Doctor of Philosophy

dissertationAn important aspect of medical research is the understanding of anatomy and its relation to function in the human body. For instance, identifying changes in the brain associated with cognitive decline helps in understanding the process of aging and age-related neurological disorders. The field of computational anatomy provides a rich mathematical setting for statistical analysis of complex geometrical structures seen in 3D medical images. At its core, computational anatomy is based on the representation of anatomical shape and its variability as elements of nonflat manifold of diffeomorphisms with an associated Riemannian structure. Although such manifolds effectively represent natural biological variability, intrinsic methods of statistical analysis within these spaces remain deficient at large. This dissertation contributes two critical missing pieces for statistics in diffeomorphisms: (1) multivariate regression models for cross-sectional study of shapes, and (2) generalization of classical Euclidean, mixed-effects models to manifolds for longitudinal studies. These models are based on the principle that statistics on manifold-valued information must respect the intrinsic geometry of that space. The multivariate regression methods provide statistical descriptors of the relationships of anatomy with clinical indicators. The novel theory of hierarchical geodesic models (HGMs) is developed as a natural generalization of hierarchical linear models (HLMs) to describe longitudinal data on curved manifolds. Using a hierarchy of geodesics, the HGMs address the challenge of modeling the shape-data with unbalanced designs typically arising as a result of follow-up medical studies. More generally, this research establishes a mathematical foundation to study dynamics of changes in anatomy and the associated clinical progression with time. This dissertation also provides efficient algorithms that utilize state-of-the-art high performance computing architectures to solve models on large-scale, longitudinal imaging data. These manifold-based methods are applied to predictive modeling of neurological disorders such as Alzheimer's disease. Overall, this dissertation enables clinicians and researchers to better utilize the structural information available in medical images

Quantifying anatomical shape variations in neurological disorders

We develop a multivariate analysis of brain anatomy to identify the relevant shape deformation patterns and quantify the shape changes that explain corresponding variations in clinical neuropsychological measures. We use kernel Partial Least Squares (PLS) and formulate a regression model in the tangent space of the manifold of diffeomorphisms characterized by deformation momenta. The scalar deformation momenta completely encode the diffeomorphic changes in anatomical shape. In this model, the clinical measures are the response variables, while the anatomical variability is treated as the independent variable. To better understand the “shape—clinical response” relationship, we also control for demographic confounders, such as age, gender, and years of education in our regression model. We evaluate the proposed methodology on the Alzheimer’s Disease Neuroimaging Initiative (ADNI) database using baseline structural MR imaging data and neuropsychological evaluation test scores. We demonstrate the ability of our model to quantify the anatomical deformations in units of clinical response. Our results also demonstrate that the proposed method is generic and generates reliable shape deformations both in terms of the extracted patterns and the amount of shape changes. We found that while the hippocampus and amygdala emerge as mainly responsible for changes in test scores for global measures of dementia and memory function, they are not a determinant factor for executive function. Another critical finding was the appearance of thalamus and putamen as most important regions that relate to executive function. These resulting anatomical regions were consistent with very high confidence irrespective of the size of the population used in the study. This data-driven global analysis of brain anatomy was able to reach similar conclusions as other studies in Alzheimer’s Disease based on predefined ROIs, together with the identification of other new patterns of deformation. The proposed methodology thus holds promise for discovering new patterns of shape changes in the human brain that could add to our understanding of disease progression in neurological disorders

Multimodal MRI-based Imputation of the Aβ+ in Early Mild Cognitive Impairment.

ObjectiveTo identify brain atrophy from structural-MRI and cerebral blood flow(CBF) patterns from arterial spin labeling perfusion-MRI that are best predictors of the Aβ-burden, measured as composite 18F-AV45-PET uptake, in individuals with early mild cognitive impairment(MCI). Furthermore, to assess the relative importance of imaging modalities in classification of Aβ+/Aβ- early mild cognitive impairment.MethodsSixty-seven ADNI-GO/2 participants with early-MCI were included. Voxel-wise anatomical shape variation measures were computed by estimating the initial diffeomorphic mapping momenta from an unbiased control template. CBF measures normalized to average motor cortex CBF were mapped onto the template space. Using partial least squares regression, we identified the structural and CBF signatures of Aβ after accounting for normal cofounding effects of age, sex, and education.Results18F-AV45-positive early-MCIs could be identified with 83% classification accuracy, 87% positive predictive value, and 84% negative predictive value by multidisciplinary classifiers combining demographics data, ApoE ε4-genotype, and a multimodal MRI-based Aβ score.InterpretationMultimodal-MRI can be used to predict the amyloid status of early-MCI individuals. MRI is a very attractive candidate for the identification of inexpensive and non-invasive surrogate biomarkers of Aβ deposition. Our approach is expected to have value for the identification of individuals likely to be Aβ+ in circumstances where cost or logistical problems prevent Aβ detection using cerebrospinal fluid analysis or Aβ-PET. This can also be used in clinical settings and clinical trials, aiding subject recruitment and evaluation of treatment efficacy. Imputation of the Aβ-positivity status could also complement Aβ-PET by identifying individuals who would benefit the most from this assessment

Doctor of Philosophy

dissertationStatistical analysis of time dependent imaging data is crucial for understanding normal anatomical development as well as disease progression. The most promising studies are of longitudinal design, where repeated observations are obtained from the same subjects. Analysis in this case is challenging due to the difficulty in modeling longitudinal changes, such as growth, and comparing changes across different populations. In any case, the study of anatomical change over time has the potential to further our understanding of many dynamic processes. What is needed are accurate computational models to capture, describe, and quantify anatomical change over time. Anatomical shape is encoded in a variety of representations, such as medical imaging data and derived geometric information extracted as points, curves, and/or surfaces. By considering various shape representations embedded into the same ambient space as a shape complex, either in 2D or 3D, we obtain a more comprehensive description of the anatomy than provided by an single isolated shape. In this dissertation, we develop spatiotemporal models of anatomical change designed to leverage multiple shape representations simultaneously. Rather than study directly the geometric changes to a shape itself, we instead consider how the ambient space deforms, which allows all embedded shapes to be included simultaneously in model estimation. Around this idea, we develop two complementary spatiotemporal models: a flexible nonparametric model designed to capture complex anatomical trajectories, and a generative model designed as a compact statistical representation of anatomical change. We present several ways spatiotemporal models can support the statistical analysis of scalar measurements, such as volume, extracted from shape. Finally, we cover the statistical analysis of higher dimensional shape features to take better advantage of the rich morphometric information provided by shape, as well as the trajectory of change captured by spatiotemporal models

A comparison of various MRI feature types for characterizing whole brain anatomical differences using linear pattern recognition methods

There is a widespread interest in applying pattern recognition methods to anatomical neuroimaging data, but so far, there has been relatively little investigation into how best to derive image features in order to make the most accurate predictions. In this work, a Gaussian Process machine learning approach was used for predicting age, gender and body mass index (BMI) of subjects in the IXI dataset, as well as age, gender and diagnostic status using the ABIDE and COBRE datasets. MRI data were segmented and aligned using SPM12, and a variety of feature representations were derived from this preprocessing. We compared classification and regression accuracy using the different sorts of features, and with various degrees of spatial smoothing. Results suggested that feature sets that did not ignore the implicit background tissue class, tended to result in better overall performance, whereas some of the most commonly used feature sets performed relatively poorly

Automated, high accuracy classification of Parkinsonian disorders: a pattern recognition approach

Progressive supranuclear palsy (PSP), multiple system atrophy (MSA) and idiopathic Parkinson’s disease (IPD) can be clinically indistinguishable, especially in the early stages, despite distinct patterns of molecular pathology. Structural neuroimaging holds promise for providing objective biomarkers for discriminating these diseases at the single subject level but all studies to date have reported incomplete separation of disease groups. In this study, we employed multi-class pattern recognition to assess the value of anatomical patterns derived from a widely available structural neuroimaging sequence for automated classification of these disorders. To achieve this, 17 patients with PSP, 14 with IPD and 19 with MSA were scanned using structural MRI along with 19 healthy controls (HCs). An advanced probabilistic pattern recognition approach was employed to evaluate the diagnostic value of several pre-defined anatomical patterns for discriminating the disorders, including: (i) a subcortical motor network; (ii) each of its component regions and (iii) the whole brain. All disease groups could be discriminated simultaneously with high accuracy using the subcortical motor network. The region providing the most accurate predictions overall was the midbrain/brainstem, which discriminated all disease groups from one another and from HCs. The subcortical network also produced more accurate predictions than the whole brain and all of its constituent regions. PSP was accurately predicted from the midbrain/brainstem, cerebellum and all basal ganglia compartments; MSA from the midbrain/brainstem and cerebellum and IPD from the midbrain/brainstem only. This study demonstrates that automated analysis of structural MRI can accurately predict diagnosis in individual patients with Parkinsonian disorders, and identifies distinct patterns of regional atrophy particularly useful for this process

Sparse Adaptive Parameterization of Variability in Image Ensembles

International audienceThis paper introduces a new parameterization of diffeomorphic deformations for the characterization of the variability in image ensembles. Dense diffeomorphic deformations are built by interpolating the motion of a finite set of control points that forms a Hamiltonian flow of self-interacting particles. The proposed approach estimates a template image representative of a given image set, an optimal set of control points that focuses on the most variable parts of the image, and template-to-image registrations that quantify the variability within the image set. The method automatically selects the most relevant control points for the characterization of the image variability and estimates their optimal positions in the template domain. The optimization in position is done during the estimation of the deformations without adding any computational cost at each step of the gradient descent. The selection of the control points is done by adding a L 1 prior to the objective function, which is optimized using the FISTA algorithm

Mixture of Kernels and Iterated Semidirect Product of Diffeomorphisms Groups

In the framework of large deformation diffeomorphic metric mapping (LDDMM), we develop a multi-scale theory for the diffeomorphism group based on previous works. The purpose of the paper is (1) to develop in details a variational approach for multi-scale analysis of diffeomorphisms, (2) to generalise to several scales the semidirect product representation and (3) to illustrate the resulting diffeomorphic decomposition on synthetic and real images. We also show that the approaches presented in other papers and the mixture of kernels are equivalent.Comment: 21 pages, revised version without section on evaluatio

Doctor of Philosophy in Computing

dissertationAn important area of medical imaging research is studying anatomical diffeomorphic shape changes and detecting their relationship to disease processes. For example, neurodegenerative disorders change the shape of the brain, thus identifying differences between the healthy control subjects and patients affected by these diseases can help with understanding the disease processes. Previous research proposed a variety of mathematical approaches for statistical analysis of geometrical brain structure in three-dimensional (3D) medical imaging, including atlas building, brain variability quantification, regression, etc. The critical component in these statistical models is that the geometrical structure is represented by transformations rather than the actual image data. Despite the fact that such statistical models effectively provide a way for analyzing shape variation, none of them have a truly probabilistic interpretation. This dissertation contributes a novel Bayesian framework of statistical shape analysis for generic manifold data and its application to shape variability and brain magnetic resonance imaging (MRI). After we carefully define the distributions on manifolds, we then build Bayesian models for analyzing the intrinsic variability of manifold data, involving the mean point, principal modes, and parameter estimation. Because there is no closed-form solution for Bayesian inference of these models on manifolds, we develop a Markov Chain Monte Carlo method to sample the hidden variables from the distribution. The main advantages of these Bayesian approaches are that they provide parameter estimation and automatic dimensionality reduction for analyzing generic manifold-valued data, such as diffeomorphisms. Modeling the mean point of a group of images in a Bayesian manner allows for learning the regularity parameter from data directly rather than having to set it manually, which eliminates the effort of cross validation for parameter selection. In population studies, our Bayesian model of principal modes analysis (1) automatically extracts a low-dimensional, second-order statistics of manifold data variability and (2) gives a better geometric data fit than nonprobabilistic models. To make this Bayesian framework computationally more efficient for high-dimensional diffeomorphisms, this dissertation presents an algorithm, FLASH (finite-dimensional Lie algebras for shooting), that hugely speeds up the diffeomorphic image registration. Instead of formulating diffeomorphisms in a continuous variational problem, Flash defines a completely new discrete reparameterization of diffeomorphisms in a low-dimensional bandlimited velocity space, which results in the Bayesian inference via sampling on the space of diffeomorphisms being more feasible in time. Our entire Bayesian framework in this dissertation is used for statistical analysis of shape data and brain MRIs. It has the potential to improve hypothesis testing, classification, and mixture models