Anatomical texture patterns identify cerebellar distinctions between essential tremor and Parkinson's disease

Voxel-based morphometry is an established technique to study focal structural brain differences in neurologic disease. More recently, texture-based analysis methods have enabled a pattern-based assessment of group differences, at the patch level rather than at the voxel level, allowing a more sensitive localization of structural differences between patient populations. In this study, we propose a texture-based approach to identify structural differences between the cerebellum of patients with Parkinson's disease (n =???280) and essential tremor (n =???109). We analyzed anatomical differences of the cerebellum among patients using two features: T1-weighted MRI intensity, and a texture-based similarity feature. Our results show anatomical differences between groups that are localized to the inferior part of the cerebellar cortex. Both the T1-weighted intensity and texture showed differences in lobules VIII and IX, vermis VIII and IX, and middle peduncle, but the texture analysis revealed additional differences in the dentate nucleus, lobules VI and VII, vermis VI and VII. This comparison emphasizes how T1-weighted intensity and texture-based methods can provide a complementary anatomical structure analysis. While texture-based similarity shows high sensitivity for gray matter differences, T1-weighted intensity shows sensitivity for the detection of white matter differences

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

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

Computer aided diagnosis in temporal lobe epilepsy and Alzheimer's dementia

Computer aided diagnosis within neuroimaging must rely on advanced image processing techniques to detect and quantify subtle signal changes that may be surrogate indicators of disease state. This thesis proposes two such novel methodologies that are both based on large volumes of interest, are data driven, and use cross-sectional scans: appearance-based classification (ABC) and voxel-based classification (VBC).The concept of appearance in ABC represents the union of intensity and shape information extracted from magnetic resonance images (MRI). The classification method relies on a linear modeling of appearance features via principal components analysis, and comparison of the distribution of projection coordinates for the populations under study within a reference multidimensional appearance eigenspace. Classification is achieved using forward, stepwise linear discriminant analyses, in multiple cross-validated trials. In this work, the ABC methodology is shown to accurately lateralize the seizure focus in temporal lobe epilepsy (TLE), differentiate normal aging individuals from patients with either Alzheimer's dementia (AD) or Mild Cognitive Impairment (MCI), and finally predict the progression of MCI patients to AD. These applications demonstrated that the ABC technique is robust to different signal changes due to two distinct pathologies, to low resolution data and motion artifacts, and to possible differences inherent to multi-site acquisition.The VBC technique relies on voxel-based morphometry to identify regions of grey and white matter concentration differences between co-registered cohorts of individuals, and then on linear modeling of variables extracted from these regions. Classification is achieved using linear discriminant analyses within a multivariate space composed of voxel-based morphometry measures related to grey and white matter concentration, along with clinical variables of interest. VBC is shown to increase the accuracy of prediction of one-year clinical status from three to four out of five TLE patients having undergone selective amygdalo-hippocampectomy. These two techniques are shown to have the necessary potential to solve current problems in neurological research, assist clinical physicians with their decision-making process and influence positively patient management

Increased hippocampal shape asymmetry and volumetric ventricular asymmetry in autism spectrum disorder

Autism spectrum disorder (ASD) is a prevalent and fast-growing pervasive neurodevelopmental disorder worldwide. Despite the increasing prevalence of ASD and the breadth of research conducted on the disorder, a conclusive etiology has yet to be established and controversy still exists surrounding the anatomical abnormalities in ASD. In particular, structural asymmetries have seldom been investigated in ASD, especially in subcortical regions. Additionally, the majority of studies for identifying structural biomarkers associated with ASD have focused on small sample sizes. Therefore, the present study utilizes a large-scale, multi-site database to investigate asymmetries in the amygdala, hippocampus, and lateral ventricles, given the potential involvement of these regions in ASD. Contrary to prior work, we are not only computing volumetric asymmetries, but also shape asymmetries, using a new measure of asymmetry based on spectral shape descriptors. This measure represents the magnitude of the asymmetry and therefore captures both directional and undirectional asymmetry. The asymmetry analysis is conducted on 437 individuals with ASD and 511 healthy controls using T1-weighted MRI scans from the Autism Brain Imaging Data Exchange (ABIDE) database. Results reveal significant asymmetries in the hippocampus and the ventricles, but not in the amygdala, in individuals with ASD. We observe a significant increase in shape asymmetry in the hippocampus, as well as increased volumetric asymmetry in the lateral ventricles in individuals with ASD. Asymmetries in these regions have not previously been reported, likely due to the different characterization of neuroanatomical asymmetry and smaller sample sizes used in previous studies. Given that these results were demonstrated in a large cohort, such asymmetries may be worthy of consideration in the development of neurodiagnostic classification tools for ASD

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.EThOS - Electronic Theses Online ServiceGBUnited Kingdo

Deep learning of brain asymmetry digital biomarkers to support early diagnosis of cognitive decline and dementia

Early identification of degenerative processes in the human brain is essential for proper care and treatment. This may involve different instrumental diagnostic methods, including the most popular computer tomography (CT), magnetic resonance imaging (MRI) and positron emission tomography (PET) scans. These technologies provide detailed information about the shape, size, and function of the human brain. Structural and functional cerebral changes can be detected by computational algorithms and used to diagnose dementia and its stages (amnestic early mild cognitive impairment - EMCI, Alzheimer’s Disease - AD). They can help monitor the progress of the disease. Transformation shifts in the degree of asymmetry between the left and right hemispheres illustrate the initialization or development of a pathological process in the brain. In this vein, this study proposes a new digital biomarker for the diagnosis of early dementia based on the detection of image asymmetries and crosssectional comparison of NC (normal cognitively), EMCI and AD subjects. Features of brain asymmetries extracted from MRI of the ADNI and OASIS databases are used to analyze structural brain changes and machine learning classification of the pathology. The experimental part of the study includes results of supervised machine learning algorithms and transfer learning architectures of convolutional neural networks for distinguishing between cognitively normal subjects and patients with early or progressive dementia. The proposed pipeline offers a low-cost imaging biomarker for the classification of dementia. It can be potentially helpful to other brain degenerative disorders accompanied by changes in brain asymmetries

Improved Segmentation of the Intracranial and Ventricular Volumes in Populations with Cerebrovascular Lesions and Atrophy Using 3D CNNs

Successful segmentation of the total intracranial vault (ICV) and ventricles is of critical importance when studying neurodegeneration through neuroimaging. We present iCVMapper and VentMapper, robust algorithms that use a convolutional neural network (CNN) to segment the ICV and ventricles from both single and multi-contrast MRI data. Our models were trained on a large dataset from two multi-site studies (N = 528 subjects for ICV, N = 501 for ventricular segmentation) consisting of older adults with varying degrees of cerebrovascular lesions and atrophy, which pose significant challenges for most segmentation approaches. The models were tested on 238 participants, including subjects with vascular cognitive impairment and high white matter hyperintensity burden. Two of the three test sets came from studies not used in the training dataset. We assessed our algorithms relative to four state-of-the-art ICV extraction methods (MONSTR, BET, Deep Extraction, FreeSurfer, DeepMedic), as well as two ventricular segmentation tools (FreeSurfer, DeepMedic). Our multi-contrast models outperformed other methods across many of the evaluation metrics, with average Dice coefficients of 0.98 and 0.96 for ICV and ventricular segmentation respectively. Both models were also the most time efficient, segmenting the structures in orders of magnitude faster than some of the other available methods. Our networks showed an increased accuracy with the use of a conditional random field (CRF) as a post-processing step. We further validated both segmentation models, highlighting their robustness to images with lower resolution and signal-to-noise ratio, compared to tested techniques. The pipeline and models are available at: https://icvmapp3r.readthedocs.io and https://ventmapp3r.readthedocs.io to enable further investigation of the roles of ICV and ventricles in relation to normal aging and neurodegeneration in large multi-site studies

Classification of dementias based on brain radiomics features

Dissertação de mestrado integrado em Engenharia InformáticaNeurodegenerative diseases impair the functioning of the brain and are characterized by alterations in the morphology of specific brain regions. Some of the main disorders include Alzheimer's, Parkinson's, and Huntington's diseases, and the number of cases increases exponentially since ageing is one of the main risk factors. Trying to identify the areas in which this type of disease appears is something that can have a very positive impact in this area of Medicine and can guarantee a more appropriate treatment or allow the improvement of the quality of life of patients. With the current technological advances, computer tools are capable of performing a structural or functional analysis of neuroimaging data from Magnetic Resonance Images(MRI). Therefore, Medical Informatics uses these techniques to create and manage medical neuroimaging data to improve the diagnosis and management of these patients. MRI is the image type used in the analysis of the brain area and points to a promising and reliable diagnostic tool since it allows high-quality images in various planes or strategies and MRI methods are fundamental diagnostic tools in clinical practice, allowing the diagnosis of pathologic processes such as stroke or brain tumours. However, structural MRI has limitations for the diagnosis of neurodegenerative disorders since it mainly identifies atrophy of brain regions. Currently, there is increased interest in informatics applications capable of monitoring and quantifying human brain imaging alterations, with potential for neurodegenerative disorders diagnosis and monitoring. One of these applications is Radiomics, which corresponds to a methodolog ythat allows the extraction of features from images of a given region of the brain. Specific quantitative metrics from MRI are acquired by this tool, and they correspond to a set of features, including texture, shape, among others. To standardize Radiomics application, specific libraries have been proposed to be used by the bioinformatics and biomedical communities, such as PyRadiomics, which corresponds to an open source Python package for extracting Radiomics of MRIs. Therefore, this dissertation was developed based on magnetic resonance images and the study of Deep Learning (DL) techniques to assist researchers and neuroradiologists in the diagnosis and prediction of neurodegenerative disease development. Two different main tasks were made: first, a segmentation, using FreeSurfer, of different regions of the brain and then, a model was build from radiomic features extracted from each part of the brain and interpreted for knowledge extraction.As doenças neurodegenerativas estão associadas ao funcionamento do cérebro e caracterizam-se pelo facto de serem altamente incapacitantes. São exemplos destas, as doenças de Alzheimer, Parkinson e Huntington, e o seu número de casos tem vindo a aumentar exponencialmente, uma vez que o envelhecimento é um dos principais factores de risco. Tentar identificar quais são as regiões cerebrais que permitem predizer o seu aparecimento e desenvolvimento é algo que, sendo possível, terá um impacto muito positivo nesta área da Medicina e poderá garantir um tratamento mais adequado, ou simplesmente melhorar a qualidade de vida dos pacientes. Com os avanços tecnológicos atuais, foram desenvolvidas ferramentas informáticas que são capazes de efetuar uma análise estrutural ou funcional de Ressonâncias Magnéticas (MRI), sendo essas ferramentas usadas para promover a melhoria e o conhecimento clínico. Deste modo, as constantes evoluções científicas têm realçado o papel da Informática Médica na neuroimagem para criar e gerenciar dados médicos, melhorando o diagnóstico destes pacientes. A MRI é o tipo de imagem utilizada na análise de regiões cerebrais e aponta para uma ferramenta de diagnóstico promissora e fiável, uma vez que permite obter imagens de alta qualidade em vários planos, permitindo assim, o diagnóstico de processos patológicos, tais como acidentes vasculares ou tumores cerebrais. Atualmente, existem inúmeras aplicações informáticas capazes de efetuar análises estruturais e funcionais do cérebro humano, pois é este o principal órgão afetado pelas doenças neurodegenerativas. Uma dessas aplicações é o Radiomics, que permite fazer a extração de features de imagens do cérebro. A biblioteca a utilizar será PyRadiomics, que corresponde a um package open source em Python para a extração de features Radiomics de imagens médicas. As features correspondem a características da imagem. Assim sendo, a presente dissertação foi desenvolvida com base em imagens de ressonância magnética e no estudo das técnicas de Deep Learning para investigar e auxiliar os médicos neurorradiologistas a diagnosticar e a prever o desenvolvimento de doenças neurodegenerativas. Foram feitas duas principais tarefas: primeiro, uma segmentação, utilizando o software FreeSurfer, de diferentes regiões do cérebro e, de seguida, foi construído um modelo a partir das features radiómicas extraídas de cada parte do cérebro que foi interpretado