Our HMF consists of three modules: 1) a module to impute missing PET images, 2) a module to extract multimodality features from MRI and PET images, and 3) a module to fuse the extracted multimodality features. To address the issue of small sample sizes, we employ a cross-domain knowledge transfer strategy from the ADNI dataset, which includes 795 subjects, to independent small-scale AD-related cohorts, in order to leverage the rich knowledge present within the ADNI. The proposed HMF is extensively evaluated in three AD-related studies with 272 subjects across multiple disease stages, such as subjective cognitive decline and mild cognitive impairment. Experimental results demonstrate the superiority of our method over several state-of-the-art approaches in forecasting progression trajectories of AD-related cognitive decline.

An attention-based deep learning approach for the classification of subjective cognitive decline and mild cognitive impairment using resting-state EEG

Objective. This study aims to design and implement the first deep learning (DL) model to classify subjects in the prodromic states of Alzheimer's disease (AD) based on resting-state electroencephalographic (EEG) signals.Approach. EEG recordings of 17 healthy controls (HCs), 56 subjective cognitive decline (SCD) and 45 mild cognitive impairment (MCI) subjects were acquired at resting state. After preprocessing, we selected sections corresponding to eyes-closed condition. Five different datasets were created by extracting delta, theta, alpha, beta and delta-to-theta frequency bands using bandpass filters. To classify SCDvsMCI and HCvsSCDvsMCI, we propose a framework based on the transformer architecture, which uses multi-head attention to focus on the most relevant parts of the input signals. We trained and validated the model on each dataset with a leave-one-subject-out cross-validation approach, splitting the signals into 10 s epochs. Subjects were assigned to the same class as the majority of their epochs. Classification performances of the transformer were assessed for both epochs and subjects and compared with other DL models.Main results. Results showed that the delta dataset allowed our model to achieve the best performances for the discrimination of SCD and MCI, reaching an Area Under the ROC Curve (AUC) of 0.807, while the highest results for the HCvsSCDvsMCI classification were obtained on alpha and theta with a micro-AUC higher than 0.74.Significance. We demonstrated that DL approaches can support the adoption of non-invasive and economic techniques as EEG to stratify patients in the clinical population at risk for AD. This result was achieved since the attention mechanism was able to learn temporal dependencies of the signal, focusing on the most discriminative patterns, achieving state-of-the-art results by using a deep model of reduced complexity. Our results were consistent with clinical evidence that changes in brain activity are progressive when considering early stages of AD.

Domain-Prior-Induced Structural MRI Adaptation for Clinical Progression Prediction of Subjective Cognitive Decline

Growing evidence shows that subjective cognitive decline (SCD) among elderly individuals is the possible pre-clinical stage of Alzheimer's disease (AD). To prevent the potential disease conversion, it is critical to investigate biomarkers for SCD progression. Previous learning-based methods employ T1-weighted magnetic resonance imaging (MRI) data to aid the future progression prediction of SCD, but often fail to build reliable models due to the insufficient number of subjects and imbalanced sample classes. A few studies suggest building a model on a large-scale AD-related dataset and then applying it to another dataset for SCD progression via transfer learning. Unfortunately, they usually ignore significant data distribution gaps between different centers/domains. With the prior knowledge that SCD is at increased risk of underlying AD pathology, we propose a domain-prior-induced structural MRI adaptation (DSMA) method for SCD progression prediction by mitigating the distribution gap between SCD and AD groups. The proposed DSMA method consists of two parallel feature encoders for MRI feature learning in the labeled source domain and unlabeled target domain, an attention block to locate potential disease-associated brain regions, and a feature adaptation module based on maximum mean discrepancy (MMD) for cross-domain feature alignment. Experimental results on the public ADNI dataset and an SCD dataset demonstrate the superiority of our method over several state-of-the-arts.

Dementia-related user-based collaborative filtering for imputing missing data and generating a reliability scale on clinical test scores

Medical doctors may struggle to diagnose dementia, particularly when clinical test scores are missing or incorrect. In case of any doubts, both morphometrics and demographics are crucial when examining dementia in medicine. This study aims to impute and verify clinical test scores with brain MRI analysis and additional demographics, thereby proposing a decision support system that improves diagnosis and prognosis in an easy-to-understand manner. Therefore, we impute the missing clinical test score values by unsupervised dementia-related user-based collaborative filtering to minimize errors. By analyzing succession rates, we propose a reliability scale that can be utilized for the consistency of existing clinical test scores. The complete base of 816 ADNI1-screening samples was processed, and a hybrid set of 603 features was handled. Moreover, the detailed parameters in use, such as the best neighborhood and input features were evaluated for further comparative analysis. Overall, certain collaborative filtering configurations outperformed alternative state-of-the-art imputation techniques. The imputation system and reliability scale based on the proposed methodology are promising for supporting the clinical tests.

Transfer Learning Approaches for Neuroimaging Analysis: A Scoping Review

Deep learning algorithms have been moderately successful in diagnoses of diseases by analyzing medical images especially through neuroimaging that is rich in annotated data. Transfer learning methods have demonstrated strong performance in tackling annotated data. It utilizes and transfers knowledge learned from a source domain to target domain even when the dataset is small. There are multiple approaches to transfer learning that result in a range of performance estimates in diagnosis, detection, and classification of clinical problems. Therefore, in this paper, we reviewed transfer learning approaches, their design attributes, and their applications to neuroimaging problems. We reviewed two main literature databases and included the most relevant studies using predefined inclusion criteria. Among 50 reviewed studies, more than half of them are on transfer learning for Alzheimer's disease. Brain mapping and brain tumor detection were second and third most discussed research problems, respectively. The most common source dataset for transfer learning was ImageNet, which is not a neuroimaging dataset. This suggests that the majority of studies preferred pre-trained models instead of training their own model on a neuroimaging dataset. Although, about one third of studies designed their own architecture, most studies used existing Convolutional Neural Network architectures. Magnetic Resonance Imaging was the most common imaging modality. In almost all studies, transfer learning contributed to better performance in diagnosis, classification, segmentation of different neuroimaging diseases and problems, than methods without transfer learning. Among different transfer learning approaches, fine-tuning all convolutional and fully-connected layers approach and freezing convolutional layers and fine-tuning fully-connected layers approach demonstrated superior performance in terms of accuracy. These recent transfer learning approaches not only show great performance but also require less computational resources and time.