Texture Analysis in Magnetic Resonance Imaging: Review and Considerations for Future Applications

Texture analysis is a technique used for the quantification of image texture. It has been successfully used in many fields, and in the past years it has been applied in magnetic resonance imaging (MRI) as a computer-aided diagnostic tool. Quantification of the intrinsic heterogeneity of different tissues and lesions is necessary as they are usually imperceptible to the human eye. In the present chapter, we describe texture analysis as a process consisting of six steps: MRI acquisition, region of interest (ROI) definition, ROI preprocessing, feature extraction, feature selection, and classification. There is a great variety of methods and techniques to be chosen at each step and all of them can somehow affect the outcome of the texture analysis application. We reviewed the literature regarding texture analysis in clinical MRI focusing on the important considerations to be taken at each step of the process in order to obtain maximum benefits and to avoid misleading results

Quantitative analysis with machine learning models for multi-parametric brain imaging data

Gliomas are considered to be the most common primary adult malignant brain tumor. With the dramatic increases in computational power and improvements in image analysis algorithms, computer-aided medical image analysis has been introduced into clinical applications. Precision tumor grading and genotyping play an indispensable role in clinical diagnosis, treatment and prognosis. Gliomas diagnostic procedures include histopathological imaging tests, molecular imaging scans and tumor grading. Pathologic review of tumor morphology in histologic sections is the traditional method for cancer classification and grading, yet human study has limitations that can result in low reproducibility and inter-observer agreement. Compared with histopathological images, Magnetic resonance (MR) imaging present the different structure and functional features, which might serve as noninvasive surrogates for tumor genotypes. Therefore, computer-aided image analysis has been adopted in clinical application, which might partially overcome these shortcomings due to its capacity to quantitatively and reproducibly measure multilevel features on multi-parametric medical information. Imaging features obtained from a single modal image do not fully represent the disease, so quantitative imaging features, including morphological, structural, cellular and molecular level features, derived from multi-modality medical images should be integrated into computer-aided medical image analysis. The image quality differentiation between multi-modality images is a challenge in the field of computer-aided medical image analysis. In this thesis, we aim to integrate the quantitative imaging data obtained from multiple modalities into mathematical models of tumor prediction response to achieve additional insights into practical predictive value. Our major contributions in this thesis are: 1. Firstly, to resolve the imaging quality difference and observer-dependent in histological image diagnosis, we proposed an automated machine-learning brain tumor-grading platform to investigate contributions of multi-parameters from multimodal data including imaging parameters or features from Whole Slide Images (WSI) and the proliferation marker KI-67. For each WSI, we extract both visual parameters such as morphology parameters and sub-visual parameters including first-order and second-order features. A quantitative interpretable machine learning approach (Local Interpretable Model-Agnostic Explanations) was followed to measure the contribution of features for single case. Most grading systems based on machine learning models are considered “black boxes,” whereas with this system the clinically trusted reasoning could be revealed. The quantitative analysis and explanation may assist clinicians to better understand the disease and accordingly to choose optimal treatments for improving clinical outcomes. 2. Based on the automated brain tumor-grading platform we propose, multimodal Magnetic Resonance Images (MRIs) have been introduced in our research. A new imaging–tissue correlation based approach called RA-PA-Thomics was proposed to predict the IDH genotype. Inspired by the concept of image fusion, we integrate multimodal MRIs and the scans of histopathological images for indirect, fast, and cost saving IDH genotyping. The proposed model has been verified by multiple evaluation criteria for the integrated data set and compared to the results in the prior art. The experimental data set includes public data sets and image information from two hospitals. Experimental results indicate that the model provided improves the accuracy of glioma grading and genotyping

Texture Analysis Platform for Imaging Biomarker Research

abstract: The rate of progress in improving survival of patients with solid tumors is slow due to late stage diagnosis and poor tumor characterization processes that fail to effectively reflect the nature of tumor before treatment or the subsequent change in its dynamics because of treatment. Further advancement of targeted therapies relies on advancements in biomarker research. In the context of solid tumors, bio-specimen samples such as biopsies serve as the main source of biomarkers used in the treatment and monitoring of cancer, even though biopsy samples are susceptible to sampling error and more importantly, are local and offer a narrow temporal scope. Because of its established role in cancer care and its non-invasive nature imaging offers the potential to complement the findings of cancer biology. Over the past decade, a compelling body of literature has emerged suggesting a more pivotal role for imaging in the diagnosis, prognosis, and monitoring of diseases. These advances have facilitated the rise of an emerging practice known as Radiomics: the extraction and analysis of large numbers of quantitative features from medical images to improve disease characterization and prediction of outcome. It has been suggested that radiomics can contribute to biomarker discovery by detecting imaging traits that are complementary or interchangeable with other markers. This thesis seeks further advancement of imaging biomarker discovery. This research unfolds over two aims: I) developing a comprehensive methodological pipeline for converting diagnostic imaging data into mineable sources of information, and II) investigating the utility of imaging data in clinical diagnostic applications. Four validation studies were conducted using the radiomics pipeline developed in aim I. These studies had the following goals: (1 distinguishing between benign and malignant head and neck lesions (2) differentiating benign and malignant breast cancers, (3) predicting the status of Human Papillomavirus in head and neck cancers, and (4) predicting neuropsychological performances as they relate to Alzheimer’s disease progression. The long-term objective of this thesis is to improve patient outcome and survival by facilitating incorporation of routine care imaging data into decision making processes.Dissertation/ThesisDoctoral Dissertation Biomedical Informatics 201

Complexity Reduction in Image-Based Breast Cancer Care

The diversity of malignancies of the breast requires personalized diagnostic and therapeutic decision making in a complex situation. This thesis contributes in three clinical areas: (1) For clinical diagnostic image evaluation, computer-aided detection and diagnosis of mass and non-mass lesions in breast MRI is developed. 4D texture features characterize mass lesions. For non-mass lesions, a combined detection/characterisation method utilizes the bilateral symmetry of the breast s contrast agent uptake. (2) To improve clinical workflows, a breast MRI reading paradigm is proposed, exemplified by a breast MRI reading workstation prototype. Instead of mouse and keyboard, it is operated using multi-touch gestures. The concept is extended to mammography screening, introducing efficient navigation aids. (3) Contributions to finite element modeling of breast tissue deformations tackle two clinical problems: surgery planning and the prediction of the breast deformation in a MRI biopsy device

A novel diffusion tensor imaging-based computer-aided diagnostic system for early diagnosis of autism.

Autism spectrum disorders (ASDs) denote a significant growing public health concern. Currently, one in 68 children has been diagnosed with ASDs in the United States, and most children are diagnosed after the age of four, despite the fact that ASDs can be identified as early as age two. The ultimate goal of this thesis is to develop a computer-aided diagnosis (CAD) system for the accurate and early diagnosis of ASDs using diffusion tensor imaging (DTI). This CAD system consists of three main steps. First, the brain tissues are segmented based on three image descriptors: a visual appearance model that has the ability to model a large dimensional feature space, a shape model that is adapted during the segmentation process using first- and second-order visual appearance features, and a spatially invariant second-order homogeneity descriptor. Secondly, discriminatory features are extracted from the segmented brains. Cortex shape variability is assessed using shape construction methods, and white matter integrity is further examined through connectivity analysis. Finally, the diagnostic capabilities of these extracted features are investigated. The accuracy of the presented CAD system has been tested on 25 infants with a high risk of developing ASDs. The preliminary diagnostic results are promising in identifying autistic from control patients

Morphological quantitation software in breast MRI: application to neoadjuvant chemotherapy patients

The work in this thesis examines the use of texture analysis techniques and shape descriptors to analyse MR images of the breast and their application as a potential quantitative tool for prognostic indication.Textural information is undoubtedly very heavily used in a radiologist’s decision making process. However, subtle variations in texture are often missed, thus by quantitatively analysing MR images the textural properties that would otherwise be impossible to discern by simply visually inspecting the image can be obtained. Texture analysis is commonly used in image classification of aerial and satellite photography, studies have also focussed on utilising texture in MRI especially in the brain. Recent research has focussed on other organs such as the breast wherein lesion morphology is known to be an important diagnostic and prognostic indicator. Recent work suggests benefits in assessing lesion texture in dynamic contrast-enhanced (DCE) images, especially with regards to changes during the initial enhancement and subsequent washout phases. The commonest form of analysis is the spatial grey-level dependence matrix method, but there is no direct evidence concerning the most appropriate pixel separation and number of grey levels to utilise in the required co-occurrence matrix calculations. The aim of this work is to systematically assess the efficacy of DCE-MRI based textural analysis in predicting response to chemotherapy in a cohort of breast cancer patients. In addition an attempt was made to use shape parameters in order to assess tumour surface irregularity, and as a predictor of response to chemotherapy.In further work this study aimed to texture map DCE MR images of breast patients utilising the co-occurrence method but on a pixel by pixel basis in order to determine threshold values for normal, benign and malignant tissue and ultimately creating functionality within the in house developed software to highlight hotspots outlining areas of interest (possible lesions). Benign and normal data was taken from MRI screening data and malignant data from patients referred with known malignancies.This work has highlighted that textural differences between groups (based on response, nodal status, triple negative and biopsy grade groupings) are apparent and appear to be most evident 1-3 minutes post-contrast administration. Whilst the large number of statistical tests undertaken necessitates a degree of caution in interpreting the results, the fact that significant differences for certain texture parameters and groupings are consistently observed is encouraging.With regards to shape analysis this thesis has highlighted that some differences between groups were seen in shape descriptors but that shape may be limited as a prognostic indicator. Using textural analysis gave a higher proportion of significant differences whilst shape analysis results showed inconsistency across time points.With regards to the mapping this work successfully analysed the texture maps for each case and established lesion detection is possible. The study successfully highlighted hotspots in the breast patients data post texture mapping, and has demonstrated the relationship between sensitivity and false positive rate via hotspot thresholding

Augmented breast tumor classification by perfusion analysis

Magnetic resonance and computed tomography imaging aid in the diagnosis and analysis of pathologic conditions. Blood flow, or perfusion, through a region of tissue can be computed from a time series of contrast-enhanced images. Perfusion is an important set of physiological parameters that reflect angiogenesis. In cancer, heightened angiogenesis is a key process in the growth and spread of tumorous masses. An automatic classification technique using recovered perfusion may prove to be a highly accurate diagnostic tool. Such a classification system would supplement existing histopathological tests, and help physicians to choose the most optimal treatment protocol. Perfusion is obtained through deconvolution of signal intensity series and a pharmacokinetic model. However, many computational problems complicate the accurate-consistent recovery of perfusion. The high time-resolution acquisition of images decreases signal-to-noise, producing poor deconvolution solutions. The delivery of contrast agent as a function of time must also be determined or sampled before deconvolution can proceed. Some regions of the body, such as the brain, provide a nearby artery to serve as this arterial input function. Poor estimates can lead to an over or under estimation of perfusion. Breast tissue is an example of one tissue region where a clearly defined artery is not present. This proposes a new method of using recovered perfusion and spatial information in an automated classifier. This classifier grades suspected lesions as benign or malignant. This method can be integrated into a computer-aided diagnostic system to enhance the value of medical imagery

A novel MRA-based framework for the detection of changes in cerebrovascular blood pressure.

Background: High blood pressure (HBP) affects 75 million adults and is the primary or contributing cause of mortality in 410,000 adults each year in the United States. Chronic HBP leads to cerebrovascular changes and is a significant contributor for strokes, dementia, and cognitive impairment. Non-invasive measurement of changes in cerebral vasculature and blood pressure (BP) may enable physicians to optimally treat HBP patients. This manuscript describes a method to non-invasively quantify changes in cerebral vasculature and BP using Magnetic Resonance Angiography (MRA) imaging. Methods: MRA images and BP measurements were obtained from patients (n=15, M=8, F=7, Age= 49.2 ± 7.3 years) over a span of 700 days. A novel segmentation algorithm was developed to identify brain vasculature from surrounding tissue. The data was processed to calculate the vascular probability distribution function (PDF); a measure of the vascular diameters in the brain. The initial (day 0) PDF and final (day 700) PDF were used to correlate the changes in cerebral vasculature and BP. Correlation was determined by a mixed effects linear model analysis. Results: The segmentation algorithm had a 99.9% specificity and 99.7% sensitivity in identifying and delineating cerebral vasculature. The PDFs had a statistically significant correlation to BP changes below the circle of Willis (p-value = 0.0007), but not significant (p-value = 0.53) above the circle of Willis, due to smaller blood vessels. Conclusion: Changes in cerebral vasculature and pressure can be non-invasively obtained through MRA image analysis, which may be a useful tool for clinicians to optimize medical management of HBP