Motion robust acquisition and reconstruction of quantitative T2* maps in the developing brain

The goal of the research presented in this thesis was to develop methods for quantitative T2* mapping of the developing brain. Brain maturation in the early period of life involves complex structural and physiological changes caused by synaptogenesis, myelination and growth of cells. Molecular structures and biological processes give rise to varying levels of T2* relaxation time, which is an inherent contrast mechanism in magnetic resonance imaging. The knowledge of T2* relaxation times in the brain can thus help with evaluation of pathology by establishing its normative values in the key areas of the brain. T2* relaxation values are a valuable biomarker for myelin microstructure and iron concentration, as well as an important guide towards achievement of optimal fMRI contrast. However, fetal MR imaging is a significant step up from neonatal or adult MR imaging due to the complexity of the acquisition and reconstruction techniques that are required to provide high quality artifact-free images in the presence of maternal respiration and unpredictable fetal motion. The first contribution of this thesis, described in Chapter 4, presents a novel acquisition method for measurement of fetal brain T2* values. At the time of publication, this was the first study of fetal brain T2* values. Single shot multi-echo gradient echo EPI was proposed as a rapid method for measuring fetal T2* values by effectively freezing intra-slice motion. The study concluded that fetal T2* values are higher than those previously reported for pre-term neonates and decline with a consistent trend across gestational age. The data also suggested that longer than usual echo times or direct T2* measurement should be considered when performing fetal fMRI in order to reach optimal BOLD sensitivity. For the second contribution, described in Chapter 5, measurements were extended to a higher field strength of 3T and reported, for the first time, both for fetal and neonatal subjects at this field strength. The technical contribution of this work is a fully automatic segmentation framework that propagates brain tissue labels onto the acquired T2* maps without the need for manual intervention. The third contribution, described in Chapter 6, proposed a new method for performing 3D fetal brain reconstruction where the available data is sparse and is therefore limited in the use of current state of the art techniques for 3D brain reconstruction in the presence of motion. To enable a high resolution reconstruction, a generative adversarial network was trained to perform image to image translation between T2 weighted and T2* weighted data. Translated images could then be served as a prior for slice alignment and super resolution reconstruction of 3D brain image.Open Acces

Deep learning for unsupervised domain adaptation in medical imaging: Recent advancements and future perspectives

Deep learning has demonstrated remarkable performance across various tasks in medical imaging. However, these approaches primarily focus on supervised learning, assuming that the training and testing data are drawn from the same distribution. Unfortunately, this assumption may not always hold true in practice. To address these issues, unsupervised domain adaptation (UDA) techniques have been developed to transfer knowledge from a labeled domain to a related but unlabeled domain. In recent years, significant advancements have been made in UDA, resulting in a wide range of methodologies, including feature alignment, image translation, self-supervision, and disentangled representation methods, among others. In this paper, we provide a comprehensive literature review of recent deep UDA approaches in medical imaging from a technical perspective. Specifically, we categorize current UDA research in medical imaging into six groups and further divide them into finer subcategories based on the different tasks they perform. We also discuss the respective datasets used in the studies to assess the divergence between the different domains. Finally, we discuss emerging areas and provide insights and discussions on future research directions to conclude this survey.Comment: Under Revie

Machine Learning and Deep Learning Approaches for Brain Disease Diagnosis : Principles and Recent Advances

This work was supported in part by the National Research Foundation of Korea-Grant funded by the Korean Government (Ministry of Science and ICT) under Grant NRF 2020R1A2B5B02002478, and in part by Sejong University through its Faculty Research Program under Grant 20212023.Peer reviewedPublisher PD

DETECTING BRAIN-WIDE INTRINSIC CONNECTIVITY NETWORKS USING fMRI IN MICE

Functional neuroimaging methods in mice are essential for unraveling complex neuronal networks that underlie maladaptive behavior in neurological disorder models. By using fMRI to detect intrinsic connectivity networks in mice, we can examine large scale alteration in brain activity and functional connectivity to establish causal associations in brain network changes. The work presented in this dissertation is organized into five chapters. Chapter 1 provides the necessary background required to understand how functional neuroimaging tools such as fMRI detect signal changes attributed to spontaneous neuronal activity of intrinsic connectivity networks in mice. Chapter 2 describes the development of our isotropic fMRI acquisition sequence in mice and semi-automated pipeline for mouse fMRI data. Naïve mouse fMRI scans were used to validated the pipeline by reliably and reproducibly extracting intrinsic connectivity networks. Chapter 3 establishes the development and validation of a novel superparamagenetic iron-oxide nanoparticle to enhance fMRI signal sensitivity. Chapter 4 studies the effects norepinephrine released by locus coeruleus neurons on the default mode network in mice. Norepinephrine release selectively enhanced neuronal activity and connectivity in the Frontal module of the default mode network by suppressing information flow from the Retrosplenial-Hippocampal to the Association modules. Chapter 5 addresses the implications of our findings and addresses the limitations and future studies that can be conducted to expand on this research.Doctor of Philosoph

Multi-parametric Imaging Using Hybrid PET/MR to Investigate the Epileptogenic Brain

Neuroimaging analysis has led to fundamental discoveries about the healthy and pathological human brain. Different imaging modalities allow garnering complementary information about brain metabolism, structure and function. To ensure that the integration of imaging data from these modalities is robust and reliable, it is fundamental to attain deep knowledge of each modality individually. Epilepsy, a neurological condition characterised by recurrent spontaneous seizures, represents a field in which applications of neuroimaging and multi-parametric imaging are particularly promising to guide diagnosis and treatment. In this PhD thesis, I focused on different imaging modalities and investigated advanced denoising and analysis strategies to improve their application to epilepsy. The first project focused on fluorodeoxyglucose (FDG) positron emission tomography (PET), a well-established imaging modality assessing brain metabolism, and aimed to develop a novel, semi-quantitative pipeline to analyse data in children with epilepsy, thus aiding presurgical planning. As pipelines for FDG-PET analysis in children are currently lacking, I developed age-appropriate templates to provide statistical parametric maps identifying epileptogenic areas on patient scans. The second and third projects focused on two magnetic resonance imaging (MRI) modalities: resting-state functional MRI (rs-fMRI) and arterial spin labelling (ASL), respectively. The aim was to i) probe the efficacy of different fMRI denoising pipelines, and ii) formally compare different ASL data acquisition strategies. In the former case, I compared different pre-processing methods and assessed their impact on fMRI signal quality and related functional connectivity analyses. In the latter case, I compared two ASL sequences to investigate their ability to quantify cerebral blood flow and interregional brain connectivity. The final project addressed the combination of rs-fMRI and ASL, and leveraged graph-theoretical analysis tools to i) compare metrics estimated via these two imaging modalities in healthy subjects and ii) assess topological changes captured by these modalities in a sample of temporal lobe epilepsy patients

Application of Deep Learning to Brain Connectivity Classification in Large MRI Datasets

The use of machine learning for whole-brain classification of magnetic resonance imaging (MRI) data is of clear interest, both for understanding phenotypic differences in brain structure and function and for diagnostic applications. Developments of deep learning models in the past decade have revolutionized photographic image and speech recognition, bringing promise to do the same to other fields of science. However, there are many practical and theoretical challenges in the translation of such methods to the unique context of MRIs of the brain. This thesis presents a theoretical underpinning for whole-brain classification of extremely large datasets of multi-site MRIs, including machine learning model architecture, dataset curation methods, machine learning visualization methods, encoding of MRI data, and feature extraction. To replicate large sample sizes typically applied to deep learning models, a dataset of over 50,000 functional and structural MRIs was amassed from nine different databases, and the undertaken analyses were conducted on three covariates commonly found across these collections: sex, resting state/task, and autism spectrum disorder. I find that deep learning is not only a method that has promise for clinical application in the future, but also a powerful statistical tool for analyzing complex, nonlinear relationships in brain data where conventional statistics may fail. However, results are also dependent on factors such as dataset imbalances, confounding factors such as motion and head size, selected methods of encoding MRI data, variability of machine learning models and selected methods of visualizing the machine learning results. In this thesis, I present the following methodological innovations: (1) a method of balancing datasets as a means of regressing out measurable confounding factors; (2) a means of removing spatial biases from deep learning visualization methods; (3) methods of encoding functional and structural datasets as connectivity matrices; (4) the use of ensemble models and convolutional neural network architectures to improve classification accuracy and consistency; (5) adaptation of deep learning visualization methods to study brain connections utilized in the classification process. Additionally, I discuss interpretations, limitations, and future directions of this research.Gates Cambridge Scholarshi

Quantification of cortical folding using MR image data

The cerebral cortex is a thin layer of tissue lining the brain where neural circuits perform important high level functions including sensory perception, motor control and language processing. In the third trimester the fetal cortex folds rapidly from a smooth sheet into a highly convoluted arrangement of gyri and sulci. Premature birth is a high risk factor for poor neurodevelopmental outcome and has been associated with abnormal cortical development, however the nature of the disruption to developmental processes is not fully understood. Recent developments in magnetic resonance imaging have allowed the acquisition of high quality brain images of preterms and also fetuses in-utero. The aim of this thesis is to develop techniques which quantify folding from these images in order to better understand cortical development in these two populations. A framework is presented that quantifies global and regional folding using curvature-based measures. This methodology was applied to fetuses over a wide gestational age range (21.7 to 38.9 weeks) for a large number of subjects (N = 80) extending our understanding of how the cortex folds through this critical developmental period. The changing relationship between the folding measures and gestational age was modelled with a Gompertz function which allowed an accurate prediction of physiological age. A spectral-based method is outlined for constructing a spatio-temporal surface atlas (a sequence of mean cortical surface meshes for weekly intervals). A key advantage of this method is the ability to do group-wise atlasing without bias to the anatomy of an initial reference subject. Mean surface templates were constructed for both fetuses and preterms allowing a preliminary comparison of mean cortical shape over the postmenstrual age range 28-36 weeks. Displacement patterns were revealed which intensified with increasing prematurity, however more work is needed to evaluate the reliability of these findings.Open Acces

Identifying Changes of Functional Brain Networks using Graph Theory

This thesis gives an overview on how to estimate changes in functional brain networks using graph theoretical measures. It explains the assessment and definition of functional brain networks derived from fMRI data. More explicitly, this thesis provides examples and newly developed methods on the measurement and visualization of changes due to pathology, external electrical stimulation or ongoing internal thought processes. These changes can occur on long as well as on short time scales and might be a key to understanding brain pathologies and their development. Furthermore, this thesis describes new methods to investigate and visualize these changes on both time scales and provides a more complete picture of the brain as a dynamic and constantly changing network.:1 Introduction 1.1 General Introduction 1.2 Functional Magnetic Resonance Imaging 1.3 Resting-state fMRI 1.4 Brain Networks and Graph Theory 1.5 White-Matter Lesions and Small Vessel Disease 1.6 Transcranial Direct Current Stimulation 1.7 Dynamic Functional Connectivity 2 Publications 2.1 Resting developments: a review of fMRI post-processing methodologies for spontaneous brain activity 2.2 Early small vessel disease affects fronto-parietal and cerebellar hubs in close correlation with clinical symptoms - A resting-state fMRI study 2.3 Dynamic modulation of intrinsic functional connectivity by transcranial direct current stimulation 2.4 Three-dimensional mean-shift edge bundling for the visualization of functional connectivity in the brain 2.5 Dynamic network participation of functional connectivity hubs assessed by resting-state fMRI 3 Summary 4 Bibliography 5. Appendix 5.1 Erklärung über die eigenständige Abfassung der Arbeit 5.2 Curriculum vitae 5.3 Publications 5.4 Acknowledgement

Machine Learning And Quantitative Neuroimaging In Epilepsy And Low Field Mri

Medical imaging plays a key role in the diagnosis and management of neurological disorders. Magnetic resonance imaging (MRI) has proven particularly useful, as it produces high resolution images with excellent tissue contrast, permitting clinicians to identify lesions and select appropriate treatments. However, demand for MRI services has outpaced the availability of qualified experts to operate, maintain, and interpret images from these devices. Radiologists often rely on time-consuming manual analyses, which further limits throughput. Moreover, a large portion of the world’s population cannot currently access MRI, and demand for medical imaging services will continue to increase as healthcare quality improves globally. To address these challenges, we must find innovative ways to automate medical processing and produce lower-cost medical imaging devices. Recent advances in deep learning and low-field MRI hardware offer potential solutions, providing lower-cost methods for processing and collecting images, respectively. This thesis aims to develop and validate lower-cost methods for collecting and interpreting neuroimaging using machine learning algorithms and portable, low-field MRI technology. In the first section, I develop a deep learning algorithm that automatically segments resection cavities in epilepsy surgery patients and quantifies removed tissues. I also compare the impacts of epilepsy surgery on remote brain regions, demonstrating that more selective procedures minimize postoperative cortical thinning. In the second section, I explore and validate clinical applications for a new portable, low-field MRI device. Using open-source imaging and machine learning, I propose a low-cost method for simulating diagnostic performance for novel imaging devices when only sparse data is available. Additionally, I validate device performance in multiple sclerosis by directly comparing the low-field device to standard-of-care imaging using a range of manual and automated analyses. My hope is that machine learning and low-field MRI will increase medical imaging access and improve patient care worldwide

Predictive Diagnosis of Alzheimer's Disease using Diffusion MRI

Age-related neurodegenerative diseases, including Alzheimer’s Disease (AD), are an increasing cause of concern for the world’s ageing population. The current consensus in the research community is that the main setbacks in the treatment of AD include the inability to diagnose it in its early stages and the lack of accurate stratification techniques for the prodromal stages of the disease and normal control (NC) subject groups. Numerous studies show that AD causes damage to the white matter microstructure in the brain. Commonly used techniques for diagnosing this disease include, neuropsychological assessments, genetics, proteomics, and image-based analysis. However, unlike these techniques, recent advances in Diffusion Magnetic Resonance Imaging (dMRI) analysis posits its sensitivity to the microstructural organization of cerebral white matter, and hence its applicability for early diagnosis of AD. Since tissue damage is reflected in the pattern of water diffusion in neural fibre structures, dMRI can be used to track disease-related changes in the brain. Contemporary dMRI approaches are broadly classified as being either region-based or tract-based. This thesis draws on the strengths of both these approaches by proposing an original extension of region-based methods to the simultaneous analysis of multiple brain regions. A predefined set of features is derived from dMRI data and used to compute the probabilistic distances between different brain regions. The resulting statistical associations can be modelled as an undirected and fully-connected graph encoding a unique brain connectivity pattern. Subsequently, the characteristics of this graph are used for the stratification of AD and NC subjects. Although the current work focuses on AD and NC subject populations, the perfect separability achieved between the two groups suggests the suitability of the technique for separating NC, AD, in addition to subjects in the prodromal stage of the disease, i.e., mild cognitive impairment (MCI)