Anatomy-guided joint tissue segmentation and topological correction for 6-month infant brain MRI with risk of autism

Structure-Aware Brain Tissue Segmentation for Isointense Infant MRI Data Using Multi-Phase Multi-Scale Assistance Network

Accurate and automatic brain tissue segmentation is crucial for tracking brain development and diagnosing brain disorders. However, due to inherently ongoing myelination and maturation during the first postnatal year, the intensity distributions of gray matter and white matter in the infant brain MRI at the age of around 6 months old (a.k.a. isointense phase) are highly overlapped, which makes tissue segmentation very challenging, even for experts. To address this issue, in this study, we propose a multi-phase multi-scale assistance segmentation framework, which comprises a structure-preserved generative adversarial network (SPGAN) and a multi-phase multi-scale assisted segmentation network (MASN). SPGAN bi-directionally synthesizes isointense and adult-like data. The synthetic isointense data essentially augment the training dataset, combined with high-quality annotations transferred from its adult-like counterpart. By contrast, the synthetic adult-like data offers clear tissue structures and is concatenated with isointense data to serve as the input of MASN. In particular, MASN is designed with two-branch networks, which simultaneously segment tissues with two phases (isointense and adult-like) and two scales by also preserving their correspondences. We further propose a boundary refinement module to extract maximum gradients from local feature maps to indicate tissue boundaries, prompting MASN to focus more on boundaries where segmentation errors are prone to occur. Extensive experiments on the National Database for Autism Research and Baby Connectome Project datasets quantitatively and qualitatively demonstrate the superiority of our proposed framework compared with seven state-of-the-art methods.

Transferring Adult-Like Phase Images for Robust Multi-View Isointense Infant Brain Segmentation

Accurate tissue segmentation of infant brain in magnetic resonance (MR) images is crucial for charting early brain development and identifying biomarkers. Due to ongoing myelination and maturation, in the isointense phase (6-9 months of age), the gray and white matters of infant brain exhibit similar intensity levels in MR images, posing significant challenges for tissue segmentation. Meanwhile, in the adult-like phase around 12 months of age, the MR images show high tissue contrast and can be easily segmented. In this paper, we propose to effectively exploit adult-like phase images to achieve robust multi-view isointense infant brain segmentation. Specifically, in one way, we transfer adult-like phase images to the isointense view, which have similar tissue contrast as the isointense phase images, and use the transferred images to train an isointense-view segmentation network. On the other way, we transfer isointense phase images to the adult-like view, which have enhanced tissue contrast, for training a segmentation network in the adult-like view. The segmentation networks of different views form a multi-path architecture that performs multi-view learning to further boost the segmentation performance. Since anatomy-preserving style transfer is key to the downstream segmentation task, we develop a Disentangled Cycle-consistent Adversarial Network (DCAN) with strong regularization terms to accurately transfer realistic tissue contrast between isointense and adult-like phase images while still maintaining their structural consistency. Experiments on both NDAR and iSeg-2019 datasets demonstrate a significant superior performance of our method over the state-of-the-art methods.

Subject-specific atlas for automatic brain tissue segmentation of neonatal magnetic resonance images

Developing advanced systems for 3D brain tissue segmentation from neonatal magnetic resonance (MR) images is vital for newborn structural analysis. However, automatic segmentation of neonatal brain tissues is challenging due to smaller head size and inverted T1/T2 tissue contrast compared to adults. In this work, a subject-specific atlas based technique is presented for segmentation of gray matter (GM), white matter (WM), and cerebrospinal fluid (CSF) from neonatal MR images. It involves atlas selection, subject-specific atlas creation using random forest (RF) classifier, and brain tissue segmentation using the expectation maximization-Markov random field (EM-MRF) method. To increase the segmentation accuracy, different tissue intensity- and gradient-based features were used. Evaluation on 40 neonatal MR images (gestational age of 37-44 weeks) demonstrated an overall accuracy of 94.3% and an average Dice similarity coefficient (DSC) of 0.945 (GM), 0.947 (WM), and 0.912 (CSF). Compared to multi-atlas segmentation methods like SEGMA and EM-MRF with multiple atlases, our method improved accuracy by up to 4%, particularly in complex tissue regions. Our proposed method allows accurate brain tissue segmentation, a crucial step in brain magnetic resonance imaging (MRI) applications including brain surface reconstruction and realistic head model creation in neonates.

An end-to-end infant brain parcellation pipeline

Objective

Accurate infant brain parcellation is crucial for understanding early brain development; however, it is challenging due to the inherent low tissue contrast, high noise, and severe partial volume effects in infant magnetic resonance images (MRIs). The aim of this study was to develop an end-to-end pipeline that enabled accurate parcellation of infant brain MRIs.

Methods

We proposed an end-to-end pipeline that employs a two-stage global-to-local approach for accurate parcellation of infant brain MRIs. Specifically, in the global regions of interest (ROIs) localization stage, a combination of transformer and convolution operations was employed to capture both global spatial features and fine texture features, enabling an approximate localization of the ROIs across the whole brain. In the local ROIs refinement stage, leveraging the position priors from the first stage along with the raw MRIs, the boundaries o the ROIs are refined for a more accurate parcellation.

Results

We utilized the Dice ratio to evaluate the accuracy of parcellation results. Results on 263 subjects from National Database for Autism Research (NDAR), Baby Connectome Project (BCP) and Cross-site datasets demonstrated the better accuracy and robustness of our method than other competing methods.

Conclusion

Our end-to-end pipeline may be capable of accurately parcellating 6-month-old infant brain MRIs.

Fighting the scanner effect in brain MRI segmentation with a progressive level-of-detail network trained on multi-site data

Many clinical and research studies of the human brain require accurate structural MRI segmentation. While traditional atlas-based methods can be applied to volumes from any acquisition site, recent deep learning algorithms ensure high accuracy only when tested on data from the same sites exploited in training (i.e., internal data). Performance degradation experienced on external data (i.e., unseen volumes from unseen sites) is due to the inter-site variability in intensity distributions, and to unique artefacts caused by different MR scanner models and acquisition parameters. To mitigate this site-dependency, often referred to as the scanner effect, we propose LOD-Brain, a 3D convolutional neural network with progressive levels-of-detail (LOD), able to segment brain data from any site. Coarser network levels are responsible for learning a robust anatomical prior helpful in identifying brain structures and their locations, while finer levels refine the model to handle site-specific intensity distributions and anatomical variations. We ensure robustness across sites by training the model on an unprecedentedly rich dataset aggregating data from open repositories: almost 27,000 T1w volumes from around 160 acquisition sites, at 1.5 - 3T, from a population spanning from 8 to 90 years old. Extensive tests demonstrate that LOD-Brain produces state-of-the-art results, with no significant difference in performance between internal and external sites, and robust to challenging anatomical variations. Its portability paves the way for large-scale applications across different healthcare institutions, patient populations, and imaging technology manufacturers. Code, model, and demo are available on the project website.

Deep learning techniques for isointense infant brain tissue segmentation: a systematic literature review

Introduction

To improve comprehension of initial brain growth in wellness along with sickness, it is essential to precisely segment child brain magnetic resonance imaging (MRI) into white matter (WM) and gray matter (GM), along with cerebrospinal fluid (CSF). Nonetheless, in the isointense phase (6-8 months of age), the inborn myelination and development activities, WM along with GM display alike stages of intensity in both T1-weighted and T2-weighted MRI, making tissue segmentation extremely difficult.

Methods

The comprehensive review of studies related to isointense brain MRI segmentation approaches is highlighted in this publication. The main aim and contribution of this study is to aid researchers by providing a thorough review to make their search for isointense brain MRI segmentation easier. The systematic literature review is performed from four points of reference: (1) review of studies concerning isointense brain MRI segmentation; (2) research contribution and future works and limitations; (3) frequently applied evaluation metrics and datasets; (4) findings of this studies.

Results and discussion

The systemic review is performed on studies that were published in the period of 2012 to 2022. A total of 19 primary studies of isointense brain MRI segmentation were selected to report the research question stated in this review.

3D-MASNet: 3D mixed-scale asymmetric convolutional segmentation network for 6-month-old infant brain MR images

Precise segmentation of infant brain magnetic resonance (MR) images into gray matter (GM), white matter (WM), and cerebrospinal fluid (CSF) are essential for studying neuroanatomical hallmarks of early brain development. However, for 6-month-old infants, the extremely low-intensity contrast caused by inherent myelination hinders accurate tissue segmentation. Existing convolutional neural networks (CNNs) based segmentation models for this task generally employ single-scale symmetric convolutions, which are inefficient for encoding the isointense tissue boundaries in baby brain images. Here, we propose a 3D mixed-scale asymmetric convolutional segmentation network (3D-MASNet) framework for brain MR images of 6-month-old infants. We replaced the traditional convolutional layer of an existing to-be-trained network with a 3D mixed-scale convolution block consisting of asymmetric kernels (MixACB) during the training phase and then equivalently converted it into the original network. Five canonical CNN segmentation models were evaluated using both T1- and T2-weighted images of 23 6-month-old infants from iSeg-2019 datasets, which contained manual labels as ground truth. MixACB significantly enhanced the average accuracy of all five models and obtained the most considerable improvement in the fully convolutional network model (CC-3D-FCN) and the highest performance in the Dense U-Net model. This approach further obtained Dice coefficient accuracies of 0.931, 0.912, and 0.961 in GM, WM, and CSF, respectively, ranking first among 30 teams on the validation dataset of the iSeg-2019 Grand Challenge. Thus, the proposed 3D-MASNet can improve the accuracy of existing CNNs-based segmentation models as a plug-and-play solution that offers a promising technique for future infant brain MRI studies.

Multi-Site Infant Brain Segmentation Algorithms: The iSeg-2019 Challenge

To better understand early brain development in health and disorder, it is critical to accurately segment infant brain magnetic resonance (MR) images into white matter (WM), gray matter (GM), and cerebrospinal fluid (CSF). Deep learning-based methods have achieved state-of-the-art performance; h owever, one of the major limitations is that the learning-based methods may suffer from the multi-site issue, that is, the models trained on a dataset from one site may not be applicable to the datasets acquired from other sites with different imaging protocols/scanners. To promote methodological development in the community, the iSeg-2019 challenge (http://iseg2019.web.unc.edu) provides a set of 6-month infant subjects from multiple sites with different protocols/scanners for the participating methods. T raining/validation subjects are from UNC (MAP) and testing subjects are from UNC/UMN (BCP), Stanford University, and Emory University. By the time of writing, there are 30 automatic segmentation methods participated in the iSeg-2019. In this article, 8 top-ranked methods were reviewed by detailing their pipelines/implementations, presenting experimental results, and evaluating performance across different sites in terms of whole brain, regions of interest, and gyral landmark curves. We further pointed out their limitations and possible directions for addressing the multi-site issue. We find that multi-site consistency is still an open issue. We hope that the multi-site dataset in the iSeg-2019 and this review article will attract more researchers to address the challenging and critical multi-site issue in practice.

Automatic brain extraction from 3D fetal MR image with deep learning-based multi-step framework

Brain extraction is a fundamental prerequisite step in neuroimage analysis for fetus. Due to surrounding maternal tissues and unpredictable movement, brain extraction from fetal Magnetic Resonance (MR) images is a challenging task. In this paper, we propose a novel deep learning-based multi-step framework for brain extraction from 3D fetal MR images. In the first step, a global localization network is applied to estimate probability maps for brain candidates. Connected-component labeling algorithm is applied to eliminate small erroneous components and accurately locate the candidate brain area. In the second step, a local refinement network is implemented in the brain candidate area to obtain fine-grained probability maps. Final extraction results are derived by a fusion network with the two cascaded probability maps obtained from previous two steps. Experimental results demonstrate that our proposed method has superior performance compared with existing deep learning-based methods.

Noncontact optical imaging of brain hemodynamics in preterm infants: a preliminary study

Extremely preterm infants' hemodynamic instability places them at high risk of brain injury. Currently there is no reliable bedside method to continuously monitor cerebral hemodynamics in the neonatal intensive care unit (NICU). This paper reports a feasibility study to adapt and test an innovative speckle contrast diffuse correlation tomography (scDCT) device for noncontact, high-density, 3D imaging of cerebral blood flow (CBF) in preterm infants. The scDCT scans a focused point near-infrared illumination to multiple source positions for deep tissue penetration, and controls an electron multiplying charge-coupled-device camera with thousands of pixels to achieve a high-density sampling. The optimized scDCT for use in preterm infants was first evaluated against an established diffuse correlation spectroscopy in an infant-head-simulating phantom with known properties. The observed significant correlation between the two measurements verified the capability of scDCT for transcranial brain imaging. The insignificant influence of transparent incubator wall on scDCT measurements was then confirmed by comparing adult forearm blood flow responses to artery cuff occlusions measured inside and outside the incubator. Finally, the scDCT device was moved to the NICU to image CBF variations in two preterm infants. Infant #1 with no major organ deficits showed little CBF fluctuation over the first 3 weeks of life. Infant #2 showed a significant CBF increase after the 2 h pharmacotherapy for patent ductus arteriosus closure. While these CBF variations meet physiological expectations, the fact that no significant changes are noted with peripheral monitoring of blood oxygen saturation suggests necessity of direct cerebral monitoring. This feasibility study with timely technology development is an important and necessary step towards larger clinical studies with more subjects to further validate it for continuous monitoring and instant management of cerebral pathologies and interventions in the NICU.

A Deep Spatial Context Guided Framework for Infant Brain Subcortical Segmentation

Accurate subcortical segmentation of infant brain magnetic resonance (MR) images is crucial for studying early subcortical structural growth patterns and related diseases diagnosis. However, dynamic intensity changes, low tissue contrast, and small subcortical size of infant brain MR images make subcortical segmentation a challenging task. In this paper, we propose a spatial context guided, coarse-to-fine deep convolutional neural network (CNN) based framework for accurate infant subcortical segmentation. At the coarse stage, we propose a signed distance map (SDM) learning UNet (SDM-UNet) to predict SDMs from the original multi-modal images, including T1w, T2w, and T1w/T2w images. By doing this, the spatial context information, including the relative position information across different structures and the shape information of the segmented structures contained in the ground-truth SDMs, is used for supervising the SDM-UNet to remedy the bad influence from the low tissue contrast in infant brain MR images and generate high-quality SDMs. To improve the robustness to outliers, a Correntropy based loss is introduced in SDM-UNet to penalize the difference between the ground-truth SDMs and predicted SDMs in training. At the fine stage, the predicted SDMs, which contains spatial context information of subcortical structures, are combined with the multi-modal images, and then fed into a multi-source and multi-path UNet (M2-UNet) for delivering refined segmentation. We validate our method on an infant brain MR image dataset with 24 scans by evaluating the Dice ratio between our segmentation and the manual delineation. Compared to four state-of-the-art methods, our method consistently achieves better performances in both qualitative and quantitative evaluations.

Hierarchical Fully Convolutional Network for Joint Atrophy Localization and Alzheimer's Disease Diagnosis Using Structural MRI

Structural magnetic resonance imaging (sMRI) has been widely used for computer-aided diagnosis of neurodegenerative disorders, e.g., Alzheimer's disease (AD), due to its sensitivity to morphological changes caused by brain atrophy. Recently, a few deep learning methods (e.g., convolutional neural networks, CNNs) have been proposed to learn task-oriented features from sMRI for AD diagnosis, and achieved superior performance than the conventional learning-based methods using hand-crafted features. However, these existing CNN-based methods still require the pre-determination of informative locations in sMRI. That is, the stage of discriminative atrophy localization is isolated to the latter stages of feature extraction and classifier construction. In this paper, we propose a hierarchical fully convolutional network (H-FCN) to automatically identify discriminative local patches and regions in the whole brain sMRI, upon which multi-scale feature representations are then jointly learned and fused to construct hierarchical classification models for AD diagnosis. Our proposed H-FCN method was evaluated on a large cohort of subjects from two independent datasets (i.e., ADNI-1 and ADNI-2), demonstrating good performance on joint discriminative atrophy localization and brain disease diagnosis.

A Survey on Computer-Aided Diagnosis of Brain Disorders through MRI Based on Machine Learning and Data Mining Methodologies with an Emphasis on Alzheimer Disease Diagnosis and the Contribution of the Multimodal Fusion

Computer-aided diagnostic (CAD) systems use machine learning methods that provide a synergistic effect between the neuroradiologist and the computer, enabling an efficient and rapid diagnosis of the patient’s condition. As part of the early diagnosis of Alzheimer’s disease (AD), which is a major public health problem, the CAD system provides a neuropsychological assessment that helps mitigate its effects. The use of data fusion techniques by CAD systems has proven to be useful, they allow for the merging of information relating to the brain and its tissues from MRI, with that of other types of modalities. This multimodal fusion refines the quality of brain images by reducing redundancy and randomness, which contributes to improving the clinical reliability of the diagnosis compared to the use of a single modality. The purpose of this article is first to determine the main steps of the CAD system for brain magnetic resonance imaging (MRI). Then to bring together some research work related to the diagnosis of brain disorders, emphasizing AD. Thus the most used methods in the stages of classification and brain regions segmentation are described, highlighting their advantages and disadvantages. Secondly, on the basis of the raised problem, we propose a solution within the framework of multimodal fusion. In this context, based on quantitative measurement parameters, a performance study of multimodal CAD systems is proposed by comparing their effectiveness with those exploiting a single MRI modality. In this case, advances in information fusion techniques in medical imagery are accentuated, highlighting their advantages and disadvantages. The contribution of multimodal fusion and the interest of hybrid models are finally addressed, as well as the main scientific assertions made, in the field of brain disease diagnosis.

Role of deep learning in infant brain MRI analysis

Deep learning algorithms and in particular convolutional networks have shown tremendous success in medical image analysis applications, though relatively few methods have been applied to infant MRI data due numerous inherent challenges such as inhomogenous tissue appearance across the image, considerable image intensity variability across the first year of life, and a low signal to noise setting. This paper presents methods addressing these challenges in two selected applications, specifically infant brain tissue segmentation at the isointense stage and presymptomatic disease prediction in neurodevelopmental disorders. Corresponding methods are reviewed and compared, and open issues are identified, namely low data size restrictions, class imbalance problems, and lack of interpretation of the resulting deep learning solutions. We discuss how existing solutions can be adapted to approach these issues as well as how generative models seem to be a particularly strong contender to address them.

Topological correction of infant white matter surfaces using anatomically constrained convolutional neural network

Reconstruction of accurate cortical surfaces without topological errors (i.e., handles and holes) from infant brain MR images is very important in early brain development studies. However, infant brain MR images typically suffer extremely low tissue contrast and dynamic imaging appearance patterns. Thus, it is inevitable to have large amounts of topological errors in the segmented infant brain tissue images, which lead to inaccurately reconstructed cortical surfaces with topological errors. To address this issue, inspired by recent advances in deep learning, we propose an anatomically constrained network for topological correction on infant cortical surfaces. Specifically, in our method, we first locate regions of potential topological defects by leveraging a topology-preserving level set method. Then, we propose an anatomically constrained network to correct those candidate voxels in the located regions. Since infant cortical surfaces often contain large and complex handles or holes, it is difficult to completely correct all errors using one-shot correction. Therefore, we further enroll these two steps into an iterative framework to gradually correct large topological errors. To the best of our knowledge, this is the first work to introduce deep learning approach for topological correction of infant cortical surfaces. We compare our method with the state-of-the-art methods on both simulated topological errors and real topological errors in human infant brain MR images. Moreover, we also validate our method on the infant brain MR images of macaques. All experimental results show the superior performance of the proposed method.

Benchmark on Automatic 6-month-old Infant Brain Segmentation Algorithms: The iSeg-2017 Challenge

Accurate segmentation of infant brain magnetic resonance (MR) images into white matter (WM), gray matter (GM), and cerebrospinal fluid (CSF) is an indispensable foundation for early studying of brain growth patterns and morphological changes in neurodevelopmental disorders. Nevertheless, in the isointense phase (approximately 6-9 months of age), due to inherent myelination and maturation process, WM and GM exhibit similar levels of intensity in both T1-weighted (T1w) and T2-weighted (T2w) MR images, making tissue segmentation very challenging. Despite many efforts were devoted to brain segmentation, only few studies have focused on the segmentation of 6-month infant brain images. With the idea of boosting methodological development in the community, iSeg-2017 challenge (http://iseg2017.web.unc.edu) provides a set of 6-month infant subjects with manual labels for training and testing the participating methods. Among the 21 automatic segmentation methods participating in iSeg-2017, we review the 8 top-ranked teams, in terms of Dice ratio, modified Hausdorff distance and average surface distance, and introduce their pipelines, implementations, as well as source codes. We further discuss limitations and possible future directions. We hope the dataset in iSeg-2017 and this review article could provide insights into methodological development for the community.

Anatomy-guided joint tissue segmentation and topological correction for 6-month infant brain MRI with risk of autism

Tissue segmentation of infant brain MRIs with risk of autism is critically important for characterizing early brain development and identifying biomarkers. However, it is challenging due to low tissue contrast caused by inherent ongoing myelination and maturation. In particular, at around 6 months of age, the voxel intensities in both gray matter and white matter are within similar ranges, thus leading to the lowest image contrast in the first postnatal year. Previous studies typically employed intensity images and tentatively estimated tissue probabilities to train a sequence of classifiers for tissue segmentation. However, the important prior knowledge of brain anatomy is largely ignored during the segmentation. Consequently, the segmentation accuracy is still limited and topological errors frequently exist, which will significantly degrade the performance of subsequent analyses. Although topological errors could be partially handled by retrospective topological correction methods, their results may still be anatomically incorrect. To address these challenges, in this article, we propose an anatomy-guided joint tissue segmentation and topological correction framework for isointense infant MRI. Particularly, we adopt a signed distance map with respect to the outer cortical surface as anatomical prior knowledge, and incorporate such prior information into the proposed framework to guide segmentation in ambiguous regions. Experimental results on the subjects acquired from National Database for Autism Research demonstrate the effectiveness to topological errors and also some levels of robustness to motion. Comparisons with the state-of-the-art methods further demonstrate the advantages of the proposed method in terms of both segmentation accuracy and topological correctness.