Automated Extraction of Biomarkers for Alzheimer's Disease from Brain Magnetic Resonance Images

In this work, different techniques for the automated extraction of biomarkers for Alzheimer's disease (AD) from brain magnetic resonance imaging (MRI) are proposed. The described work forms part of PredictAD (www.predictad.eu), a joined European research project aiming at the identification of a unified biomarker for AD combining different clinical and imaging measurements. Two different approaches are followed in this thesis towards the extraction of MRI-based biomarkers: (I) the extraction of traditional morphological biomarkers based on neuronatomical structures and (II) the extraction of data-driven biomarkers applying machine-learning techniques. A novel method for a unified and automated estimation of structural volumes and volume changes is proposed. Furthermore, a new technique that allows the low-dimensional representation of a high-dimensional image population for data analysis and visualization is described. All presented methods are evaluated on images from the Alzheimer's Disease Neuroimaging Initiative (ADNI), providing a large and diverse clinical database. A rigorous evaluation of the power of all identified biomarkers to discriminate between clinical subject groups is presented. In addition, the agreement of automatically derived volumes with reference labels as well as the power of the proposed method to measure changes in a subject's atrophy rate are assessed. The proposed methods compare favorably to state-of-the art techniques in neuroimaging in terms of accuracy, robustness and run-time

Statistical analysis for longitudinal MR imaging of dementia

Serial Magnetic Resonance (MR) Imaging can reveal structural atrophy in the brains of subjects with neurodegenerative diseases such as Alzheimer’s Disease (AD). Methods of computational neuroanatomy allow the detection of statistically significant patterns of brain change over time and/or over multiple subjects. The focus of this thesis is the development and application of statistical and supporting methodology for the analysis of three-dimensional brain imaging data. There is a particular emphasis on longitudinal data, though much of the statistical methodology is more general. New methods of voxel-based morphometry (VBM) are developed for serial MR data, employing combinations of tissue segmentation and longitudinal non-rigid registration. The methods are evaluated using novel quantitative metrics based on simulated data. Contributions to general aspects of VBM are also made, and include a publication concerning guidelines for reporting VBM studies, and another examining an issue in the selection of which voxels to include in the statistical analysis mask for VBM of atrophic conditions. Research is carried out into the statistical theory of permutation testing for application to multivariate general linear models, and is then used to build software for the analysis of multivariate deformation- and tensor-based morphometry data, efficiently correcting for the multiple comparison problem inherent in voxel-wise analysis of images. Monte Carlo simulation studies extend results available in the literature regarding the different strategies available for permutation testing in the presence of confounds. Theoretical aspects of longitudinal deformation- and tensor-based morphometry are explored, such as the options for combining within- and between-subject deformation fields. Practical investigation of several different methods and variants is performed for a longitudinal AD study

Global image registration using a symmetric block-matching approach.

Most medical image registration algorithms suffer from a directionality bias that has been shown to largely impact subsequent analyses. Several approaches have been proposed in the literature to address this bias in the context of nonlinear registration, but little work has been done for global registration. We propose a symmetric approach based on a block-matching technique and least-trimmed square regression. The proposed method is suitable for multimodal registration and is robust to outliers in the input images. The symmetric framework is compared with the original asymmetric block-matching technique and is shown to outperform it in terms of accuracy and robustness. The methodology presented in this article has been made available to the community as part of the NiftyReg open-source package

Automated morphometric analysis and phenotyping of mouse brains from structural µMR images

In light of the utility and increasing ubiquity of mouse models of genetic and neurological disease, I describefully automated pipelines for the investigation of structural microscopic magnetic resonance images of mouse brains – for both high-throughput phenotyping, and monitoring disease. Mouse models offer unparalleled insight into genetic function and brain plasticity, in phenotyping studies; and neurodegenerative disease onset and progression, in therapeutic trials. I developed two cohesive, automatic software tools, for Voxel- and Tensor-Based Morphometry (V/TBM) and the Boundary Shift Integral (BSI), in the mouse brain. V/TBM are advantageous for their ability to highlight morphological differences between groups, without laboriously delineating regions of interest. The BSI is a powerful and sensitive imaging biomarker for the detection of atrophy. The resulting pipelines are described in detail. I show the translation and application of open-source software developed for clinical MRI analysis to mouse brain data: for tissue segmentation into high-quality, subject-specific maps, using contemporary multi-atlas techniques; and for symmetric, inverse-consistent registration. I describe atlases and parameters suitable for the preclinical paradigm, and illustrate and discuss image processing challenges encountered and overcome during development. As proof of principle and to illustrate robustness, I used both pipelines with in and ex vivo mouse brain datasets to identify differences between groups, representing the morphological influence of genes, and subtle, longitudinal changes over time, in particular relation to Down syndrome and Alzheimer’s disease. I also discuss the merits of transitioning preclinical analysis from predominately ex vivo MRI to in vivo, where morphometry is still viable and fewer mice are necessary. This thesis conveys the cross-disciplinary translation of up-to-date image analysis techniques to the preclinical paradigm; the development of novel methods and adaptations to robustly process large cohorts of data; and the sensitive detection of phenotypic differences and neurodegenerative changes in the mouse brai

Symmetric diffeomorphic modeling of longtudinal structural MRI

This technology report describes the longitudinal registration approach that we intend to incorporate into SPM12. It essentially describes a group-wise intra-subject modeling framework, which combines diffeomorphic and rigid-body registration, incorporating a correction for the intensity inhomogeneity artifact usually seen in MRI data. Emphasis is placed on achieving internal consistency and accounting for many of the mathematical subtleties that most implementations overlook. The implementation was evaluated using examples from the OASIS Longitudinal MRI Data in Non-demented and Demented Older Adults

MULTIVARIATE MODELING OF COGNITIVE PERFORMANCE AND CATEGORICAL PERCEPTION FROM NEUROIMAGING DATA

State-of-the-art cognitive-neuroscience mainly uses hypothesis-driven statistical testing to characterize and model neural disorders and diseases. While such techniques have proven to be powerful in understanding diseases and disorders, they are inadequate in explaining causal relationships as well as individuality and variations. In this study, we proposed multivariate data-driven approaches for predictive modeling of cognitive events and disorders. We developed network descriptions of both structural and functional connectivities that are critical in multivariate modeling of cognitive performance (i.e., fluency, attention, and working memory) and categorical perceptions (i.e., emotion, speech perception). We also performed dynamic network analysis on brain connectivity measures to determine the role of different functional areas in relation to categorical perceptions and cognitive events. Our empirical studies of structural connectivity were performed using Diffusion Tensor Imaging (DTI). The main objective was to discover the role of structural connectivity in selecting clinically interpretable features that are consistent over a large range of model parameters in classifying cognitive performances in relation to Acute Lymphoblastic Leukemia (ALL). The proposed approach substantially improved accuracy (13% - 26%) over existing models and also selected a relevant, small subset of features that were verified by domain experts. In summary, the proposed approach produced interpretable models with better generalization.Functional connectivity is related to similar patterns of activation in different brain regions regardless of the apparent physical connectedness of the regions. The proposed data-driven approach to the source localized electroencephalogram (EEG) data includes an array of tools such as graph mining, feature selection, and multivariate analysis to determine the functional connectivity in categorical perceptions. We used the network description to correctly classify listeners behavioral responses with an accuracy over 92% on 35 participants. State-of-the-art network description of human brain assumes static connectivities. However, brain networks in relation to perception and cognition are complex and dynamic. Analysis of transient functional networks with spatiotemporal variations to understand cognitive functions remains challenging. One of the critical missing links is the lack of sophisticated methodologies in understanding dynamics neural activity patterns. We proposed a clustering-based complex dynamic network analysis on source localized EEG data to understand the commonality and differences in gender-specific emotion processing. Besides, we also adopted Bayesian nonparametric framework for segmentation neural activity with a finite number of microstates. This approach enabled us to find the default network and transient pattern of the underlying neural mechanism in relation to categorical perception. In summary, multivariate and dynamic network analysis methods developed in this dissertation to analyze structural and functional connectivities will have a far-reaching impact on computational neuroscience to identify meaningful changes in spatiotemporal brain activities

CT colonography: Inverse-consistent symmetric registration of prone and supine inner colon surfaces

CT colonography interpretation is difficult and time-consuming because fecal residue or fluid can mimic or obscure polyps, leading to diagnostic errors. To compensate for this, it is normal practice to obtain CT data with the patient in prone and supine positions. Repositioning redistributes fecal residue and colonic gas; fecal residue tends to move, while fixed mural pathology does not. The cornerstone of competent interpretation is the matching of corresponding endoluminal locations between prone and supine acquisitions. Robust and accurate automated registration between acquisitions should lead to faster and more accurate detection of colorectal cancer and polyps. Any directional bias when registering the colonic surfaces could lead to incorrect anatomical correspondence resulting in reader error. We aim to reduce directional bias and so increase robustness by adapting a cylindrical registration algorithm to penalize inverse-consistency error, using a symmetric optimization. Using 17 validation cases, the mean inverse-consistency error was reduced significantly by 86%, from 3.3 mm to 0.45 mm. Furthermore, we show improved alignment of the prone and supine colonic surfaces, evidenced by a reduction in the mean-of-squared-differences by 43% overall. Mean registration error, measured at a sparse set of manually selected reference points, remained at the same level as the non-symmetric method (no significant differences). Our results suggest that the inverse-consistent symmetric algorithm performs more robustly than non-symmetric implementation of B-spline registration

Bayesian longitudinal segmentation of hippocampal substructures in brain MRI using subject-specific atlases

AbstractThe hippocampal formation is a complex, heterogeneous structure that consists of a number of distinct, interacting subregions. Atrophy of these subregions is implied in a variety of neurodegenerative diseases, most prominently in Alzheimer's disease (AD). Thanks to the increasing resolution of MR images and computational atlases, automatic segmentation of hippocampal subregions is becoming feasible in MRI scans. Here we introduce a generative model for dedicated longitudinal segmentation that relies on subject-specific atlases. The segmentations of the scans at the different time points are jointly computed using Bayesian inference. All time points are treated the same to avoid processing bias. We evaluate this approach using over 4700 scans from two publicly available datasets (ADNI and MIRIAD). In test–retest reliability experiments, the proposed method yielded significantly lower volume differences and significantly higher Dice overlaps than the cross-sectional approach for nearly every subregion (average across subregions: 4.5% vs. 6.5%, Dice overlap: 81.8% vs. 75.4%). The longitudinal algorithm also demonstrated increased sensitivity to group differences: in MIRIAD (69 subjects: 46 with AD and 23 controls), it found differences in atrophy rates between AD and controls that the cross sectional method could not detect in a number of subregions: right parasubiculum, left and right presubiculum, right subiculum, left dentate gyrus, left CA4, left HATA and right tail. In ADNI (836 subjects: 369 with AD, 215 with early cognitive impairment — eMCI — and 252 controls), all methods found significant differences between AD and controls, but the proposed longitudinal algorithm detected differences between controls and eMCI and differences between eMCI and AD that the cross sectional method could not find: left presubiculum, right subiculum, left and right parasubiculum, left and right HATA. Moreover, many of the differences that the cross-sectional method already found were detected with higher significance. The presented algorithm will be made available as part of the open-source neuroimaging package FreeSurfer