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Uhm KH, Jung SW, Hong SH, Ko SJ. Lesion-aware cross-phase attention network for renal tumor subtype classification on multi-phase CT scans. Comput Biol Med 2024; 178:108746. [PMID: 38878403 DOI: 10.1016/j.compbiomed.2024.108746] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Revised: 03/25/2024] [Accepted: 06/08/2024] [Indexed: 07/24/2024]
Abstract
Multi-phase computed tomography (CT) has been widely used for the preoperative diagnosis of kidney cancer due to its non-invasive nature and ability to characterize renal lesions. However, since enhancement patterns of renal lesions across CT phases are different even for the same lesion type, the visual assessment by radiologists suffers from inter-observer variability in clinical practice. Although deep learning-based approaches have been recently explored for differential diagnosis of kidney cancer, they do not explicitly model the relationships between CT phases in the network design, limiting the diagnostic performance. In this paper, we propose a novel lesion-aware cross-phase attention network (LACPANet) that can effectively capture temporal dependencies of renal lesions across CT phases to accurately classify the lesions into five major pathological subtypes from time-series multi-phase CT images. We introduce a 3D inter-phase lesion-aware attention mechanism to learn effective 3D lesion features that are used to estimate attention weights describing the inter-phase relations of the enhancement patterns. We also present a multi-scale attention scheme to capture and aggregate temporal patterns of lesion features at different spatial scales for further improvement. Extensive experiments on multi-phase CT scans of kidney cancer patients from the collected dataset demonstrate that our LACPANet outperforms state-of-the-art approaches in diagnostic accuracy.
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Affiliation(s)
- Kwang-Hyun Uhm
- Department of Electrical Engineering Korea University, Seoul, Korea
| | - Seung-Won Jung
- Department of Electrical Engineering Korea University, Seoul, Korea.
| | - Sung-Hoo Hong
- Department of Urology, The Catholic University of Korea, Seoul, Korea
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Gryshchuk V, Singh D, Teipel S, Dyrba M. Contrastive Self-supervised Learning for Neurodegenerative Disorder Classification. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2024:2024.07.03.24309882. [PMID: 39006425 PMCID: PMC11245060 DOI: 10.1101/2024.07.03.24309882] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/16/2024]
Abstract
Neurodegenerative diseases such as Alzheimer's disease (AD) or frontotemporal lobar degeneration (FTLD) involve specific loss of brain volume, detectable in vivo using T1-weighted MRI scans. Supervised machine learning approaches classifying neurodegenerative diseases require diagnostic-labels for each sample. However, it can be difficult to obtain expert labels for a large amount of data. Self-supervised learning (SSL) offers an alternative for training machine learning models without data-labels. We investigated if the SSL models can applied to distinguish between different neurodegenerative disorders in an interpretable manner. Our method comprises a feature extractor and a downstream classification head. A deep convolutional neural network trained in a contrastive self-supervised way serves as the feature extractor, learning latent representation, while the classifier head is a single-layer perceptron. We used N=2694 T1-weighted MRI scans from four data cohorts: two ADNI datasets, AIBL and FTLDNI, including cognitively normal controls (CN), cases with prodromal and clinical AD, as well as FTLD cases differentiated into its sub-types. Our results showed that the feature extractor trained in a self-supervised way provides generalizable and robust representations for the downstream classification. For AD vs. CN, our model achieves 82% balanced accuracy on the test subset and 80% on an independent holdout dataset. Similarly, the Behavioral variant of frontotemporal dementia (BV) vs. CN model attains an 88% balanced accuracy on the test subset. The average feature attribution heatmaps obtained by the Integrated Gradient method highlighted hallmark regions, i.e., temporal gray matter atrophy for AD, and insular atrophy for BV. In conclusion, our models perform comparably to state-of-the-art supervised deep learning approaches. This suggests that the SSL methodology can successfully make use of unannotated neuroimaging datasets as training data while remaining robust and interpretable.
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Bottani S, Thibeau-Sutre E, Maire A, Ströer S, Dormont D, Colliot O, Burgos N. Contrast-enhanced to non-contrast-enhanced image translation to exploit a clinical data warehouse of T1-weighted brain MRI. BMC Med Imaging 2024; 24:67. [PMID: 38504179 PMCID: PMC10953143 DOI: 10.1186/s12880-024-01242-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Accepted: 03/07/2024] [Indexed: 03/21/2024] Open
Abstract
BACKGROUND Clinical data warehouses provide access to massive amounts of medical images, but these images are often heterogeneous. They can for instance include images acquired both with or without the injection of a gadolinium-based contrast agent. Harmonizing such data sets is thus fundamental to guarantee unbiased results, for example when performing differential diagnosis. Furthermore, classical neuroimaging software tools for feature extraction are typically applied only to images without gadolinium. The objective of this work is to evaluate how image translation can be useful to exploit a highly heterogeneous data set containing both contrast-enhanced and non-contrast-enhanced images from a clinical data warehouse. METHODS We propose and compare different 3D U-Net and conditional GAN models to convert contrast-enhanced T1-weighted (T1ce) into non-contrast-enhanced (T1nce) brain MRI. These models were trained using 230 image pairs and tested on 77 image pairs from the clinical data warehouse of the Greater Paris area. RESULTS Validation using standard image similarity measures demonstrated that the similarity between real and synthetic T1nce images was higher than between real T1nce and T1ce images for all the models compared. The best performing models were further validated on a segmentation task. We showed that tissue volumes extracted from synthetic T1nce images were closer to those of real T1nce images than volumes extracted from T1ce images. CONCLUSION We showed that deep learning models initially developed with research quality data could synthesize T1nce from T1ce images of clinical quality and that reliable features could be extracted from the synthetic images, thus demonstrating the ability of such methods to help exploit a data set coming from a clinical data warehouse.
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Affiliation(s)
- Simona Bottani
- Sorbonne Université, Institut du Cerveau - Paris Brain Institute - ICM, CNRS, Inria, Inserm, AP-HP, Hôpital de la Pitié-Salpêtrière, Paris, 75013, France
| | - Elina Thibeau-Sutre
- Sorbonne Université, Institut du Cerveau - Paris Brain Institute - ICM, CNRS, Inria, Inserm, AP-HP, Hôpital de la Pitié-Salpêtrière, Paris, 75013, France
| | - Aurélien Maire
- Innovation & Données - Département des Services Numériques, AP-HP, Paris, 75013, France
| | - Sebastian Ströer
- Hôpital Pitié Salpêtrière, Department of Neuroradiology, AP-HP, Paris, 75012, France
| | - Didier Dormont
- Sorbonne Université, Institut du Cerveau - Paris Brain Institute - ICM, CNRS, Inria, Inserm, AP-HP, Hôpital de la Pitié-Salpêtrière, DMU DIAMENT, Paris, 75013, France
| | - Olivier Colliot
- Sorbonne Université, Institut du Cerveau - Paris Brain Institute - ICM, CNRS, Inria, Inserm, AP-HP, Hôpital de la Pitié-Salpêtrière, Paris, 75013, France
| | - Ninon Burgos
- Sorbonne Université, Institut du Cerveau - Paris Brain Institute - ICM, CNRS, Inria, Inserm, AP-HP, Hôpital de la Pitié-Salpêtrière, Paris, 75013, France.
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Ma D, Stocks J, Rosen H, Kantarci K, Lockhart SN, Bateman JR, Craft S, Gurcan MN, Popuri K, Beg MF, Wang L. Differential diagnosis of frontotemporal dementia subtypes with explainable deep learning on structural MRI. Front Neurosci 2024; 18:1331677. [PMID: 38384484 PMCID: PMC10879283 DOI: 10.3389/fnins.2024.1331677] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Accepted: 01/08/2024] [Indexed: 02/23/2024] Open
Abstract
Background Frontotemporal dementia (FTD) represents a collection of neurobehavioral and neurocognitive syndromes that are associated with a significant degree of clinical, pathological, and genetic heterogeneity. Such heterogeneity hinders the identification of effective biomarkers, preventing effective targeted recruitment of participants in clinical trials for developing potential interventions and treatments. In the present study, we aim to automatically differentiate patients with three clinical phenotypes of FTD, behavioral-variant FTD (bvFTD), semantic variant PPA (svPPA), and nonfluent variant PPA (nfvPPA), based on their structural MRI by training a deep neural network (DNN). Methods Data from 277 FTD patients (173 bvFTD, 63 nfvPPA, and 41 svPPA) recruited from two multi-site neuroimaging datasets: the Frontotemporal Lobar Degeneration Neuroimaging Initiative and the ARTFL-LEFFTDS Longitudinal Frontotemporal Lobar Degeneration databases. Raw T1-weighted MRI data were preprocessed and parcellated into patch-based ROIs, with cortical thickness and volume features extracted and harmonized to control the confounding effects of sex, age, total intracranial volume, cohort, and scanner difference. A multi-type parallel feature embedding framework was trained to classify three FTD subtypes with a weighted cross-entropy loss function used to account for unbalanced sample sizes. Feature visualization was achieved through post-hoc analysis using an integrated gradient approach. Results The proposed differential diagnosis framework achieved a mean balanced accuracy of 0.80 for bvFTD, 0.82 for nfvPPA, 0.89 for svPPA, and an overall balanced accuracy of 0.84. Feature importance maps showed more localized differential patterns among different FTD subtypes compared to groupwise statistical mapping. Conclusion In this study, we demonstrated the efficiency and effectiveness of using explainable deep-learning-based parallel feature embedding and visualization framework on MRI-derived multi-type structural patterns to differentiate three clinically defined subphenotypes of FTD: bvFTD, nfvPPA, and svPPA, which could help with the identification of at-risk populations for early and precise diagnosis for intervention planning.
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Affiliation(s)
- Da Ma
- Department of Internal Medicine, Wake Forest University School of Medicine, Winston-Salem, NC, United States
| | - Jane Stocks
- Department of Psychiatry and Behavioral Health, Northwestern University Feinberg School of Medicine, Chicago, IL, United States
| | - Howard Rosen
- Weill Institute for Neurosciences, University of California San Francisco, San Francisco, CA, United States
| | - Kejal Kantarci
- Department of Radiology, Mayo Clinic, Rochester, MN, United States
| | - Samuel N. Lockhart
- Department of Internal Medicine, Wake Forest University School of Medicine, Winston-Salem, NC, United States
| | - James R. Bateman
- Department of Neurology, Wake Forest University School of Medicine, Winston-Salem, NC, United States
| | - Suzanne Craft
- Department of Internal Medicine, Wake Forest University School of Medicine, Winston-Salem, NC, United States
| | - Metin N. Gurcan
- Department of Internal Medicine, Wake Forest University School of Medicine, Winston-Salem, NC, United States
| | - Karteek Popuri
- Department of Computer Science, Memorial University of Newfoundland, St. John's, NL, Canada
| | - Mirza Faisal Beg
- School of Engineering Science, Simon Fraser University, Burnaby, BC, Canada
| | - Lei Wang
- Department of Psychiatry and Behavioral Health, Northwestern University Feinberg School of Medicine, Chicago, IL, United States
- Department of Psychiatry and Behavioral Health, Ohio State University Wexner Medical Center, Columbus, OH, United States
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Bottani S, Burgos N, Maire A, Saracino D, Ströer S, Dormont D, Colliot O. Evaluation of MRI-based machine learning approaches for computer-aided diagnosis of dementia in a clinical data warehouse. Med Image Anal 2023; 89:102903. [PMID: 37523918 DOI: 10.1016/j.media.2023.102903] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Revised: 06/01/2023] [Accepted: 07/12/2023] [Indexed: 08/02/2023]
Abstract
A variety of algorithms have been proposed for computer-aided diagnosis of dementia from anatomical brain MRI. These approaches achieve high accuracy when applied to research data sets but their performance on real-life clinical routine data has not been evaluated yet. The aim of this work was to study the performance of such approaches on clinical routine data, based on a hospital data warehouse, and to compare the results to those obtained on a research data set. The clinical data set was extracted from the hospital data warehouse of the Greater Paris area, which includes 39 different hospitals. The research set was composed of data from the Alzheimer's Disease Neuroimaging Initiative data set. In the clinical set, the population of interest was identified by exploiting the diagnostic codes from the 10th revision of the International Classification of Diseases that are assigned to each patient. We studied how the imbalance of the training sets, in terms of contrast agent injection and image quality, may bias the results. We demonstrated that computer-aided diagnosis performance was strongly biased upwards (over 17 percent points of balanced accuracy) by the confounders of image quality and contrast agent injection, a phenomenon known as the Clever Hans effect or shortcut learning. When these biases were removed, the performance was very poor. In any case, the performance was considerably lower than on the research data set. Our study highlights that there are still considerable challenges for translating dementia computer-aided diagnosis systems to clinical routine.
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Affiliation(s)
- Simona Bottani
- Sorbonne Université, Institut du Cerveau - Paris Brain Institute - ICM, CNRS, Inria, Inserm, AP-HP, Hôpital de la Pitié-Salpêtrière, Paris, 75013, France
| | - Ninon Burgos
- Sorbonne Université, Institut du Cerveau - Paris Brain Institute - ICM, CNRS, Inria, Inserm, AP-HP, Hôpital de la Pitié-Salpêtrière, Paris, 75013, France
| | | | - Dario Saracino
- Sorbonne Université, Institut du Cerveau - Paris Brain Institute - ICM, CNRS, Inria, Inserm, AP-HP, Hôpital de la Pitié-Salpêtrière, Paris, 75013, France; IM2A, Reference Centre for Rare or Early-Onset Dementias, Département de Neurologie, AP-HP, Hôpital de la Pitié Salpêtrière, Paris, 75013, France
| | - Sebastian Ströer
- AP-HP, Hôpital de la Pitié Salpêtrière, Department of Neuroradiology, Paris, 75013, France
| | - Didier Dormont
- AP-HP, Hôpital de la Pitié Salpêtrière, Department of Neuroradiology, Paris, 75013, France; Sorbonne Université, Institut du Cerveau - Paris Brain Institute - ICM, CNRS, Inria, Inserm, AP-HP, Hôpital de la Pitié-Salpêtrière, DMU DIAMENT, Paris, 75013, France
| | - Olivier Colliot
- Sorbonne Université, Institut du Cerveau - Paris Brain Institute - ICM, CNRS, Inria, Inserm, AP-HP, Hôpital de la Pitié-Salpêtrière, Paris, 75013, France.
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Chouliaras L, O'Brien JT. The use of neuroimaging techniques in the early and differential diagnosis of dementia. Mol Psychiatry 2023; 28:4084-4097. [PMID: 37608222 PMCID: PMC10827668 DOI: 10.1038/s41380-023-02215-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2023] [Revised: 07/27/2023] [Accepted: 08/03/2023] [Indexed: 08/24/2023]
Abstract
Dementia is a leading cause of disability and death worldwide. At present there is no disease modifying treatment for any of the most common types of dementia such as Alzheimer's disease (AD), Vascular dementia, Lewy Body Dementia (LBD) and Frontotemporal dementia (FTD). Early and accurate diagnosis of dementia subtype is critical to improving clinical care and developing better treatments. Structural and molecular imaging has contributed to a better understanding of the pathophysiology of neurodegenerative dementias and is increasingly being adopted into clinical practice for early and accurate diagnosis. In this review we summarise the contribution imaging has made with particular focus on multimodal magnetic resonance imaging (MRI) and positron emission tomography imaging (PET). Structural MRI is widely used in clinical practice and can help exclude reversible causes of memory problems but has relatively low sensitivity for the early and differential diagnosis of dementia subtypes. 18F-fluorodeoxyglucose PET has high sensitivity and specificity for AD and FTD, while PET with ligands for amyloid and tau can improve the differential diagnosis of AD and non-AD dementias, including recognition at prodromal stages. Dopaminergic imaging can assist with the diagnosis of LBD. The lack of a validated tracer for α-synuclein or TAR DNA-binding protein 43 (TDP-43) imaging remain notable gaps, though work is ongoing. Emerging PET tracers such as 11C-UCB-J for synaptic imaging may be sensitive early markers but overall larger longitudinal multi-centre cross diagnostic imaging studies are needed.
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Affiliation(s)
- Leonidas Chouliaras
- Department of Psychiatry, University of Cambridge School of Clinical Medicine, Cambridge, UK
- Specialist Dementia and Frailty Service, Essex Partnership University NHS Foundation Trust, St Margaret's Hospital, Epping, UK
| | - John T O'Brien
- Department of Psychiatry, University of Cambridge School of Clinical Medicine, Cambridge, UK.
- Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK.
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Nguyen HD, Clément M, Planche V, Mansencal B, Coupé P. Deep grading for MRI-based differential diagnosis of Alzheimer's disease and Frontotemporal dementia. Artif Intell Med 2023; 144:102636. [PMID: 37783553 PMCID: PMC10904714 DOI: 10.1016/j.artmed.2023.102636] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Revised: 06/22/2023] [Accepted: 08/11/2023] [Indexed: 10/04/2023]
Abstract
Alzheimer's disease and Frontotemporal dementia are common forms of neurodegenerative dementia. Behavioral alterations and cognitive impairments are found in the clinical courses of both diseases, and their differential diagnosis can sometimes pose challenges for physicians. Therefore, an accurate tool dedicated to this diagnostic challenge can be valuable in clinical practice. However, current structural imaging methods mainly focus on the detection of each disease but rarely on their differential diagnosis. In this paper, we propose a deep learning-based approach for both disease detection and differential diagnosis. We suggest utilizing two types of biomarkers for this application: structure grading and structure atrophy. First, we propose to train a large ensemble of 3D U-Nets to locally determine the anatomical patterns of healthy people, patients with Alzheimer's disease and patients with Frontotemporal dementia using structural MRI as input. The output of the ensemble is a 2-channel disease's coordinate map, which can be transformed into a 3D grading map that is easily interpretable for clinicians. This 2-channel disease's coordinate map is coupled with a multi-layer perceptron classifier for different classification tasks. Second, we propose to combine our deep learning framework with a traditional machine learning strategy based on volume to improve the model discriminative capacity and robustness. After both cross-validation and external validation, our experiments, based on 3319 MRIs, demonstrated that our method produces competitive results compared to state-of-the-art methods for both disease detection and differential diagnosis.
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Affiliation(s)
- Huy-Dung Nguyen
- Univ. Bordeaux, CNRS, Bordeaux INP, LaBRI, UMR 5800, 33400 Talence, France.
| | - Michaël Clément
- Univ. Bordeaux, CNRS, Bordeaux INP, LaBRI, UMR 5800, 33400 Talence, France
| | - Vincent Planche
- Univ. Bordeaux, CNRS, Institut des Maladies Neurodégénératives, UMR 5293, 33000 Bordeaux, France; Centre Mémoire Ressources Recherches, Pôle de Neurosciences Cliniques, CHU de Bordeaux, 33000 Bordeaux, France
| | - Boris Mansencal
- Univ. Bordeaux, CNRS, Bordeaux INP, LaBRI, UMR 5800, 33400 Talence, France
| | - Pierrick Coupé
- Univ. Bordeaux, CNRS, Bordeaux INP, LaBRI, UMR 5800, 33400 Talence, France
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Tomasello L, Carlucci L, Laganà A, Galletta S, Marinelli CV, Raffaele M, Zoccolotti P. Neuropsychological Evaluation and Quantitative EEG in Patients with Frontotemporal Dementia, Alzheimer's Disease, and Mild Cognitive Impairment. Brain Sci 2023; 13:930. [PMID: 37371408 DOI: 10.3390/brainsci13060930] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2023] [Revised: 05/25/2023] [Accepted: 06/05/2023] [Indexed: 06/29/2023] Open
Abstract
This study analyzed the efficacy of EEG resting state and neuropsychological performances in discriminating patients with different forms of dementia, or mild cognitive impairment (MCI), compared with control subjects. Forty-four patients with dementia (nineteen patients with AD, and seven with FTD), eighteen with MCI, and nineteen healthy subjects, matched for age and gender, underwent an extensive neuropsychological test battery and an EEG resting state recording. Results showed greater theta activation in posterior areas in the Alzheimer's disease (AD) and Fronto-Temporal Dementia (FTD) groups compared with the MCI and control groups. AD patients also showed more delta band activity in the temporal-occipital areas than controls and MCI patients. By contrast, the alpha and beta bands did not discriminate among groups. A hierarchical clustering analysis based on neuropsychological and EEG data yielded a three-factor solution. The clusters differed for several neuropsychological measures, as well as for beta and theta bands. Neuropsychological tests were most sensitive in capturing an initial cognitive decline, while increased theta activity was uniquely associated with a substantial worsening of the clinical picture, representing a negative prognostic factor. In line with the Research Domains Framework (RDoC) perspective, the joint use of cognitive and neurophysiological data may provide converging evidence to document the evolution of cognitive skills in at-risk individuals.
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Affiliation(s)
- Letteria Tomasello
- Department of Clinical and Experimental Medicine, University of Messina, 98122 Messina, Italy
- Faculty of Medicine and Dentistry, Sapienza University of Rome, 00185 Rome, Italy
| | - Leonardo Carlucci
- Learning Sciences Hub, Department of Humanities, Letters, Cultural Heritage and Educational Studies, Foggia University, 71121 Foggia, Italy
| | - Angelina Laganà
- Department of Biomedical and Dental Sciences, Morphological and Functional Images, 98122 Messina, Italy
| | - Santi Galletta
- Réseau Hospitalier Neuchâtelois (RHNe), Service de Neurologie et Neuroréadaptation, 2000 Neuchâtel, Switzerland
| | - Chiara Valeria Marinelli
- Learning Sciences Hub, Department of Humanities, Letters, Cultural Heritage and Educational Studies, Foggia University, 71121 Foggia, Italy
| | - Massimo Raffaele
- Department of Clinical and Experimental Medicine, University of Messina, 98122 Messina, Italy
| | - Pierluigi Zoccolotti
- Tuscany Rehabilitation Clinic, 52025 Montevarchi, Italy
- Department of Psychology, Sapienza University of Rome, 00185 Rome, Italy
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Combining Neuropsychological Assessment with Neuroimaging to Distinguish Early-Stage Alzheimer's Disease from Frontotemporal Lobar Degeneration in Non-Western Tonal Native Language-Speaking Individuals Living in Taiwan: A Case Series. J Clin Med 2023; 12:jcm12041322. [PMID: 36835856 PMCID: PMC9961761 DOI: 10.3390/jcm12041322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Revised: 12/25/2022] [Accepted: 02/01/2023] [Indexed: 02/10/2023] Open
Abstract
Neuropsychological tests (NPTs), which are routinely used in clinical practice for assessment of dementia, are also considered to be essential for differential diagnosis of Alzheimer's disease (AD) and frontotemporal lobar degeneration (FTLD), especially the behavioral variants of frontotemporal dementia (bvFTD) and primary progressive aphasia (PPA) at their initial clinical presentations. However, the heterogeneous features of these diseases, which have many overlapping signs, make differentiation between AD and FTLD highly challenging. Moreover, NPTs were primarily developed in Western countries and for native speakers of non-tonal languages. Hence, there is an ongoing dispute over the validity and reliability of these tests in culturally different and typologically diverse language populations. The purpose of this case series was to examine which of the NPTs adjusted for Taiwanese society may be used to distinguish these two diseases. Since AD and FTLD have different effects on individuals' brain, we combined NPTs with neuroimaging. We found that participants diagnosed with FTLD had lower scores in NPTs assessing language or social cognition than AD participants. PPA participants also had lower measures in the Free and Cued Selective Reminding Test than those diagnosed with bvFTD, while bvFTD participants showed poorer performances in the behavioral measures than PPA participants. In addition, the initial diagnosis was supported by the standard one-year clinical follow-up.
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Gonzalez-Gomez R, Ibañez A, Moguilner S. Multiclass characterization of frontotemporal dementia variants via multimodal brain network computational inference. Netw Neurosci 2023; 7:322-350. [PMID: 37333999 PMCID: PMC10270711 DOI: 10.1162/netn_a_00285] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Accepted: 10/03/2022] [Indexed: 04/03/2024] Open
Abstract
Characterizing a particular neurodegenerative condition against others possible diseases remains a challenge along clinical, biomarker, and neuroscientific levels. This is the particular case of frontotemporal dementia (FTD) variants, where their specific characterization requires high levels of expertise and multidisciplinary teams to subtly distinguish among similar physiopathological processes. Here, we used a computational approach of multimodal brain networks to address simultaneous multiclass classification of 298 subjects (one group against all others), including five FTD variants: behavioral variant FTD, corticobasal syndrome, nonfluent variant primary progressive aphasia, progressive supranuclear palsy, and semantic variant primary progressive aphasia, with healthy controls. Fourteen machine learning classifiers were trained with functional and structural connectivity metrics calculated through different methods. Due to the large number of variables, dimensionality was reduced, employing statistical comparisons and progressive elimination to assess feature stability under nested cross-validation. The machine learning performance was measured through the area under the receiver operating characteristic curves, reaching 0.81 on average, with a standard deviation of 0.09. Furthermore, the contributions of demographic and cognitive data were also assessed via multifeatured classifiers. An accurate simultaneous multiclass classification of each FTD variant against other variants and controls was obtained based on the selection of an optimum set of features. The classifiers incorporating the brain's network and cognitive assessment increased performance metrics. Multimodal classifiers evidenced specific variants' compromise, across modalities and methods through feature importance analysis. If replicated and validated, this approach may help to support clinical decision tools aimed to detect specific affectations in the context of overlapping diseases.
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Affiliation(s)
- Raul Gonzalez-Gomez
- Latin American Brain Health Institute (BrainLat), Universidad Adolfo Ibañez, Santiago de Chile, Chile
- Center for Social and Cognitive Neuroscience, School of Psychology, Universidad Adolfo Ibañez, Santiago de Chile, Chile
| | - Agustín Ibañez
- Latin American Brain Health Institute (BrainLat), Universidad Adolfo Ibañez, Santiago de Chile, Chile
- Cognitive Neuroscience Center, Universidad de San Andres, Buenos Aires, Argentina
- Global Brain Health Institute, University of California San Francisco, San Francisco, CA, USA
- Trinity College Dublin, Dublin, Ireland
| | - Sebastian Moguilner
- Center for Social and Cognitive Neuroscience, School of Psychology, Universidad Adolfo Ibañez, Santiago de Chile, Chile
- Cognitive Neuroscience Center, Universidad de San Andres, Buenos Aires, Argentina
- Global Brain Health Institute, University of California San Francisco, San Francisco, CA, USA
- Department of Neurology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
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11
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Di Benedetto M, Carrara F, Tafuri B, Nigro S, De Blasi R, Falchi F, Gennaro C, Gigli G, Logroscino G, Amato G. Deep networks for behavioral variant frontotemporal dementia identification from multiple acquisition sources. Comput Biol Med 2022; 148:105937. [PMID: 35985188 DOI: 10.1016/j.compbiomed.2022.105937] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Revised: 06/28/2022] [Accepted: 07/21/2022] [Indexed: 11/03/2022]
Abstract
Behavioral variant frontotemporal dementia (bvFTD) is a neurodegenerative syndrome whose clinical diagnosis remains a challenging task especially in the early stage of the disease. Currently, the presence of frontal and anterior temporal lobe atrophies on magnetic resonance imaging (MRI) is part of the diagnostic criteria for bvFTD. However, MRI data processing is usually dependent on the acquisition device and mostly require human-assisted crafting of feature extraction. Following the impressive improvements of deep architectures, in this study we report on bvFTD identification using various classes of artificial neural networks, and present the results we achieved on classification accuracy and obliviousness on acquisition devices using extensive hyperparameter search. In particular, we will demonstrate the stability and generalization of different deep networks based on the attention mechanism, where data intra-mixing confers models the ability to identify the disorder even on MRI data in inter-device settings, i.e., on data produced by different acquisition devices and without model fine tuning, as shown from the very encouraging performance evaluations that dramatically reach and overcome the 90% value on the AuROC and balanced accuracy metrics.
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Affiliation(s)
- Marco Di Benedetto
- Institute of Information Science and Technologies "Alessandro Faedo" (ISTI), National Research Council (CNR), Pisa (PI), Italy.
| | - Fabio Carrara
- Institute of Information Science and Technologies "Alessandro Faedo" (ISTI), National Research Council (CNR), Pisa (PI), Italy
| | - Benedetta Tafuri
- Center for Neurodegenerative Diseases and the Aging Brain, University of Bari "Aldo Moro", Tricase (LE), Italy; Department of Basic Medicine, Neuroscience, and Sense Organs, University of Bari'Aldo Moro', Bari (BA), Italy
| | - Salvatore Nigro
- Center for Neurodegenerative Diseases and the Aging Brain, University of Bari "Aldo Moro", Tricase (LE), Italy; Institute of Nanotechnology (NANOTEC), National Research Council (CNR), Lecce (LE), Italy
| | - Roberto De Blasi
- Department of Radiology, "Pia Fondazione Cardinale G. Panico", Tricase, Lecce (LE), Italy
| | - Fabrizio Falchi
- Institute of Information Science and Technologies "Alessandro Faedo" (ISTI), National Research Council (CNR), Pisa (PI), Italy
| | - Claudio Gennaro
- Institute of Information Science and Technologies "Alessandro Faedo" (ISTI), National Research Council (CNR), Pisa (PI), Italy
| | - Giuseppe Gigli
- Institute of Nanotechnology (NANOTEC), National Research Council (CNR), Lecce (LE), Italy; Department of Mathematics and Physics "Ennio De Giorgi", University of Salento, Campus Ecotekne, Lecce (LE), Italy
| | - Giancarlo Logroscino
- Center for Neurodegenerative Diseases and the Aging Brain, University of Bari "Aldo Moro", Tricase (LE), Italy; Department of Basic Medicine, Neuroscience, and Sense Organs, University of Bari'Aldo Moro', Bari (BA), Italy
| | - Giuseppe Amato
- Institute of Information Science and Technologies "Alessandro Faedo" (ISTI), National Research Council (CNR), Pisa (PI), Italy
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12
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Duan YY, Qin J, Qiu WQ, Li SY, Li C, Liu AS, Chen X, Zhang CX. Performance of a generative adversarial network using ultrasound images to stage liver fibrosis and predict cirrhosis based on a deep-learning radiomics nomogram. Clin Radiol 2022; 77:e723-e731. [PMID: 35811157 DOI: 10.1016/j.crad.2022.06.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Revised: 05/31/2022] [Accepted: 06/07/2022] [Indexed: 12/18/2022]
Abstract
AIM To investigate the performance of a generative adversarial network (GAN) model for staging liver fibrosis and its radiomics-based nomogram for predicting cirrhosis. MATERIALS AND METHODS This two-centre retrospective study included 434 patients for whom input data of ultrasound images and histopathological data (obtained within 1 month of ultrasound examinations) were assigned to the training cohort (249 patients), the internal cohort (92 patients), and the external (93 patients) cohort. A data augmentation method based on a GAN model was used. The discriminative performance was evaluated for classifying fibrosis of S4 and ≥S3. Deep-learning radiomics features were extracted for the prediction of cirrhosis (S4). To perform feature reduction and selection, the least absolute shrinkage and selection operator (LASSO) algorithm was applied. Radiomics scores, along with clinical factors, were incorporated into a nomogram using multivariable logistic regression analysis. The performance of the models was estimated with respect to discrimination power, calibration, and clinical benefits. RESULTS The areas under the receiver operating characteristic curve (AUCs) values of the GAN were 0.832/0.762 (≥S3), and 0.867/0.835 (S4) for internal/external test sets, respectively. The radiomics nomogram that intergrated radiomics scores and clinical factors showed good calibration and discrimination ability of 0.922 (AUC) in the training dataset, 0.896 in the internal dataset, and 0.861 in the external dataset. Decision curve analysis (DCA) demonstrated that the nomogram outperformed radiologist and haematological indices in terms of the most clinical benefits. CONCLUSIONS The GAN model could be applied to discriminate fibrosis stages, and a favourable predictive accuracy for diagnosing cirrhosis was achieved using a deep-learning radiomics nomogram.
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Affiliation(s)
- Y-Y Duan
- Department of Ultrasound, The First Affiliated Hospital of Anhui Medical University, No. 218 Jixi Road, Shushan District, Hefei 230022, Anhui Province, China
| | - J Qin
- Department of Ultrasound, The First Affiliated Hospital of Anhui Medical University, No. 218 Jixi Road, Shushan District, Hefei 230022, Anhui Province, China
| | - W-Q Qiu
- Department of Ultrasound, The First Affiliated Hospital of Anhui Medical University, No. 218 Jixi Road, Shushan District, Hefei 230022, Anhui Province, China
| | - S-Y Li
- Department of Ultrasound, The Affiliated Yantai Yuhuangding Hospital of Qingdao University, No. 20 Yuhuangdingdong Road, Zhifu District, Yantai 264099, Shandong Province, China
| | - C Li
- Department of Biomedical Engineering, Hefei University of Technology, No. 193 Tunxi Road, Baohe District, Hefei 230009, Anhui Province, China
| | - A-S Liu
- Department of Ultrasound, The First Affiliated Hospital of Anhui University of Chinese Medicine, No. 117 Meishan Road, Shushan District, Hefei 230022, Anhui Province, China
| | - X Chen
- Department of Electronic Engineering and Information Science, University of Science and Technology of China, No. 93 Jinzhai Road, Baohe District, Hefei 230026, Anhui Province, China
| | - C-X Zhang
- Department of Ultrasound, The First Affiliated Hospital of Anhui Medical University, No. 218 Jixi Road, Shushan District, Hefei 230022, Anhui Province, China.
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13
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Termine A, Fabrizio C, Caltagirone C, Petrosini L. A Reproducible Deep-Learning-Based Computer-Aided Diagnosis Tool for Frontotemporal Dementia Using MONAI and Clinica Frameworks. Life (Basel) 2022; 12:947. [PMID: 35888037 PMCID: PMC9323676 DOI: 10.3390/life12070947] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Revised: 06/16/2022] [Accepted: 06/21/2022] [Indexed: 12/16/2022] Open
Abstract
Despite Artificial Intelligence (AI) being a leading technology in biomedical research, real-life implementation of AI-based Computer-Aided Diagnosis (CAD) tools into the clinical setting is still remote due to unstandardized practices during development. However, few or no attempts have been made to propose a reproducible CAD development workflow for 3D MRI data. In this paper, we present the development of an easily reproducible and reliable CAD tool using the Clinica and MONAI frameworks that were developed to introduce standardized practices in medical imaging. A Deep Learning (DL) algorithm was trained to detect frontotemporal dementia (FTD) on data from the NIFD database to ensure reproducibility. The DL model yielded 0.80 accuracy (95% confidence intervals: 0.64, 0.91), 1 sensitivity, 0.6 specificity, 0.83 F1-score, and 0.86 AUC, achieving a comparable performance with other FTD classification approaches. Explainable AI methods were applied to understand AI behavior and to identify regions of the images where the DL model misbehaves. Attention maps highlighted that its decision was driven by hallmarking brain areas for FTD and helped us to understand how to improve FTD detection. The proposed standardized methodology could be useful for benchmark comparison in FTD classification. AI-based CAD tools should be developed with the goal of standardizing pipelines, as varying pre-processing and training methods, along with the absence of model behavior explanations, negatively impact regulators' attitudes towards CAD. The adoption of common best practices for neuroimaging data analysis is a step toward fast evaluation of efficacy and safety of CAD and may accelerate the adoption of AI products in the healthcare system.
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Affiliation(s)
- Andrea Termine
- Data Science Unit, IRCCS Santa Lucia Foundation, 00143 Rome, Italy; (A.T.); (C.F.)
| | - Carlo Fabrizio
- Data Science Unit, IRCCS Santa Lucia Foundation, 00143 Rome, Italy; (A.T.); (C.F.)
| | - Carlo Caltagirone
- Department of Clinical and Behavioral Neurology, IRCCS Santa Lucia Foundation, 00179 Rome, Italy;
| | - Laura Petrosini
- Experimental and Behavioral Neurophysiology, IRCCS Santa Lucia Foundation, 00143 Rome, Italy
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14
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Qiu S, Miller MI, Joshi PS, Lee JC, Xue C, Ni Y, Wang Y, De Anda-Duran I, Hwang PH, Cramer JA, Dwyer BC, Hao H, Kaku MC, Kedar S, Lee PH, Mian AZ, Murman DL, O'Shea S, Paul AB, Saint-Hilaire MH, Alton Sartor E, Saxena AR, Shih LC, Small JE, Smith MJ, Swaminathan A, Takahashi CE, Taraschenko O, You H, Yuan J, Zhou Y, Zhu S, Alosco ML, Mez J, Stein TD, Poston KL, Au R, Kolachalama VB. Multimodal deep learning for Alzheimer's disease dementia assessment. Nat Commun 2022; 13:3404. [PMID: 35725739 PMCID: PMC9209452 DOI: 10.1038/s41467-022-31037-5] [Citation(s) in RCA: 51] [Impact Index Per Article: 25.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2021] [Accepted: 05/06/2022] [Indexed: 02/02/2023] Open
Abstract
Worldwide, there are nearly 10 million new cases of dementia annually, of which Alzheimer's disease (AD) is the most common. New measures are needed to improve the diagnosis of individuals with cognitive impairment due to various etiologies. Here, we report a deep learning framework that accomplishes multiple diagnostic steps in successive fashion to identify persons with normal cognition (NC), mild cognitive impairment (MCI), AD, and non-AD dementias (nADD). We demonstrate a range of models capable of accepting flexible combinations of routinely collected clinical information, including demographics, medical history, neuropsychological testing, neuroimaging, and functional assessments. We then show that these frameworks compare favorably with the diagnostic accuracy of practicing neurologists and neuroradiologists. Lastly, we apply interpretability methods in computer vision to show that disease-specific patterns detected by our models track distinct patterns of degenerative changes throughout the brain and correspond closely with the presence of neuropathological lesions on autopsy. Our work demonstrates methodologies for validating computational predictions with established standards of medical diagnosis.
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Grants
- R01 AG054076 NIA NIH HHS
- R01 AG016495 NIA NIH HHS
- U19 AG065156 NIA NIH HHS
- P30 AG066515 NIA NIH HHS
- RF1 AG062109 NIA NIH HHS
- RF1 AG072654 NIA NIH HHS
- R01 NS115114 NINDS NIH HHS
- R01 HL159620 NHLBI NIH HHS
- R56 AG062109 NIA NIH HHS
- P30 AG013846 NIA NIH HHS
- R21 CA253498 NCI NIH HHS
- K23 NS075097 NINDS NIH HHS
- U19 AG068753 NIA NIH HHS
- P30 AG066546 NIA NIH HHS
- R01 AG033040 NIA NIH HHS
- The Karen Toffler Charitable Trust, the Michael J. Fox Foundation, the Lewy Body Dementia Association, the Alzheimer’s Drug Discovery Foundation, the American Heart Association (20SFRN35460031), and the National Institutes of Health (R01-HL159620, R21-CA253498, RF1-AG062109, RF1-AG072654, U19-AG065156, P30-AG066515, R01-NS115114, K23-NS075097, U19-AG068753 and P30-AG013846).
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Affiliation(s)
- Shangran Qiu
- Department of Medicine, Boston University School of Medicine, Boston, MA, USA
- Department of Physics, College of Arts & Sciences, Boston University, Boston, MA, USA
| | - Matthew I Miller
- Department of Medicine, Boston University School of Medicine, Boston, MA, USA
| | - Prajakta S Joshi
- Department of Anatomy and Neurobiology, Boston University School of Medicine, Boston, MA, USA
- Department of General Dentistry, Boston University School of Dental Medicine, Boston, MA, USA
- The Framingham Heart Study, Boston University School of Medicine, Boston, MA, USA
| | - Joyce C Lee
- Department of Medicine, Boston University School of Medicine, Boston, MA, USA
| | - Chonghua Xue
- Department of Medicine, Boston University School of Medicine, Boston, MA, USA
- Department of Anatomy and Neurobiology, Boston University School of Medicine, Boston, MA, USA
| | - Yunruo Ni
- Department of Medicine, Boston University School of Medicine, Boston, MA, USA
| | - Yuwei Wang
- Department of Medicine, Boston University School of Medicine, Boston, MA, USA
| | - Ileana De Anda-Duran
- School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA, USA
| | - Phillip H Hwang
- Department of Anatomy and Neurobiology, Boston University School of Medicine, Boston, MA, USA
| | - Justin A Cramer
- Department of Radiology, College of Medicine, University of Nebraska Medical Center, Omaha, NE, USA
| | - Brigid C Dwyer
- Department of Neurology, Boston University School of Medicine, Boston, MA, USA
| | - Honglin Hao
- Department of Neurology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
| | - Michelle C Kaku
- Department of Neurology, Boston University School of Medicine, Boston, MA, USA
| | - Sachin Kedar
- Department of Neurological Sciences, College of Medicine, University of Nebraska Medical Center, Omaha, NE, USA
- Department Neurology, Emory University School of Medicine, Atlanta, GA, USA
- Department Ophthalmology, Emory University School of Medicine, Atlanta, GA, USA
| | - Peter H Lee
- Department of Radiology, Lahey Hospital & Medical Center, Burlington, MA, USA
| | - Asim Z Mian
- Department of Radiology, Boston University School of Medicine, Boston, MA, USA
| | - Daniel L Murman
- Department of Neurological Sciences, College of Medicine, University of Nebraska Medical Center, Omaha, NE, USA
| | - Sarah O'Shea
- Department of Neurology, Boston University School of Medicine, Boston, MA, USA
| | - Aaron B Paul
- Department of Radiology, Lahey Hospital & Medical Center, Burlington, MA, USA
| | | | - E Alton Sartor
- Department of Neurology, Boston University School of Medicine, Boston, MA, USA
| | - Aneeta R Saxena
- Department of Neurology, Boston University School of Medicine, Boston, MA, USA
| | - Ludy C Shih
- Department of Neurology, Boston University School of Medicine, Boston, MA, USA
| | - Juan E Small
- Department of Radiology, Lahey Hospital & Medical Center, Burlington, MA, USA
| | - Maximilian J Smith
- Department of Radiology, Lahey Hospital & Medical Center, Burlington, MA, USA
| | - Arun Swaminathan
- Department of Neurological Sciences, College of Medicine, University of Nebraska Medical Center, Omaha, NE, USA
| | | | - Olga Taraschenko
- Department of Neurological Sciences, College of Medicine, University of Nebraska Medical Center, Omaha, NE, USA
| | - Hui You
- Department of Radiology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
| | - Jing Yuan
- Department of Neurology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
| | - Yan Zhou
- Department of Neurology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
| | - Shuhan Zhu
- Department of Neurology, Boston University School of Medicine, Boston, MA, USA
| | - Michael L Alosco
- Department of Neurology, Boston University School of Medicine, Boston, MA, USA
- Boston University Alzheimer's Disease Research Center, Boston, MA, USA
| | - Jesse Mez
- The Framingham Heart Study, Boston University School of Medicine, Boston, MA, USA
- Department of Neurology, Boston University School of Medicine, Boston, MA, USA
- Boston University Alzheimer's Disease Research Center, Boston, MA, USA
| | - Thor D Stein
- Boston University Alzheimer's Disease Research Center, Boston, MA, USA
- Department of Pathology and Laboratory Medicine, Boston University School of Medicine, Boston, MA, USA
- Boston VA Healthcare System, Boston, MA, USA
- Bedford VA Healthcare System, Bedford, MA, USA
| | | | - Rhoda Au
- Department of Anatomy and Neurobiology, Boston University School of Medicine, Boston, MA, USA
- The Framingham Heart Study, Boston University School of Medicine, Boston, MA, USA
- Department of Neurology, Boston University School of Medicine, Boston, MA, USA
- Boston University Alzheimer's Disease Research Center, Boston, MA, USA
- Department of Epidemiology, Boston University School of Public Health, Boston, MA, USA
| | - Vijaya B Kolachalama
- Department of Medicine, Boston University School of Medicine, Boston, MA, USA.
- Boston University Alzheimer's Disease Research Center, Boston, MA, USA.
- Department of Computer Science, Boston University, Boston, MA, USA.
- Faculty of Computing & Data Sciences, Boston University, Boston, MA, USA.
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15
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Ali H, Biswas R, Ali F, Shah U, Alamgir A, Mousa O, Shah Z. The role of generative adversarial networks in brain MRI: a scoping review. Insights Imaging 2022; 13:98. [PMID: 35662369 PMCID: PMC9167371 DOI: 10.1186/s13244-022-01237-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2022] [Accepted: 05/11/2022] [Indexed: 11/23/2022] Open
Abstract
The performance of artificial intelligence (AI) for brain MRI can improve if enough data are made available. Generative adversarial networks (GANs) showed a lot of potential to generate synthetic MRI data that can capture the distribution of real MRI. Besides, GANs are also popular for segmentation, noise removal, and super-resolution of brain MRI images. This scoping review aims to explore how GANs methods are being used on brain MRI data, as reported in the literature. The review describes the different applications of GANs for brain MRI, presents the most commonly used GANs architectures, and summarizes the publicly available brain MRI datasets for advancing the research and development of GANs-based approaches. This review followed the guidelines of PRISMA-ScR to perform the study search and selection. The search was conducted on five popular scientific databases. The screening and selection of studies were performed by two independent reviewers, followed by validation by a third reviewer. Finally, the data were synthesized using a narrative approach. This review included 139 studies out of 789 search results. The most common use case of GANs was the synthesis of brain MRI images for data augmentation. GANs were also used to segment brain tumors and translate healthy images to diseased images or CT to MRI and vice versa. The included studies showed that GANs could enhance the performance of AI methods used on brain MRI imaging data. However, more efforts are needed to transform the GANs-based methods in clinical applications.
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Affiliation(s)
- Hazrat Ali
- College of Science and Engineering, Hamad Bin Khalifa University, Qatar Foundation, 34110, Doha, Qatar.
| | - Rafiul Biswas
- College of Science and Engineering, Hamad Bin Khalifa University, Qatar Foundation, 34110, Doha, Qatar
| | - Farida Ali
- College of Science and Engineering, Hamad Bin Khalifa University, Qatar Foundation, 34110, Doha, Qatar
| | - Uzair Shah
- College of Science and Engineering, Hamad Bin Khalifa University, Qatar Foundation, 34110, Doha, Qatar
| | - Asma Alamgir
- College of Science and Engineering, Hamad Bin Khalifa University, Qatar Foundation, 34110, Doha, Qatar
| | - Osama Mousa
- College of Science and Engineering, Hamad Bin Khalifa University, Qatar Foundation, 34110, Doha, Qatar
| | - Zubair Shah
- College of Science and Engineering, Hamad Bin Khalifa University, Qatar Foundation, 34110, Doha, Qatar.
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16
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Deep Learning-Based Diagnosis of Alzheimer’s Disease. J Pers Med 2022; 12:jpm12050815. [PMID: 35629237 PMCID: PMC9143671 DOI: 10.3390/jpm12050815] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2022] [Revised: 05/15/2022] [Accepted: 05/16/2022] [Indexed: 12/27/2022] Open
Abstract
Alzheimer’s disease (AD), the most familiar type of dementia, is a severe concern in modern healthcare. Around 5.5 million people aged 65 and above have AD, and it is the sixth leading cause of mortality in the US. AD is an irreversible, degenerative brain disorder characterized by a loss of cognitive function and has no proven cure. Deep learning techniques have gained popularity in recent years, particularly in the domains of natural language processing and computer vision. Since 2014, these techniques have begun to achieve substantial consideration in AD diagnosis research, and the number of papers published in this arena is rising drastically. Deep learning techniques have been reported to be more accurate for AD diagnosis in comparison to conventional machine learning models. Motivated to explore the potential of deep learning in AD diagnosis, this study reviews the current state-of-the-art in AD diagnosis using deep learning. We summarize the most recent trends and findings using a thorough literature review. The study also explores the different biomarkers and datasets for AD diagnosis. Even though deep learning has shown promise in AD diagnosis, there are still several challenges that need to be addressed.
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17
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Ma D, Kumar M, Khetan V, Sen P, Bhende M, Chen S, Yu TTL, Lee S, Navajas EV, Matsubara JA, Ju MJ, Sarunic MV, Raman R, Beg MF. Clinical explainable differential diagnosis of polypoidal choroidal vasculopathy and age-related macular degeneration using deep learning. Comput Biol Med 2022; 143:105319. [PMID: 35220077 DOI: 10.1016/j.compbiomed.2022.105319] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2021] [Revised: 02/11/2022] [Accepted: 02/11/2022] [Indexed: 02/06/2023]
Abstract
BACKGROUND This study aims to achieve an automatic differential diagnosis between two types of retinal pathologies with similar pathological features - Polypoidal choroidal vasculopathy (PCV) and wet age-related macular degeneration (AMD) from volumetric optical coherence tomography (OCT) images, and identify clinically-relevant pathological features, using an explainable deep-learning-based framework. METHODS This is a retrospective study with data from a cross-sectional cohort. The OCT volume of 73 eyes from 59 patients was included in this study. Disease differentiation was achieved through single-B-scan-based classification followed by a volumetric probability prediction aggregation step. We compared different labeling strategies with and without identifying pathological B-scans within each OCT volume. Clinical interpretability was achieved through normalized aggregation of B-scan-based saliency maps followed by maximum-intensity-projection onto the en face plane. We derived the PCV score from the proposed differential diagnosis framework with different labeling strategies. The en face projection of saliency map was validated with the pathologies identified in Indocyanine green angiography (ICGA). RESULTS Model trained with both labeling strategies achieved similar level differentiation power (>90%), with good correspondence between pathological features detected from the projected en face saliency map and ICGA. CONCLUSIONS This study demonstrated the potential clinical application of non-invasive differential diagnosis using AI-driven OCT-based analysis, with minimal requirement of labeling efforts, along with clinical explainability achieved through automatically detected disease-related pathologies.
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Affiliation(s)
- Da Ma
- Wake Forest University School of Medicine, Medical Center Boulevard, Winston-Salem, NC, USA; School of Engineering Science, Simon Fraser University, Burnaby, BC, Canada.
| | - Meenakshi Kumar
- Shri Bhagwan Mahavir Vitreoretinal Service, Medical Research Foundation, Sankara Nethralaya, Chennai, India
| | - Vikas Khetan
- Shri Bhagwan Mahavir Vitreoretinal Service, Medical Research Foundation, Sankara Nethralaya, Chennai, India
| | - Parveen Sen
- Shri Bhagwan Mahavir Vitreoretinal Service, Medical Research Foundation, Sankara Nethralaya, Chennai, India
| | - Muna Bhende
- Shri Bhagwan Mahavir Vitreoretinal Service, Medical Research Foundation, Sankara Nethralaya, Chennai, India
| | - Shuo Chen
- School of Engineering Science, Simon Fraser University, Burnaby, BC, Canada
| | - Timothy T L Yu
- School of Engineering Science, Simon Fraser University, Burnaby, BC, Canada
| | - Sieun Lee
- School of Engineering Science, Simon Fraser University, Burnaby, BC, Canada; Mental Health & Clinical Neurosciences, School of Medicine, University of Nottingham, Nottingham, United Kingdom
| | - Eduardo V Navajas
- Department of Ophthalmology & Visual Sciences, The University of British Columbia, Vancouver, BC, Canada; University of British Columbia Vancouver General Hospital, Eye Care Centre, Vancouver, BC, Canada
| | - Joanne A Matsubara
- Department of Ophthalmology & Visual Sciences, The University of British Columbia, Vancouver, BC, Canada; University of British Columbia Vancouver General Hospital, Eye Care Centre, Vancouver, BC, Canada
| | - Myeong Jin Ju
- Department of Ophthalmology & Visual Sciences, The University of British Columbia, Vancouver, BC, Canada; University of British Columbia Vancouver General Hospital, Eye Care Centre, Vancouver, BC, Canada; School of Biomedical Engineering, University of British Columbia, BC, Canada
| | - Marinko V Sarunic
- School of Engineering Science, Simon Fraser University, Burnaby, BC, Canada; Institute of Ophthalmology, University College London, London, UK; Department of Medical Physics and Biomedical Engineering, University College London, United Kingdom
| | - Rajiv Raman
- Shri Bhagwan Mahavir Vitreoretinal Service, Medical Research Foundation, Sankara Nethralaya, Chennai, India.
| | - Mirza Faisal Beg
- School of Engineering Science, Simon Fraser University, Burnaby, BC, Canada.
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18
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McKenna MC, Murad A, Huynh W, Lope J, Bede P. The changing landscape of neuroimaging in frontotemporal lobar degeneration: from group-level observations to single-subject data interpretation. Expert Rev Neurother 2022; 22:179-207. [PMID: 35227146 DOI: 10.1080/14737175.2022.2048648] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
INTRODUCTION While the imaging signatures of frontotemporal lobar degeneration (FTLD) phenotypes and genotypes are well-characterised based on group-level descriptive analyses, the meaningful interpretation of single MRI scans remains challenging. Single-subject MRI classification frameworks rely on complex computational models and large training datasets to categorise individual patients into diagnostic subgroups based on distinguishing imaging features. Reliable individual subject data interpretation is hugely important in the clinical setting to expedite the diagnosis and classify individuals into relevant prognostic categories. AREAS COVERED This article reviews (1) the neuroimaging studies that propose single-subject MRI classification strategies in symptomatic and pre-symptomatic FTLD, (2) potential practical implications and (3) the limitations of current single-subject data interpretation models. EXPERT OPINION Classification studies in FTLD have demonstrated the feasibility of categorising individual subjects into diagnostic groups based on multiparametric imaging data. Preliminary data indicate that pre-symptomatic FTLD mutation carriers may also be reliably distinguished from controls. Despite momentous advances in the field, significant further improvements are needed before these models can be developed into viable clinical applications.
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Affiliation(s)
| | - Aizuri Murad
- Computational Neuroimaging Group, Trinity College Dublin, Ireland
| | - William Huynh
- Brain and Mind Centre, University of Sydney, Australia
| | - Jasmin Lope
- Computational Neuroimaging Group, Trinity College Dublin, Ireland
| | - Peter Bede
- Computational Neuroimaging Group, Trinity College Dublin, Ireland.,Pitié-Salpêtrière University Hospital, Sorbonne University, France
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19
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McKenna MC, Tahedl M, Murad A, Lope J, Hardiman O, Hutchinson S, Bede P. White matter microstructure alterations in frontotemporal dementia: Phenotype-associated signatures and single-subject interpretation. Brain Behav 2022; 12:e2500. [PMID: 35072974 PMCID: PMC8865163 DOI: 10.1002/brb3.2500] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Revised: 11/22/2021] [Accepted: 01/01/2022] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND Frontotemporal dementias (FTD) include a genetically heterogeneous group of conditions with distinctive molecular, radiological and clinical features. The majority of radiology studies in FTD compare FTD subgroups to healthy controls to describe phenotype- or genotype-associated imaging signatures. While the characterization of group-specific imaging traits is academically important, the priority of clinical imaging is the meaningful interpretation of individual datasets. METHODS To demonstrate the feasibility of single-subject magnetic resonance imaging (MRI) interpretation, we have evaluated the white matter profile of 60 patients across the clinical spectrum of FTD. A z-score-based approach was implemented, where the diffusivity metrics of individual patients were appraised with reference to demographically matched healthy controls. Fifty white matter tracts were systematically evaluated in each subject with reference to normative data. RESULTS The z-score-based approach successfully detected white matter pathology in single subjects, and group-level inferences were analogous to the outputs of standard track-based spatial statistics. CONCLUSIONS Our findings suggest that it is possible to meaningfully evaluate the diffusion profile of single FTD patients if large normative datasets are available. In contrast to the visual review of FLAIR and T2-weighted images, computational imaging offers objective, quantitative insights into white matter integrity changes even at single-subject level.
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Affiliation(s)
- Mary Clare McKenna
- Computational Neuroimaging Group, Trinity College Dublin, Dublin, Ireland
| | - Marlene Tahedl
- Computational Neuroimaging Group, Trinity College Dublin, Dublin, Ireland
| | - Aizuri Murad
- Computational Neuroimaging Group, Trinity College Dublin, Dublin, Ireland
| | - Jasmin Lope
- Computational Neuroimaging Group, Trinity College Dublin, Dublin, Ireland
| | - Orla Hardiman
- Computational Neuroimaging Group, Trinity College Dublin, Dublin, Ireland
| | | | - Peter Bede
- Computational Neuroimaging Group, Trinity College Dublin, Dublin, Ireland.,Department of Neurology, St James's Hospital, Dublin, Ireland
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20
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Bede P, Murad A, Lope J, Li Hi Shing S, Finegan E, Chipika RH, Hardiman O, Chang KM. Phenotypic categorisation of individual subjects with motor neuron disease based on radiological disease burden patterns: A machine-learning approach. J Neurol Sci 2022; 432:120079. [PMID: 34875472 DOI: 10.1016/j.jns.2021.120079] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Revised: 11/25/2021] [Accepted: 11/29/2021] [Indexed: 12/20/2022]
Abstract
Motor neuron disease is an umbrella term encompassing a multitude of clinically heterogeneous phenotypes. The early and accurate categorisation of patients is hugely important, as MND phenotypes are associated with markedly different prognoses, progression rates, care needs and benefit from divergent management strategies. The categorisation of patients shortly after symptom onset is challenging, and often lengthy clinical monitoring is needed to assign patients to the appropriate phenotypic subgroup. In this study, a multi-class machine-learning strategy was implemented to classify 300 patients based on their radiological profile into diagnostic labels along the UMN-LMN spectrum. A comprehensive panel of cortical thickness measures, subcortical grey matter variables, and white matter integrity metrics were evaluated in a multilayer perceptron (MLP) model. Additional exploratory analyses were also carried out using discriminant function analyses (DFA). Excellent classification accuracy was achieved for amyotrophic lateral sclerosis in the testing cohort (93.7%) using the MLP model, but poor diagnostic accuracy was detected for primary lateral sclerosis (43.8%) and poliomyelitis survivors (60%). Feature importance analyses highlighted the relevance of white matter diffusivity metrics and the evaluation of cerebellar indices, cingulate measures and thalamic radiation variables to discriminate MND phenotypes. Our data suggest that radiological data from single patients may be meaningfully interpreted if large training data sets are available and the provision of diagnostic probability outcomes may be clinically useful in patients with short symptom duration. The computational interpretation of multimodal radiology datasets herald viable diagnostic, prognostic and clinical trial applications.
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Affiliation(s)
- Peter Bede
- Computational Neuroimaging Group, Biomedical Sciences Institute, Trinity College Dublin, Ireland; Pitié-Salpêtrière University Hospital, Sorbonne University, Paris, France.
| | - Aizuri Murad
- Computational Neuroimaging Group, Biomedical Sciences Institute, Trinity College Dublin, Ireland
| | - Jasmin Lope
- Computational Neuroimaging Group, Biomedical Sciences Institute, Trinity College Dublin, Ireland
| | - Stacey Li Hi Shing
- Computational Neuroimaging Group, Biomedical Sciences Institute, Trinity College Dublin, Ireland
| | - Eoin Finegan
- Computational Neuroimaging Group, Biomedical Sciences Institute, Trinity College Dublin, Ireland
| | - Rangariroyashe H Chipika
- Computational Neuroimaging Group, Biomedical Sciences Institute, Trinity College Dublin, Ireland
| | - Orla Hardiman
- Computational Neuroimaging Group, Biomedical Sciences Institute, Trinity College Dublin, Ireland
| | - Kai Ming Chang
- Computational Neuroimaging Group, Biomedical Sciences Institute, Trinity College Dublin, Ireland; Department of Electronics and Computer Science, University of Southampton, UK
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21
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Mirabnahrazam G, Ma D, Lee S, Popuri K, Lee H, Cao J, Wang L, Galvin JE, Beg MF. Machine Learning Based Multimodal Neuroimaging Genomics Dementia Score for Predicting Future Conversion to Alzheimer's Disease. J Alzheimers Dis 2022; 87:1345-1365. [PMID: 35466939 PMCID: PMC9195128 DOI: 10.3233/jad-220021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND The increasing availability of databases containing both magnetic resonance imaging (MRI) and genetic data allows researchers to utilize multimodal data to better understand the characteristics of dementia of Alzheimer's type (DAT). OBJECTIVE The goal of this study was to develop and analyze novel biomarkers that can help predict the development and progression of DAT. METHODS We used feature selection and ensemble learning classifier to develop an image/genotype-based DAT score that represents a subject's likelihood of developing DAT in the future. Three feature types were used: MRI only, genetic only, and combined multimodal data. We used a novel data stratification method to better represent different stages of DAT. Using a pre-defined 0.5 threshold on DAT scores, we predicted whether a subject would develop DAT in the future. RESULTS Our results on Alzheimer's Disease Neuroimaging Initiative (ADNI) database showed that dementia scores using genetic data could better predict future DAT progression for currently normal control subjects (Accuracy = 0.857) compared to MRI (Accuracy = 0.143), while MRI can better characterize subjects with stable mild cognitive impairment (Accuracy = 0.614) compared to genetics (Accuracy = 0.356). Combining MRI and genetic data showed improved classification performance in the remaining stratified groups. CONCLUSION MRI and genetic data can contribute to DAT prediction in different ways. MRI data reflects anatomical changes in the brain, while genetic data can detect the risk of DAT progression prior to the symptomatic onset. Combining information from multimodal data appropriately can improve prediction performance.
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Affiliation(s)
| | - Da Ma
- School of Engineering, Simon Fraser University, Burnaby, BC, Canada
- School of Medicine, Wake Forest University, Winston-Salem, NC, USA
| | - Sieun Lee
- School of Engineering, Simon Fraser University, Burnaby, BC, Canada
- Mental Health & Clinical Neurosciences, School of Medicine, University of Nottingham, Nottingham, United Kingdom
| | - Karteek Popuri
- School of Engineering, Simon Fraser University, Burnaby, BC, Canada
| | - Hyunwoo Lee
- Division of Neurology, Department of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Jiguo Cao
- Department of Statistics and Actuarial Science, Simon Fraser University, Burnaby, BC, Canada
| | - Lei Wang
- Psychiatry and Behavioral Health, Ohio State University Wexner Medical Center, Columbus, OH, USA
| | - James E Galvin
- Comprehensive Center for Brain Health, Department of Neurology, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Mirza Faisal Beg
- School of Engineering, Simon Fraser University, Burnaby, BC, Canada
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22
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Ma D, Lu D, Chen S, Heisler M, Dabiri S, Lee S, Lee H, Ding GW, Sarunic MV, Beg MF. LF-UNet - A novel anatomical-aware dual-branch cascaded deep neural network for segmentation of retinal layers and fluid from optical coherence tomography images. Comput Med Imaging Graph 2021; 94:101988. [PMID: 34717264 DOI: 10.1016/j.compmedimag.2021.101988] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2020] [Revised: 08/31/2021] [Accepted: 09/11/2021] [Indexed: 11/17/2022]
Abstract
Computer-assistant diagnosis of retinal disease relies heavily on the accurate detection of retinal boundaries and other pathological features such as fluid accumulation. Optical coherence tomography (OCT) is a non-invasive ophthalmological imaging technique that has become a standard modality in the field due to its ability to detect cross-sectional retinal pathologies at the micrometer level. In this work, we presented a novel framework to achieve simultaneous retinal layers and fluid segmentation. A dual-branch deep neural network, termed LF-UNet, was proposed which combines the expansion path of the U-Net and original fully convolutional network, with a dilated network. In addition, we introduced a cascaded network framework to include the anatomical awareness embedded in the volumetric image. Cross validation experiments showed that the proposed LF-UNet has superior performance compared to the state-of-the-art methods, and that incorporating the relative positional map structural prior information could further improve the performance regardless of the network. The generalizability of the proposed network was demonstrated on an independent dataset acquired from the same types of device with different field of view, or images acquired from different device.
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Affiliation(s)
- Da Ma
- Simon Fraser University, School of Engineering Science, Burnaby V5A 1S6, Canada
| | - Donghuan Lu
- Simon Fraser University, School of Engineering Science, Burnaby V5A 1S6, Canada; Tencent Jarvis Lab, Shenzhen, China
| | - Shuo Chen
- Simon Fraser University, School of Engineering Science, Burnaby V5A 1S6, Canada
| | - Morgan Heisler
- Simon Fraser University, School of Engineering Science, Burnaby V5A 1S6, Canada
| | - Setareh Dabiri
- Simon Fraser University, School of Engineering Science, Burnaby V5A 1S6, Canada
| | - Sieun Lee
- Simon Fraser University, School of Engineering Science, Burnaby V5A 1S6, Canada
| | - Hyunwoo Lee
- Division of Neurology, Department of Medicine, University of British Columbia, Canada
| | - Gavin Weiguang Ding
- Simon Fraser University, School of Engineering Science, Burnaby V5A 1S6, Canada
| | - Marinko V Sarunic
- Simon Fraser University, School of Engineering Science, Burnaby V5A 1S6, Canada
| | - Mirza Faisal Beg
- Simon Fraser University, School of Engineering Science, Burnaby V5A 1S6, Canada.
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23
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Funayama M, Nakajima A, Kurose S, Takata T. Putative Alcohol-Related Dementia as an Early Manifestation of Right Temporal Variant of Frontotemporal Dementia. J Alzheimers Dis 2021; 83:531-537. [PMID: 34334406 DOI: 10.3233/jad-210501] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Diagnosis of frontotemporal dementia is challenging in the early stages. Various psychiatric and neurological diseases are misdiagnosed as frontotemporal dementia and vice versa. Here we present a case with right temporal variant of frontotemporal dementia who presented with alcohol dependency and remarkable behavioral symptoms and was first misdiagnosed as having alcohol-related dementia. He then revealed symptoms related to right temporal variant of frontotemporal dementia, such as prosopagnosia, difficulty recognizing his housemates, loss of empathy, ritualistic behaviors, and difficulty finding and comprehending words. Retrospectively, his alcohol dependency itself was considered an early manifestation of right temporal variant of frontotemporal dementia.
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Affiliation(s)
- Michitaka Funayama
- Department of Neuropsychiatry, Ashikaga Red Cross Hospital, Ashikaga-City, Tochigi, Japan
| | - Asuka Nakajima
- Department of Rehabilitation, Ashikaga Red Cross Hospital, Tochigi, Japan
| | - Shin Kurose
- Department of Neuropsychiatry, Ashikaga Red Cross Hospital, Ashikaga-City, Tochigi, Japan
| | - Taketo Takata
- Department of Neuropsychiatry, Ashikaga Red Cross Hospital, Ashikaga-City, Tochigi, Japan
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24
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Calhoun VD, Pearlson GD, Sui J. Data-driven approaches to neuroimaging biomarkers for neurological and psychiatric disorders: emerging approaches and examples. Curr Opin Neurol 2021; 34:469-479. [PMID: 34054110 PMCID: PMC8263510 DOI: 10.1097/wco.0000000000000967] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
PURPOSE OF REVIEW The 'holy grail' of clinical applications of neuroimaging to neurological and psychiatric disorders via personalized biomarkers has remained mostly elusive, despite considerable effort. However, there are many reasons to continue to be hopeful, as the field has made remarkable advances over the past few years, fueled by a variety of converging technical and data developments. RECENT FINDINGS We discuss a number of advances that are accelerating the push for neuroimaging biomarkers including the advent of the 'neuroscience big data' era, biomarker data competitions, the development of more sophisticated algorithms including 'guided' data-driven approaches that facilitate automation of network-based analyses, dynamic connectivity, and deep learning. Another key advance includes multimodal data fusion approaches which can provide convergent and complementary evidence pointing to possible mechanisms as well as increase predictive accuracy. SUMMARY The search for clinically relevant neuroimaging biomarkers for neurological and psychiatric disorders is rapidly accelerating. Here, we highlight some of these aspects, provide recent examples from studies in our group, and link to other ongoing work in the field. It is critical that access and use of these advanced approaches becomes mainstream, this will help propel the community forward and facilitate the production of robust and replicable neuroimaging biomarkers.
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Affiliation(s)
- Vince D Calhoun
- Tri-institutional Center for Translational Research in Neuroimaging and Data Science (TReNDS), Georgia State University, Georgia Institute of Technology, Emory University, Atlanta, Georgia
| | - Godfrey D Pearlson
- Department of Psychiatry and Neuroscience, Yale School of Medicine, New Haven, Connecticut, USA
| | - Jing Sui
- Tri-institutional Center for Translational Research in Neuroimaging and Data Science (TReNDS), Georgia State University, Georgia Institute of Technology, Emory University, Atlanta, Georgia
- Institute of Automation, Chinese Academy of Sciences, and the University of Chinese Academy of Sciences, Beijing, China
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25
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Chlap P, Min H, Vandenberg N, Dowling J, Holloway L, Haworth A. A review of medical image data augmentation techniques for deep learning applications. J Med Imaging Radiat Oncol 2021; 65:545-563. [PMID: 34145766 DOI: 10.1111/1754-9485.13261] [Citation(s) in RCA: 155] [Impact Index Per Article: 51.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2021] [Accepted: 05/23/2021] [Indexed: 12/21/2022]
Abstract
Research in artificial intelligence for radiology and radiotherapy has recently become increasingly reliant on the use of deep learning-based algorithms. While the performance of the models which these algorithms produce can significantly outperform more traditional machine learning methods, they do rely on larger datasets being available for training. To address this issue, data augmentation has become a popular method for increasing the size of a training dataset, particularly in fields where large datasets aren't typically available, which is often the case when working with medical images. Data augmentation aims to generate additional data which is used to train the model and has been shown to improve performance when validated on a separate unseen dataset. This approach has become commonplace so to help understand the types of data augmentation techniques used in state-of-the-art deep learning models, we conducted a systematic review of the literature where data augmentation was utilised on medical images (limited to CT and MRI) to train a deep learning model. Articles were categorised into basic, deformable, deep learning or other data augmentation techniques. As artificial intelligence models trained using augmented data make their way into the clinic, this review aims to give an insight to these techniques and confidence in the validity of the models produced.
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Affiliation(s)
- Phillip Chlap
- South Western Sydney Clinical School, University of New South Wales, Sydney, New South Wales, Australia.,Ingham Institute for Applied Medical Research, Sydney, New South Wales, Australia.,Liverpool and Macarthur Cancer Therapy Centre, Liverpool Hospital, Sydney, New South Wales, Australia
| | - Hang Min
- South Western Sydney Clinical School, University of New South Wales, Sydney, New South Wales, Australia.,Ingham Institute for Applied Medical Research, Sydney, New South Wales, Australia.,The Australian e-Health and Research Centre, CSIRO Health and Biosecurity, Brisbane, Queensland, Australia
| | - Nym Vandenberg
- Institute of Medical Physics, University of Sydney, Sydney, New South Wales, Australia
| | - Jason Dowling
- South Western Sydney Clinical School, University of New South Wales, Sydney, New South Wales, Australia.,The Australian e-Health and Research Centre, CSIRO Health and Biosecurity, Brisbane, Queensland, Australia
| | - Lois Holloway
- South Western Sydney Clinical School, University of New South Wales, Sydney, New South Wales, Australia.,Ingham Institute for Applied Medical Research, Sydney, New South Wales, Australia.,Liverpool and Macarthur Cancer Therapy Centre, Liverpool Hospital, Sydney, New South Wales, Australia.,Institute of Medical Physics, University of Sydney, Sydney, New South Wales, Australia.,Centre for Medical Radiation Physics, University of Wollongong, Wollongong, New South Wales, Australia
| | - Annette Haworth
- Institute of Medical Physics, University of Sydney, Sydney, New South Wales, Australia
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26
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Cui L, Chen K, Huang L, Sun J, Lv Y, Jia X, Guo Q. Changes in local brain function in mild cognitive impairment due to semantic dementia. CNS Neurosci Ther 2021; 27:587-602. [PMID: 33650764 PMCID: PMC8025655 DOI: 10.1111/cns.13621] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2020] [Revised: 01/24/2021] [Accepted: 01/28/2021] [Indexed: 11/30/2022] Open
Abstract
AIMS Mild cognitive impairment due to semantic dementia represents the preclinical stage, involving cognitive decline dominated by semantic impairment below the semantic dementia standard. Therefore, studying mild cognitive impairment due to semantic dementia may identify changes in patients before progression to dementia. However, whether changes in local functional activity occur in preclinical stages of semantic dementia remains unknown. Here, we explored local functional changes in patients with mild cognitive impairment due to semantic dementia using resting-state functional MRI. METHODS We administered a battery of neuropsychological tests to twenty-two patients with mild cognitive impairment due to semantic dementia (MCI-SD group) and nineteen healthy controls (HC group). We performed structural MRI to compare gray matter volumes, and resting-state functional MRI with multiple sub-bands and indicators to evaluate functional activity. RESULTS Neuropsychological tests revealed a significant decline in semantic performance in the MCI-SD group, but no decline in other cognitive domains. Resting-state functional MRI revealed local functional changes in multiple brain regions in the MCI-SD group, distributed in different sub-bands and indicators. In the normal band, local functional changes were only in the gray matter atrophic area. In the other sub-bands, more regions with local functional changes outside atrophic areas were found across various indicators. Among these, the degree centrality of the left precuneus in the MCI-SD group was positively correlated with general semantic tasks (oral sound naming, word-picture verification). CONCLUSION Our study revealed local functional changes in mild cognitive impairment due to semantic dementia, some of which were located outside the atrophic gray matter. Driven by functional connectivity changes, the left precuneus might play a role in preclinical semantic dementia. The study proved the value of frequency-dependent sub-bands, especially the slow-2 and slow-3 sub-bands.
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Affiliation(s)
- Liang Cui
- Department of GerontologyShanghai Jiao Tong University Affiliated Sixth People’s HospitalShanghaiChina
| | - Keliang Chen
- Department of NeurologyHuashan HospitalFudan UniversityShanghaiChina
| | - Lin Huang
- Department of GerontologyShanghai Jiao Tong University Affiliated Sixth People’s HospitalShanghaiChina
| | - Jiawei Sun
- School of Information and Electronics TechnologyJiamusi UniversityJiamusiChina
| | - Yating Lv
- Institute of Psychological SciencesHangzhou Normal UniversityHangzhouChina
- Zhejiang Key Laboratory for Research in Assessment of Cognitive ImpairmentsHangzhouChina
| | - Xize Jia
- Institute of Psychological SciencesHangzhou Normal UniversityHangzhouChina
- Zhejiang Key Laboratory for Research in Assessment of Cognitive ImpairmentsHangzhouChina
| | - Qihao Guo
- Department of GerontologyShanghai Jiao Tong University Affiliated Sixth People’s HospitalShanghaiChina
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27
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Shi H, Ma D, Nie Y, Faisal Beg M, Pei J, Cao J, Neuroimaging Initiative TAD. Early diagnosis of Alzheimer's disease on ADNI data using novel longitudinal score based on functional principal component analysis. J Med Imaging (Bellingham) 2021; 8:024502. [PMID: 33898638 DOI: 10.1117/1.jmi.8.2.024502] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Accepted: 03/12/2021] [Indexed: 11/14/2022] Open
Abstract
Methods: Alzheimer's disease (AD) is a worldwide prevalent age-related neurodegenerative disease with no available cure yet. Early prognosis is therefore crucial for planning proper clinical intervention. It is especially true for people diagnosed with mild cognitive impairment, to whom the prediction of whether and when the future disease onset would happen is particularly valuable. However, such prognostic prediction has been proven to be challenging, and previous studies have only achieved limited success. Approach: In this study, we seek to extract the principal component of the longitudinal disease progression trajectory in the early stage of AD, measured as the magnetic resonance imaging (MRI)-derived structural volume, to predict the onset of AD for mild cognitive impaired patients two years ahead. Results: Cross-validation results of LASSO regression using the longitudinal functional principal component (FPC) features show significant improved predictive power compared to training using the baseline volume 12 months before AD conversion [area under the receiver operating characteristic curve (AUC) of 0.802 versus 0.732] and 24 months before AD conversion (AUC of 0.816 versus 0.717). Conclusions: We present a framework using the FPCA to extract features from MRI-derived information collected from multiple timepoints. The results of our study demonstrate the advantageous predictive power of the population-based longitudinal features to predict the disease onset compared with using only cross-sectional data-based on volumetric features extracted from a single timepoint, demonstrating the improved prediction power using FPC-derived longitudinal features.
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Affiliation(s)
- Haolun Shi
- Simon Fraser University, Department of Statistics and Actuarial Science, Burnaby, BC, Canada
| | - Da Ma
- Simon Fraser University, School of Engineering Science, Burnaby, BC, Canada
| | - Yunlong Nie
- Simon Fraser University, Department of Statistics and Actuarial Science, Burnaby, BC, Canada
| | - Mirza Faisal Beg
- Simon Fraser University, School of Engineering Science, Burnaby, BC, Canada
| | - Jian Pei
- Simon Fraser University, Department of Statistics and Actuarial Science, Burnaby, BC, Canada.,Simon Fraser University, School of Computing Science, Burnaby, BC, Canada
| | - Jiguo Cao
- Simon Fraser University, Department of Statistics and Actuarial Science, Burnaby, BC, Canada.,Simon Fraser University, School of Computing Science, Burnaby, BC, Canada
| | - The Alzheimer's Disease Neuroimaging Initiative
- Simon Fraser University, Department of Statistics and Actuarial Science, Burnaby, BC, Canada.,Simon Fraser University, School of Engineering Science, Burnaby, BC, Canada.,Simon Fraser University, School of Computing Science, Burnaby, BC, Canada
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28
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Ma D, Yee E, Stocks JK, Jenkins LM, Popuri K, Chausse G, Wang L, Probst S, Beg MF. Blinded Clinical Evaluation for Dementia of Alzheimer's Type Classification Using FDG-PET: A Comparison Between Feature-Engineered and Non-Feature-Engineered Machine Learning Methods. J Alzheimers Dis 2021; 80:715-726. [PMID: 33579858 PMCID: PMC8978589 DOI: 10.3233/jad-201591] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
BACKGROUND Advanced machine learning methods can aid in the identification of dementia risk using neuroimaging-derived features including FDG-PET. However, to enable the translation of these methods and test their usefulness in clinical practice, it is crucial to conduct independent validation on real clinical samples, which has yet to be properly delineated in the current literature. OBJECTIVE In this paper, we present our efforts to enable such clinical translational through the evaluation and comparison of two machine-learning methods for discrimination between dementia of Alzheimer's type (DAT) and Non-DAT controls. METHODS FDG-PET-based dementia scores were generated on an independent clinical sample whose clinical diagnosis was blinded to the algorithm designers. A feature-engineered approach (multi-kernel probability classifier) and a non-feature-engineered approach (3D convolutional neural network) were analyzed. Both classifiers were pre-trained on cognitively normal subjects as well as subjects with DAT. These two methods provided a probabilistic dementia score for this previously unseen clinical data. Performance of the algorithms were compared against ground-truth dementia rating assessed by experienced nuclear physicians. RESULTS Blinded clinical evaluation on both classifiers showed good separation between the cognitively normal subjects and the patients diagnosed with DAT. The non-feature-engineered dementia score showed higher sensitivity among subjects whose diagnosis was in agreement between the machine-learning models, while the feature-engineered approach showed higher specificity in non-consensus cases. CONCLUSION In this study, we demonstrated blinded evaluation using data from an independent clinical sample for assessing the performance in DAT classification models in a clinical setting. Our results showed good generalizability for two machine-learning approaches, marking an important step for the translation of pre-trained machine-learning models into clinical practice.
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Affiliation(s)
- Da Ma
- School of Engineering Science, Simon Fraser University, Burnaby, Canada
| | - Evangeline Yee
- School of Engineering Science, Simon Fraser University, Burnaby, Canada
| | - Jane K. Stocks
- Department of Psychiatry and Behavioral Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Lisanne M. Jenkins
- Department of Psychiatry and Behavioral Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Karteek Popuri
- School of Engineering Science, Simon Fraser University, Burnaby, Canada
| | | | - Lei Wang
- Department of Psychiatry and Behavioral Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | | | - Mirza Faisal Beg
- School of Engineering Science, Simon Fraser University, Burnaby, Canada
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29
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Yee E, Ma D, Popuri K, Wang L, Beg MF. Construction of MRI-Based Alzheimer's Disease Score Based on Efficient 3D Convolutional Neural Network: Comprehensive Validation on 7,902 Images from a Multi-Center Dataset. J Alzheimers Dis 2021; 79:47-58. [PMID: 33252079 PMCID: PMC9159475 DOI: 10.3233/jad-200830] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
BACKGROUND In recent years, many convolutional neural networks (CNN) have been proposed for the classification of Alzheimer's disease. Due to memory constraints, many of the proposed CNNs work at a 2D slice-level or 3D patch-level. OBJECTIVE Here, we propose a subject-level 3D CNN that can extract the neurodegenerative patterns of the whole brain MRI and converted into a probabilistic Dementia score. METHODS We propose an efficient and lightweight subject-level 3D CNN featuring dilated convolutions. We trained our network on the ADNI data on stable Dementia of the Alzheimer's type (sDAT) from stable normal controls (sNC). To comprehensively evaluate the generalizability of our proposed network, we performed four independent tests which includes testing on images from other ADNI individuals at various stages of the dementia, images acquired from other sites (AIBL), images acquired using different protocols (OASIS), and longitudinal images acquired over a short period of time (MIRIAD). RESULTS We achieved a 5-fold cross-validated balanced accuracy of 88%in differentiating sDAT from sNC, and an overall specificity of 79.5%and sensitivity 79.7%on the entire set of 7,902 independent test images. CONCLUSION Independent testing is essential for estimating the generalization ability of the network to unseen data, but is often lacking in studies using CNN for DAT classification. This makes it difficult to compare the performances achieved using different architectures. Our comprehensive evaluation highlighting the competitive performance of our network and potential promise for generalization.
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Affiliation(s)
- Evangeline Yee
- School of Engineering Science, Simon Fraser University, Burnaby, British Columbia, Canada
| | - Da Ma
- School of Engineering Science, Simon Fraser University, Burnaby, British Columbia, Canada
| | - Karteek Popuri
- School of Engineering Science, Simon Fraser University, Burnaby, British Columbia, Canada
| | - Lei Wang
- Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA
| | - Mirza Faisal Beg
- School of Engineering Science, Simon Fraser University, Burnaby, British Columbia, Canada
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30
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Ma D, Cardoso MJ, Zuluaga MA, Modat M, Powell NM, Wiseman FK, Cleary JO, Sinclair B, Harrison IF, Siow B, Popuri K, Lee S, Matsubara JA, Sarunic MV, Beg MF, Tybulewicz VLJ, Fisher EMC, Lythgoe MF, Ourselin S. Substantially thinner internal granular layer and reduced molecular layer surface in the cerebellar cortex of the Tc1 mouse model of down syndrome - a comprehensive morphometric analysis with active staining contrast-enhanced MRI. Neuroimage 2020; 223:117271. [PMID: 32835824 PMCID: PMC8417772 DOI: 10.1016/j.neuroimage.2020.117271] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Revised: 08/03/2020] [Accepted: 08/10/2020] [Indexed: 12/18/2022] Open
Abstract
Down Syndrome is a chromosomal disorder that affects the development of cerebellar cortical lobules. Impaired neurogenesis in the cerebellum varies among different types of neuronal cells and neuronal layers. In this study, we developed an imaging analysis framework that utilizes gadolinium-enhanced ex vivo mouse brain MRI. We extracted the middle Purkinje layer of the mouse cerebellar cortex, enabling the estimation of the volume, thickness, and surface area of the entire cerebellar cortex, the internal granular layer, and the molecular layer in the Tc1 mouse model of Down Syndrome. The morphometric analysis of our method revealed that a larger proportion of the cerebellar thinning in this model of Down Syndrome resided in the inner granule cell layer, while a larger proportion of the surface area shrinkage was in the molecular layer.
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Affiliation(s)
- Da Ma
- Department of Medical Physics and Biomedical Engineering, University College London, United Kingdom; Centre for Advanced Biomedical Imaging, University College London, United Kingdom; School of Engineering Science, Simon Fraser University, Burnaby, Canada.
| | - Manuel J Cardoso
- Department of Medical Physics and Biomedical Engineering, University College London, United Kingdom; School of Biomedical Engineering & Imaging Sciences, King's College London, United Kingdom
| | - Maria A Zuluaga
- Department of Medical Physics and Biomedical Engineering, University College London, United Kingdom; Data Science Department, EURECOM, France
| | - Marc Modat
- Department of Medical Physics and Biomedical Engineering, University College London, United Kingdom; School of Biomedical Engineering & Imaging Sciences, King's College London, United Kingdom
| | - Nick M Powell
- Department of Medical Physics and Biomedical Engineering, University College London, United Kingdom; Centre for Advanced Biomedical Imaging, University College London, United Kingdom
| | - Frances K Wiseman
- UK Dementia Research Institute at University College London, UK London; Down Syndrome Consortium (LonDownS), London, United Kingdom
| | - Jon O Cleary
- Centre for Advanced Biomedical Imaging, University College London, United Kingdom; Department of Radiology, Guy´s and St Thomas' NHS Foundation Trust, United Kingdom; Melbourne Brain Centre Imaging Unit, Department of Medicine and Radiology, University of Melbourne, Melbourne, Australia
| | - Benjamin Sinclair
- Centre for Advanced Biomedical Imaging, University College London, United Kingdom
| | - Ian F Harrison
- Centre for Advanced Biomedical Imaging, University College London, United Kingdom
| | - Bernard Siow
- Centre for Advanced Biomedical Imaging, University College London, United Kingdom; The Francis Crick Institute, London, United Kingdom
| | - Karteek Popuri
- School of Engineering Science, Simon Fraser University, Burnaby, Canada
| | - Sieun Lee
- School of Engineering Science, Simon Fraser University, Burnaby, Canada
| | - Joanne A Matsubara
- Department of Ophthalmology & Visual Science, University of British Columbia, Vancouver, Canada
| | - Marinko V Sarunic
- School of Engineering Science, Simon Fraser University, Burnaby, Canada
| | - Mirza Faisal Beg
- School of Engineering Science, Simon Fraser University, Burnaby, Canada
| | - Victor L J Tybulewicz
- The Francis Crick Institute, London, United Kingdom; Department of Immunology and Inflammation, Imperial College, London, United Kingdom
| | | | - Mark F Lythgoe
- Centre for Advanced Biomedical Imaging, University College London, United Kingdom
| | - Sebastien Ourselin
- Department of Medical Physics and Biomedical Engineering, University College London, United Kingdom; School of Biomedical Engineering & Imaging Sciences, King's College London, United Kingdom
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