Automated medical diagnosis of alzheimer´s disease using an Efficient Net convolutional neural network

Producción CientíficaAlzheimer's disease (AD) poses an enormous challenge to modern healthcare. Since 2017, researchers have been using deep learning (DL) models for the early detection of AD using neuroimaging biomarkers. In this paper, we implement the EfficietNet-b0 convolutional neural network (CNN) with a novel approach—"fusion of end-to-end and transfer learning"—to classify different stages of AD. 245 T1W MRI scans of cognitively normal (CN) subjects, 229 scans of AD subjects, and 229 scans of subjects with stable mild cognitive impairment (sMCI) were employed. Each scan was preprocessed using a standard pipeline. The proposed models were trained and evaluated using preprocessed scans. For the sMCI vs. AD classification task we obtained 95.29% accuracy and 95.35% area under the curve (AUC) for model training and 93.10% accuracy and 93.00% AUC for model testing. For the multiclass AD vs. CN vs. sMCI classification task we obtained 85.66% accuracy and 86% AUC for model training and 87.38% accuracy and 88.00% AUC for model testing. Based on our experimental results, we conclude that CNN-based DL models can be used to analyze complicated MRI scan features in clinical settings.Publicación en abierto financiada por el Consorcio de Bibliotecas Universitarias de Castilla y León (BUCLE), con cargo al Programa Operativo 2014ES16RFOP009 FEDER 2014-2020 DE CASTILLA Y LEÓN, Actuación:20007-CL - Apoyo Consorcio BUCL

Standardized evaluation of algorithms for computer-aided diagnosis of dementia based on structural MRI: The CADDementia challenge

Algorithms for computer-aided diagnosis of dementia based on structural MRI have demonstrated high performance in the literature, but are difficult to compare as different data sets and methodology were used for evaluation. In addition, it is unclear how the algorithms would perform on previously unseen data, and thus, how they would perform in clinical practice when there is no real opportunity to adapt the algorithm to the data at hand. To address these comparability, generalizability and clinical applicability issues, we organized a grand challenge that aimed to objectively compare algorithms based on a clinically representative multi-center data set. Using clinical practice as the starting point, the goal was to reproduce the clinical diagnosis. Therefore, we evaluated algorithms for multi-class classification of three diagnostic groups: patients with probable Alzheimer's disease, patients with mild cognitive impairment and healthy controls. The diagnosis based on clinical criteria was used as reference standard, as it was the best available reference despite its known limitations. For evaluation, a previously unseen test set was used consisting of 354 T1-weighted MRI scans with the diagnoses blinded. Fifteen research teams participated with a total of 29 algorithms. The algorithms were trained on a small training set (n = 30) and optionally on data from other sources (e.g., the Alzheimer's Disease Neuroimaging Initiative, the Australian Imaging Biomarkers and Lifestyle flagship study of aging). The best performing algorithm yielded an accuracy of 63.0% and an area under the receiver-operating-characteristic curve (AUC) of 78.8%. In general, the best performances were achieved using feature extraction based on voxel-based morphometry or a combination of features that included volume, cortical thickness, shape and intensity. The challenge is open for new submissions via the web-based framework: http://caddementia.grand-challenge.org

Simultaneous PET-MRI Studies of the Concordance of Atrophy and Hypometabolism in Syndromic Variants of Alzheimer's Disease and Frontotemporal Dementia: An Extended Case Series

Background: Simultaneous PET-MRI is used to compare patterns of cerebral hypometabolism and atrophy in six different dementia syndromes. Objectives: The primary objective was to conduct an initial exploratory study regarding the concordance of atrophy and hypometabolism in syndromic variants of Alzheimer’s disease (AD) and frontotemporal dementia (FTD). The secondary objective was to determine the effect of image analysis methods on determination of atrophy and hypometabolism. Method: PET and MRI data were acquired simultaneously on 24 subjects with six variants of AD and FTD (n = 4 per group). Atrophy was rated visually and also quantified with measures of cortical thickness. Hypometabolism was rated visually and also quantified using atlas- and SPM-based approaches. Concordance was measured using weighted Cohen’s kappa. Results: Atrophy-hypometabolism concordance differed markedly between patient groups; kappa scores ranged from 0.13 (nonfluent/agrammatic variant of primary progressive aphasia, nfvPPA) to 0.49 (posterior cortical variant of AD, PCA). Heterogeneity was also observed within groups; the confidence intervals of kappa scores ranging from 0–0.25 for PCA to 0.29–0.61 for nfvPPA. More widespread MRI and PET changes were identified using quantitative methods than on visual rating. Conclusion: The marked differences in concordance identified in this initial study may reflect differences in the molecular pathologies underlying AD and FTD syndromic variants but also operational differences in the methods used to diagnose these syndromes. The superior ability of quantitative methodologies to detect changes on PET and MRI, if confirmed on larger cohorts, may favor their usage over qualitative visual inspection in future clinical diagnostic practic

Longitudinal Morphometric Study of Genetic Influence of APOE e4 Genotype on Hippocampal Atrophy - An N=1925 Surface-based ADNI Study

abstract: The apolipoprotein E (APOE) e4 genotype is the most prevalent known genetic risk factor for Alzheimer's disease (AD). In this paper, we examined the longitudinal effect of APOE e4 on hippocampal morphometry in Alzheimer's Disease Neuroimaging Initiative (ADNI). Generally, atrophy of hippocampus has more chance occurs in AD patients who carrying the APOE e4 allele than those who are APOE e4 noncarriers. Also, brain structure and function depend on APOE genotype not just for Alzheimer's disease patients but also in health elderly individuals, so APOE genotyping is considered critical in clinical trials of Alzheimer's disease. We used a large sample of elderly participants, with the help of a new automated surface registration system based on surface conformal parameterization with holomorphic 1-forms and surface fluid registration. In this system, we automatically segmented and constructed hippocampal surfaces from MR images at many different time points, such as 6 months, 1- and 2-year follow up. Between the two different hippocampal surfaces, we did the high-order correspondences, using a novel inverse consistent surface fluid registration method. At each time point, using Hotelling's T^2 test, we found significant morphological deformation in APOE e4 carriers relative to noncarriers in the entire cohort as well as in the non-demented (pooled MCI and control) subjects, affecting the left hippocampus more than the right, and this effect was more pronounced in e4 homozygotes than heterozygotes.Dissertation/ThesisMasters Thesis Computer Science 201

Content based retrieval of PET neurological images

Medical image management has posed challenges to many researchers, especially when the images have to be indexed and retrieved using their visual content that is meaningful to clinicians. In this study, an image retrieval system has been developed for 3D brain PET (Position emission tomography) images. It has been found that PET neurological images can be retrieved based upon their diagnostic status using only data pertaining to their content, and predominantly the visual content. During the study PET scans are spatially normalized, using existing techniques, and their visual data is quantified. The mid-sagittal-plane of each individual 3D PET scan is found and then utilized in the detection of abnormal asymmetries, such as tumours or physical injuries. All the asymmetries detected are referenced to the Talairarch and Tournoux anatomical atlas. The Cartesian co- ordinates in Talairarch space, of detected lesion, are employed along with the associated anatomical structure(s) as the indices within the content based image retrieval system. The anatomical atlas is then also utilized to isolate distinct anatomical areas that are related to a number of neurodegenerative disorders. After segmentation of the anatomical regions of interest algorithms are applied to characterize the texture of brain intensity using Gabor filters and to elucidate the mean index ratio of activation levels. These measurements are combined to produce a single feature vector that is incorporated into the content based image retrieval system. Experimental results on images with known diagnoses show that physical lesions such as head injuries and tumours can be, to a certain extent, detected correctly. Images with correctly detected and measured lesion are then retrieved from the database of images when a query pertains to the measured locale. Images with neurodegenerative disorder patterns have been indexed and retrieved via texture-based features. Retrieval accuracy is increased, for images from patients diagnosed with dementia, by combining the texture feature and mean index ratio value

Assessment Of The Interplay Between Regional β-Amyloid Burden And White Matter Hyperintensities On Cognition And Default Mode Network In Clinically Normal Older Participants

Objective: Alzheimer’s disease (AD) and subcortical vascular dementia are considered the most common pathologic contributors to dementia in the aging population. Both frequently coexist in over 80% of community dwelling adults with dementia. The neuropathological development of AD arguably begins with β-amyloid (Aβ) deposition in the brain. This series of studies aims to test the hypothesis that early focal regional amyloid deposition in the brain is associated with cognitive performance in specific cognitive domain scores in preclinical AD (pAD) (study1). Since mixed dementia is widely recognized as the norm rather than the exception, the second study aimed to explore the relation between regional and global Aβ and WMH with core cognitive function (executive function (EF) and memory) scores in cognitively normal (CN) older adults (study2). Finally, the relationship between WMH and Aβ is strongly determined by the spatial distribution of the two pathologies, so the third study aimed to quantify Aβ in Default mode network (DMN) regions to examine whether cerebral small vessels disease (SVD) disruption of connectivity affects Aβ deposition in disconnected DMN regions (study3). Method: Global and regional Standard Uptake Value ratios (SUVr) from Aβ-PET, WMH volumes from MRI FLAIR images, and cognitive test scores were analyzed across a sample of CN participants. Linear regression models adjusted for age, sex and education used to assess the relationships between regional SUVr and cognitive test scores across 99 CN from Sanders Brown Center on Aging (study1). Moderation, and mediation modeling were used to define the interplay between global, regional Aβ and WMHs measures in relation to EF and memory composite scores outcomes at baseline and after approximately 2 years across a sample of 714 CN from the Alzheimer’s Disease Neuroimaging Initiative ADNI (study2). The association of WMH volume in anatomically defined white matter tracts of atlas-based fiber tract with Aβ SUVr specifically in connected cortical regions within DMN was tested across sample of 74 CN from ADNI3. Results: EF performance was associated with increased regional SUVr in the precuneus and posterior cingulate regions only (p \u3c 0.05). The moderation regression analysis showed additive effects of Aβ and WMH over baseline memory and EF scores (p =0.401 and 0.061 respectively) and synergistic effects over follow-up EF (p \u3c 0.05). Through mediation analysis, the data from study 2 showed that WMH affects, mediated by global and regional amyloid burden, are responsible for baseline cognitive performance deficits in memory and EF. Finally, the regression analysis from study 3 demonstrated that increased WMH volumes in superior longitudinal fasciculus (SLF) was associated with increased regional SUVr in inferior parietal lobule (IPL) (p \u3c 0.05). Conclusion: While the prevailing view in the field suggests that memory performance is the earliest clinical hallmark of AD, the present data demonstrate that changes in EF, mediated by Aβ deposition in the precuneus and posterior cingulate may precede memory decline in pAD. After adding the second key driver of cognitive decline in CN, the finding suggested that WMH dependent changes in baseline cognitive performance are related to direct effect of WMH and an indirect effect through both global and regional Aβ burden. Further studies are needed to show the longitudinal influences of WMH on Aβ distributions in participants with mixed dementia

A Neuroimaging Web Interface for Data Acquisition, Processing and Visualization of Multimodal Brain Images

Structural and functional brain images are generated as essential modalities for medical experts to learn about the different functions of the brain. These images are typically visually inspected by experts. Many software packages are available to process medical images, but they are complex and difficult to use. The software packages are also hardware intensive. As a consequence, this dissertation proposes a novel Neuroimaging Web Services Interface (NWSI) as a series of processing pipelines for a common platform to store, process, visualize and share data. The NWSI system is made up of password-protected interconnected servers accessible through a web interface. The web-interface driving the NWSI is based on Drupal, a popular open source content management system. Drupal provides a user-based platform, in which the core code for the security and design tools are updated and patched frequently. New features can be added via modules, while maintaining the core software secure and intact. The webserver architecture allows for the visualization of results and the downloading of tabulated data. Several forms are ix available to capture clinical data. The processing pipeline starts with a FreeSurfer (FS) reconstruction of T1-weighted MRI images. Subsequently, PET, DTI, and fMRI images can be uploaded. The Webserver captures uploaded images and performs essential functionalities, while processing occurs in supporting servers. The computational platform is responsive and scalable. The current pipeline for PET processing calculates all regional Standardized Uptake Value ratios (SUVRs). The FS and SUVR calculations have been validated using Alzheimer\u27s Disease Neuroimaging Initiative (ADNI) results posted at Laboratory of Neuro Imaging (LONI). The NWSI system provides access to a calibration process through the centiloid scale, consolidating Florbetapir and Florbetaben tracers in amyloid PET images. The interface also offers onsite access to machine learning algorithms, and introduces new heat maps that augment expert visual rating of PET images. NWSI has been piloted using data and expertise from Mount Sinai Medical Center, the 1Florida Alzheimer’s Disease Research Center (ADRC), Baptist Health South Florida, Nicklaus Children\u27s Hospital, and the University of Miami. All results were obtained using our processing servers in order to maintain data validity, consistency, and minimal processing bias