Knowledge-Based Deformable Surface Model with Application to Segmentation of Brain Structures in MRI

We have developed a knowledge-based deformable surface for segmentation of medical images. This work has been done in the context of segmentation of hippocampus from brain MRI, due to its challenge and clinical importance. The model has a polyhedral discrete structure and is initialized automatically by analyzing brain MRI sliced by slice, and finding few landmark features at each slice using an expert system. The expert system decides on the presence of the hippocampus and its general location in each slice. The landmarks found are connected together by a triangulation method, to generate a closed initial surface. The surface deforms under defined internal and external force terms thereafter, to generate an accurate and reproducible boundary for the hippocampus. The anterior and posterior (AP) limits of the hippocampus is estimated by automatic analysis of the location of brain stem, and some of the features extracted in the initialization process. These data are combined together with a priori knowledge using Bayes method to estimate a probability density function (pdf) for the length of the structure in sagittal direction. The hippocampus AP limits are found by optimizing this pdf. The model is tested on real clinical data and the results show very good model performance.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/85930/1/Fessler166.pd

Prospective Quantitative Neuroimaging Analysis of Putative Temporal Lobe Epilepsy

Purpose: A prospective study of individual and combined quantitative imaging applications for lateralizing epileptogenicity was performed in a cohort of consecutive patients with a putative diagnosis of mesial temporal lobe epilepsy (mTLE). Methods: Quantitative metrics were applied to MRI and nuclear medicine imaging studies as part of a comprehensive presurgical investigation. The neuroimaging analytics were conducted remotely to remove bias. All quantitative lateralizing tools were trained using a separate dataset. Outcomes were determined after 2 years. Of those treated, some underwent resection, and others were implanted with a responsive neurostimulation (RNS) device. Results: Forty-eight consecutive cases underwent evaluation using nine attributes of individual or combinations of neuroimaging modalities: 1) hippocampal volume, 2) FLAIR signal, 3) PET profile, 4) multistructural analysis (MSA), 5) multimodal model analysis (MMM), 6) DTI uncertainty analysis, 7) DTI connectivity, and 9) fMRI connectivity. Of the 24 patients undergoing resection, MSA, MMM, and PET proved most effective in predicting an Engel class 1 outcome (\u3e80% accuracy). Both hippocampal volume and FLAIR signal analysis showed 76% and 69% concordance with an Engel class 1 outcome, respectively. Conclusion: Quantitative multimodal neuroimaging in the context of a putative mTLE aids in declaring laterality. The degree to which there is disagreement among the various quantitative neuroimaging metrics will judge whether epileptogenicity can be confined sufficiently to a particular temporal lobe to warrant further study and choice of therapy. Prediction models will improve with continued exploration of combined optimal neuroimaging metrics

Data mining MR image features of select structures for lateralization of mesial temporal lobe epilepsy

PURPOSE: This study systematically investigates the predictive power of volumetric imaging feature sets extracted from select neuroanatomical sites in lateralizing the epileptogenic focus in mesial temporal lobe epilepsy (mTLE) patients. METHODS: A cohort of 68 unilateral mTLE patients who had achieved an Engel class I outcome postsurgically was studied retrospectively. The volumes of multiple brain structures were extracted from preoperative magnetic resonance (MR) images in each. The MR image data set consisted of 54 patients with imaging evidence for hippocampal sclerosis (HS-P) and 14 patients without (HS-N). Data mining techniques (i.e., feature extraction, feature selection, machine learning classifiers) were applied to provide measures of the relative contributions of structures and their correlations with one another. After removing redundant correlated structures, a minimum set of structures was determined as a marker for mTLE lateralization. RESULTS: Using a logistic regression classifier, the volumes of both hippocampus and amygdala showed correct lateralization rates of 94.1%. This reflected about 11.7% improvement in accuracy relative to using hippocampal volume alone. The addition of thalamic volume increased the lateralization rate to 98.5%. This ternary-structural marker provided a 100% and 92.9% mTLE lateralization accuracy, respectively, for the HS-P and HS-N groups. CONCLUSIONS: The proposed tristructural MR imaging biomarker provides greater lateralization accuracy relative to single- and double-structural biomarkers and thus, may play a more effective role in the surgical decision-making process. Also, lateralization of the patients with insignificant atrophy of hippocampus by the proposed method supports the notion of associated structural changes involving the amygdala and thalamus

Additional file 1: of Brain region and epilepsy-associated differences in inflammatory mediator levels in medically refractory mesial temporal lobe epilepsy

Patient data repository. (XLSX 79 kb

Consensus Feature Ranking in Datasets with Missing Values

Development of a feature ranking method based upon the discriminative power of features and unbiased towards classifiers is of interest. We have studied a consensus feature ranking method, based on multiple classifiers, and have shown its superiority to well known statistical ranking methods. In a target environment such as a medical dataset, missing values and an unbalanced distribution of data must be taken into consideration in the ranking and evaluation phases in order to legitimately apply a feature ranking method. In a comparison study, a Performance Index (PI) is proposed that takes into account both the number of features and the number of samples involved in the classification