Computerized Analysis of Magnetic Resonance Images to Study Cerebral Anatomy in Developing Neonates

The study of cerebral anatomy in developing neonates is of great importance for the understanding of brain development during the early period of life. This dissertation therefore focuses on three challenges in the modelling of cerebral anatomy in neonates during brain development. The methods that have been developed all use Magnetic Resonance Images (MRI) as source data. To facilitate study of vascular development in the neonatal period, a set of image analysis algorithms are developed to automatically extract and model cerebral vessel trees. The whole process consists of cerebral vessel tracking from automatically placed seed points, vessel tree generation, and vasculature registration and matching. These algorithms have been tested on clinical Time-of- Flight (TOF) MR angiographic datasets. To facilitate study of the neonatal cortex a complete cerebral cortex segmentation and reconstruction pipeline has been developed. Segmentation of the neonatal cortex is not effectively done by existing algorithms designed for the adult brain because the contrast between grey and white matter is reversed. This causes pixels containing tissue mixtures to be incorrectly labelled by conventional methods. The neonatal cortical segmentation method that has been developed is based on a novel expectation-maximization (EM) method with explicit correction for mislabelled partial volume voxels. Based on the resulting cortical segmentation, an implicit surface evolution technique is adopted for the reconstruction of the cortex in neonates. The performance of the method is investigated by performing a detailed landmark study. To facilitate study of cortical development, a cortical surface registration algorithm for aligning the cortical surface is developed. The method first inflates extracted cortical surfaces and then performs a non-rigid surface registration using free-form deformations (FFDs) to remove residual alignment. Validation experiments using data labelled by an expert observer demonstrate that the method can capture local changes and follow the growth of specific sulcus

Assessment of the potentials and limitations of cortical-based analysis for the integration of structure and function in normal and pathological brains using MRI

The software package Brainvisa (www.brainvisa.tnfo) offers a wide range of possibilities for cortical analysis using its automatic sulci recognition feature. Automated sulci identification is an attractive feature as the manual labelling of the cortical sulci is often challenging even for the experienced neuro-radiologists. This can also be of interest in fMRI studies of individual subjects where activated regions of the cortex can simply be identified using sulcal labels without the need for normalization to an atlas. As it will be explained later in this thesis, normalization to atlas can especially be problematic for pathologic brains. In addition, Brainvisa allows for sulcal morphometry from structural MR images by estimating a wide range of sulcal properties such as size, coordinates, direction, and pattern. Morphometry of abnormal brains has gained huge interest and has been widely used in finding the biomarkers of several neurological diseases or psychiatric disorders. However mainly because of its complexity, only a limited use of sulcal morphometry has been reported so far. With a wide range of possibilities for sulcal morphometry offered by Brainvisa, it is possible to thoroughly investigate the sulcal changes due to the abnormality. However, as any other automated method, Brainvisa can be susceptible to limitations associated with image quality. Factors such as noise, spatial resolution, and so on, can have an impact on the detection of the cortical folds and estimation of their attributes. Hence the robustness of Brainvisa needs to be assessed. This can be done by estimating the reliability and reproducibility of results as well as exploring the changes in results caused by other factors. This thesis is an attempt to investigate the possible benefits of sulci identification and sulcal morphometry for functional and structural MRI studies as well as the limitations of Brainvisa. In addition, the possibility of improvement of activation localization with functional MRI studies is further investigated. This investigation was motivated by a review of other cortical-based analysis methods, namely the cortical surface-based methods, which are discussed in the literature review chapter of this thesis. The application of these approaches in functional MRI data analysis and their potential benefits is used in this investigation

Unfolding the hippocampus: An intrinsic coordinate system for subfield segmentations and quantitative mapping

The hippocampus, like the neocortex, has a morphological structure that is complex and variable in its folding pattern, especially in the hippocampal head. The current study presents a computational method to unfold hippocampal grey matter, with a particular focus on the hippocampal head where complexity is highest due to medial curving of the structure and the variable presence of digitations. This unfolding was performed on segmentations from high-resolution, T2-weighted 7T MRI data from 12 healthy participants and one surgical patient with epilepsy whose resected hippocampal tissue was used for histological validation. We traced a critical image feature composed of the hippocampal sulcus and stratum radiatum lacunosum-moleculare, (SRLM) in these images, then employed user-guided semi-automated techniques to detect and subsequently unfold the surrounding hippocampal grey matter. This unfolding was performed by solving Laplace\u27s equation in three dimensions of interest (long-axis, proximal-distal, and laminar). The resulting ‘unfolded coordinate space’ provides an intuitive way of mapping the hippocampal subfields in 2D space (long-axis and proximal-distal), such that similar borders can be applied in the head, body, and tail of the hippocampus independently of variability in folding. This unfolded coordinate space was employed to map intracortical myelin and thickness in relation to subfield borders, which revealed intracortical myelin differences that closely follow the subfield borders used here. Examination of a histological resected tissue sample from a patient with epilepsy reveals that our unfolded coordinate system has biological validity, and that subfield segmentations applied in this space are able to capture features not seen in manual tracing protocols

Assessment of the impact of the scanner-related factors on brain morphometry analysis with Brainvisa.

BACKGROUND: Brain morphometry is extensively used in cross-sectional studies. However, the difference in the estimated values of the morphometric measures between patients and healthy subjects may be small and hence overshadowed by the scanner-related variability, especially with multicentre and longitudinal studies. It is important therefore to investigate the variability and reliability of morphometric measurements between different scanners and different sessions of the same scanner. METHODS: We assessed the variability and reliability for the grey matter, white matter, cerebrospinal fluid and cerebral hemisphere volumes as well as the global sulcal index, sulcal surface and mean geodesic depth using Brainvisa. We used datasets obtained across multiple MR scanners at 1.5 T and 3 T from the same groups of 13 and 11 healthy volunteers, respectively. For each morphometric measure, we conducted ANOVA analysis and verified whether the estimated values were significantly different across different scanners or different sessions of the same scanner. The between-centre and between-visit reliabilities were estimated from their contribution to the total variance, using a random-effects ANOVA model. To estimate the main processes responsible for low reliability, the results of brain segmentation were compared to those obtained using FAST within FSL. RESULTS: In a considerable number of cases, the main effects of both centre and visit factors were found to be significant. Moreover, both between-centre and between-visit reliabilities ranged from poor to excellent for most morphometric measures. A comparison between segmentation using Brainvisa and FAST revealed that FAST improved the reliabilities for most cases, suggesting that morphometry could benefit from improving the bias correction. However, the results were still significantly different across different scanners or different visits. CONCLUSIONS: Our results confirm that for morphometry analysis with the current version of Brainvisa using data from multicentre or longitudinal studies, the scanner-related variability must be taken into account and where possible should be corrected for. We also suggest providing some flexibility to Brainvisa for a step-by-step analysis of the robustness of this package in terms of reproducibility of the results by allowing the bias corrected images to be imported from other packages and bias correction step be skipped, for example.RIGHTS : This article is licensed under the BioMed Central licence at http://www.biomedcentral.com/about/license which is similar to the 'Creative Commons Attribution Licence'. In brief you may : copy, distribute, and display the work; make derivative works; or make commercial use of the work - under the following conditions: the original author must be given credit; for any reuse or distribution, it must be made clear to others what the license terms of this work are

Computational Unfolding of the Human Hippocampus

The hippocampal subfields are defined by their unique cytoarchitectures, which many recent studies have tried to map to human in-vivo MRI because of their promise to further our understanding of hippocampal function, or its dysfunction in disease. However, recent anatomical literature has highlighted broad inter-individual variability in hippocampal morphology and subfield locations, much of which can be attributed to different folding configurations within hippocampal (or archicortical) tissue. Inspired in part by analogous surface-based neocortical analysis methods, the current thesis aimed to develop a standardized coordinate framework, or surface-based method, that respects the topology of all hippocampal folding configurations. I developed such a coordinate framework in Chapter 2, which was initialized by detailed manual segmentations of hippocampal grey matter and high myelin laminae which are visible in 7-Tesla MRI and which separate different hippocampal folds. This framework was leveraged to i) computationally unfold the hippocampus which provided implicit topological inter-individual alignment, ii) delineate subfields with high reliability and validity, and iii) extract novel structural features of hippocampal grey matter. In Chapter 3, I applied this coordinate framework to the open source BigBrain 3D histology dataset. With this framework, I computationally extracted morphological and laminar features and showed that they are sufficient to derive hippocampal subfields in a data-driven manner. This underscores the sensitivity of these computational measures and the validity of the applied subfield definitions. Finally, the unfolding coordinate framework developed in Chapter 2 and extended in Chapter 3 requires manual detection of different tissue classes that separate folds in hippocampal grey matter. This is costly in the time and the expertise required. Thus, in Chapter 4, I applied state-of-the-art deep learning methods in the open source Human Connectome Project MRI dataset to automate this process. This allowed for scalable application of the methods described in Chapters 2, 3, and 4 to similar new datasets, with support for extensions to suit data of different modalities or resolutions. Overall, the projects presented here provide multifaceted evidence for the strengths of a surface-based approach to hippocampal analysis as developed in this thesis, and these methods are readily deployable in new neuroimaging work

Preserving known anatomical topology in medical image segmentation using deep learning

Since the rise of deep learning, new medical image segmentation methods have rapidly been proposed with promising results, with each one reporting marginal improvements on the previous state-of-the-art (SOTA) method. However, on visual inspection, errors are often revealed, such as topological mistakes (e.g. holes or folds), that are not detected using traditional evaluation metrics, such as Dice. Moreover, correct topology is often essential in ensuring segmentations are anatomically and pathologically plausible and, ultimately, suitable for downstream image processing tasks. Therefore, there is a need for methods to focus on ensuring that the predicted segmentations are topologically correct, rather than just optimising the pixel-wise accuracy. In this thesis, I propose a method that utilises prior knowledge of anatomy to segment structures, whilst preserving the known topology. The presented model, Topology Encouraging Deformation Segmentation Network (TEDS-Net), performs segmentation by deforming a prior shape with the same topological features as the anatomy of interest using learnt topology-preserving deformation fields. However, here I show that such fields only guarantee topology preservation in the continuous domain and that their properties begin to break down when applied in discrete spaces. To overcome this effect, I introduced additional modifications in TEDS-Net to more strictly enforce topology preservation, a step often overlooked in previous work. Across this thesis, TEDS-Net is applied to a range of natural and medical image segmentation tasks. I show how it can be used for multiple topology types, multiple structures and in both two- and three-dimensions. Further, I show how TEDS-Net can be used to segment whole volumes using minimally annotated training data. Across these experiments, TEDS-Net outperforms all SOTA baselines on topology, whilst maintaining competitive pixel-wise accuracy. Finally, TEDS-Net is integrated into a whole medical imaging pipeline, to illustrate the importance of topologically correct segmentations for downstream tasks. TEDS-Net is used to segment the developing cortical plate from in-utero fetal brain ultrasound scans in 3D, to enable the characterisation of its complex growth and development during gestation. To the best of my knowledge, this task has only been previously attempted from magnetic resonance imaging (MRI), despite ultrasound being the modality of choice in prenatal care. This is likely due to large acoustic shadows obstructing key brain regions in ultrasound. Due to TEDS-Net anatomical constraints, it can anatomically guide the cortical plate segmentation in regions of shadows, producing a complete segmentation that enables accurate downstream analysis

Methods to automatically build Point Distribution Models for objects like hand palms and faces represented in images

In this work we developed methods to automatically extract significant points of objects like hand palms and faces represented in images that can be used to build Point Distribution Models automatically. These models are further used to segment the modelled objects in new images, through the use of Active Shape Models or Active Appearance Models. These models showed to be efficient in the segmentation of objects, but had as drawback the fact that the labelling of the landmark points was usually manually made and consequently time consuming. Thus, in this paper we describe some methods capable to extract significant points of objects like hand palms and compare the segmentation results in new images