Building a FP-CIT SPECT Brain Template Using a Posterization Approach

Dopamine transporter single-photon emission computed tomography-derived radiomics signature for detecting Parkinson's disease

BACKGROUND

We hypothesised that the radiomics signature, which includes texture information of dopamine transporter single-photon emission computed tomography (DAT-SPECT) images for Parkinson's disease (PD), may assist semi-quantitative indices. Herein, we constructed a radiomics signature using DAT-SPECT-derived radiomics features that effectively discriminated PD from healthy individuals and evaluated its classification performance.

RESULTS

We analysed 413 cases of both normal control (NC, n = 101) and PD (n = 312) groups from the Parkinson's Progression Markers Initiative database. Data were divided into the training and two test datasets with different SPECT manufacturers. DAT-SPECT images were spatially normalised to the Montreal Neurologic Institute space. We calculated 930 radiomics features, including intensity- and texture-based features in the caudate, putamen, and pallidum volumes of interest. The striatum uptake ratios (SURs) of the caudate, putamen, and pallidum were also calculated as conventional semi-quantification indices. The least absolute shrinkage and selection operator was used for feature selection and construction of the radiomics signature. The four classification models were constructed using a radiomics signature and/or semi-quantitative indicator. Furthermore, we compared the classification performance of the semi-quantitative indicator alone and the combination with the radiomics signature for the classification models. The receiver operating characteristics (ROC) analysis was used to evaluate the classification performance. The classification performance of SUR_putamen was higher than that of other semi-quantitative indicators. The radiomics signature resulted in a slightly increased area under the ROC curve (AUC) compared to SUR_putamen in each test dataset. When combined with SUR_putamen and radiomics signature, all classification models showed slightly higher AUCs than that of SUR_putamen alone.

CONCLUSION

We constructed a DAT-SPECT image-derived radiomics signature. Performance analysis showed that the current radiomics signature would be helpful for the diagnosis of PD and has the potential to provide robust diagnostic performance.

Quantifying Differences Between Affine and Nonlinear Spatial Normalization of FP-CIT Spect Images

Spatial normalization helps us to compare quantitatively two or more input brain scans. Although using an affine normalization approach preserves the anatomical structures, the neuroimaging field is more common to find works that make use of nonlinear transformations. The main reason is that they facilitate a voxel-wise comparison, not only when studying functional images but also when comparing MRI scans given that they fit better to a reference template. However, the amount of bias introduced by the nonlinear transformations can potentially alter the final outcome of a diagnosis especially when studying functional scans for neurological disorders like Parkinson's Disease. In this context, we have tried to quantify the bias introduced by the affine and the nonlinear spatial registration of FP-CIT SPECT volumes of healthy control subjects and patients with PD. For that purpose, we calculated the deformation fields of each participant and applied these deformation fields to a 3D-grid. As the space between the edges of small cubes comprising the grid change, we can quantify which parts from the brain have been enlarged, compressed or just remain the same. When the nonlinear approach is applied, scans from PD patients show a region near their striatum very similar in shape to that of healthy subjects. This artificially increases the interclass separation between patients with PD and healthy subjects as the local intensity is decreased in the latter region, and leads machine learning systems to biased results due to the artificial information introduced by these deformations.

Morphological Characterization of Functional Brain Imaging by Isosurface Analysis in Parkinson’s Disease

Finding new biomarkers to model Parkinson’s Disease (PD) is a challenge not only to help discerning between Healthy Control (HC) subjects and patients with potential PD but also as a way to measure quantitatively the loss of dopaminergic neurons mainly concentrated at substantia nigra. Within this context, this work presented here tries to provide a set of imaging features based on morphological characteristics extracted from I[Formula: see text]-Ioflupane SPECT scans to discern between HC and PD participants in a balanced set of [Formula: see text] scans from Parkinson’s Progression Markers Initiative (PPMI) database. These features, obtained from isosurfaces of each scan at different intensity levels, have been classified through the use of classical Machine Learning classifiers such as Support-Vector-Machines (SVM) or Naïve Bayesian and compared with the results obtained using a Multi-Layer Perceptron (MLP).

The proposed system, based on a Mann–Whitney–Wilcoxon U-Test for feature selection and the SVM approach, yielded a [Formula: see text] balanced accuracy when the performance was evaluated using a [Formula: see text]-fold cross-validation. This proves the reliability of these biomarkers, especially those related to sphericity, center of mass, number of vertices, 2D-projected perimeter or the 2D-projected eccentricity, among others, but including both internal and external isosurfaces.

Parkinson's Disease Detection Using Isosurfaces-Based Features and Convolutional Neural Networks

Computer aided diagnosis systems based on brain imaging are an important tool to assist in the diagnosis of Parkinson's disease, whose ultimate goal is the detection by automatic recognizing of patterns that characterize the disease. In recent times Convolutional Neural Networks (CNN) have proved to be amazingly useful for that task. The drawback, however, is that 3D brain images contain a huge amount of information that leads to complex CNN architectures. When these architectures become too complex, classification performances often degrades because the limitations of the training algorithm and overfitting. Thus, this paper proposes the use of isosurfaces as a way to reduce such amount of data while keeping the most relevant information. These isosurfaces are then used to implement a classification system which uses two of the most well-known CNN architectures, LeNet and AlexNet, to classify DaTScan images with an average accuracy of 95.1% and AUC = 97%, obtaining comparable (slightly better) values to those obtained for most of the recently proposed systems. It can be concluded therefore that the computation of isosurfaces reduces the complexity of the inputs significantly, resulting in high classification accuracies with reduced computational burden.

Assisted Diagnosis of Parkinsonism Based on the Striatal Morphology

Parkinsonism is a clinical syndrome characterized by the progressive loss of striatal dopamine. Its diagnosis is usually corroborated by neuroimaging data such as DaTSCAN neuroimages that allow visualizing the possible dopamine deficiency. During the last decade, a number of computer systems have been proposed to automatically analyze DaTSCAN neuroimages, eliminating the subjectivity inherent to the visual examination of the data. In this work, we propose a computer system based on machine learning to separate Parkinsonian patients and control subjects using the size and shape of the striatal region, modeled from DaTSCAN data. First, an algorithm based on adaptative thresholding is used to parcel the striatum. This region is then divided into two according to the brain hemisphere division and characterized with 152 measures, extracted from the volume and its three possible 2-dimensional projections. Afterwards, the Bhattacharyya distance is used to discard the least discriminative measures and, finally, the neuroimage category is estimated by means of a Support Vector Machine classifier. This method was evaluated using a dataset with 189 DaTSCAN neuroimages, obtaining an accuracy rate over 94%. This rate outperforms those obtained by previous approaches that use the intensity of each striatal voxel as a feature.

Empirical Functional PCA for 3D Image Feature Extraction Through Fractal Sampling

Medical image classification is currently a challenging task that can be used to aid the diagnosis of different brain diseases. Thus, exploratory and discriminative analysis techniques aiming to obtain representative features from the images play a decisive role in the design of effective Computer Aided Diagnosis (CAD) systems, which is especially important in the early diagnosis of dementia. In this work, we present a technique that allows using specific time series analysis techniques with 3D images. This is achieved by sampling the image using a fractal-based method which preserves the spatial relationship among voxels. In addition, a method called Empirical functional PCA (EfPCA) is presented, which combines Empirical Mode Decomposition (EMD) with functional PCA to express an image in the space spanned by a basis of empirical functions, instead of using components computed by a predefined basis as in Fourier or Wavelet analysis. The devised technique has been used to classify images from the Alzheimer’s Disease Neuroimaging Initiative (ADNI) and the Parkinson Progression Markers Initiative (PPMI), achieving accuracies up to 93% and 92% differential diagnosis tasks (AD versus controls and PD versus Controls, respectively). The results obtained validate the method, proving that the information retrieved by our methodology is significantly linked to the diseases.

Novel neural network application for bacterial colony classification

BACKGROUND

Bacterial colony morphology is the first step of classifying the bacterial species before sending them to subsequent identification process with devices, such as VITEK 2 automated system and mass spectrometry microbial identification system. It is essential as a pre-screening process because it can greatly reduce the scope of possible bacterial species and will make the subsequent identification more specific and increase work efficiency in clinical bacteriology. But this work needs adequate clinical laboratory expertise of bacterial colony morphology, which is especially difficult for beginners to handle properly. This study presents automatic programs for bacterial colony classification task, by applying the deep convolutional neural networks (CNN), which has a widespread use of digital imaging data analysis in hospitals. The most common 18 bacterial colony classes from Peking University First Hospital were used to train this framework, and other images out of these training dataset were utilized to test the performance of this classifier.

RESULTS

The feasibility of this framework was verified by the comparison between predicted result and standard bacterial category. The classification accuracy of all 18 bacteria can reach 73%, and the accuracy and specificity of each kind of bacteria can reach as high as 90%.

CONCLUSIONS

The supervised neural networks we use can have more promising classification characteristics for bacterial colony pre-screening process, and the unsupervised network should have more advantages in revealing novel characteristics from pictures, which can provide some practical indications to our clinical staffs.

Convolutional Neural Networks for Neuroimaging in Parkinson's Disease: Is Preprocessing Needed?

Spatial and intensity normalizations are nowadays a prerequisite for neuroimaging analysis. Influenced by voxel-wise and other univariate comparisons, where these corrections are key, they are commonly applied to any type of analysis and imaging modalities. Nuclear imaging modalities such as PET-FDG or FP-CIT SPECT, a common modality used in Parkinson's disease diagnosis, are especially dependent on intensity normalization. However, these steps are computationally expensive and furthermore, they may introduce deformations in the images, altering the information contained in them. Convolutional neural networks (CNNs), for their part, introduce position invariance to pattern recognition, and have been proven to classify objects regardless of their orientation, size, angle, etc. Therefore, a question arises: how well can CNNs account for spatial and intensity differences when analyzing nuclear brain imaging? Are spatial and intensity normalizations still needed? To answer this question, we have trained four different CNN models based on well-established architectures, using or not different spatial and intensity normalization preprocessings. The results show that a sufficiently complex model such as our three-dimensional version of the ALEXNET can effectively account for spatial differences, achieving a diagnosis accuracy of 94.1% with an area under the ROC curve of 0.984. The visualization of the differences via saliency maps shows that these models are correctly finding patterns that match those found in the literature, without the need of applying any complex spatial normalization procedure. However, the intensity normalization - and its type - is revealed as very influential in the results and accuracy of the trained model, and therefore must be well accounted.

Consolidation of a Learned Skill Correlates with Dopamine SPECT Uptake in Early Parkinson's Disease

BACKGROUND AND PURPOSE

Basal ganglia play a pivotal role in procedural memory. However, the correlation between skill learning and striatal ¹²³I-ioflupane uptake in Parkinson's disease (PD) has not been reported previously. Our objective was to determine whether visuomotor skill learning is associated with striatal ¹²³I-ioflupane uptake in early PD.

METHODS

We designed a case-control study to assess learning and consolidation of a visuomotor learning task (mirrored drawing of star-shaped figures) performed on two consecutive days by early-PD patients (disease duration <2 years) and age-matched healthy subjects. Outcomes were the error rate and time per trial, as well as performance indices to assess the relative improvement on the first day (learning) and the retention on the second day (consolidation). For PD patients, we evaluated the correlation of skill learning with semiquantitative ¹²³I-ioflupane uptake.

RESULTS

We included 9 PD patients and 10 control subjects with the same baseline characteristics (age, male/female ratio, educational level, Mini Mental State Examination score, and Hospital Anxiety and Depression Scale score, all p>0.18) other than the score on part III of the Movement Disorders Society Unified Parkinson's Disease Rating Scale, which was higher in the PD patients (mean±SD: 15.0±10.4 vs. 1.3±1.1, p<0.001). The learning indices were the same in the two groups (p>0.5), whereas PD patients showed a lower consolidation index for the time per trial (p=0.009). Moreover, this performance was correlated with uptake in the right caudate nucleus (Spearman's rho=0.82, p=0.007) and the right striatum (Spearman's rho=0.67, p=0.049), including when multiple linear regression adjusting for the levodopa equivalent daily dose was performed (p=0.005 for the caudate nucleus and p=0.024 for the striatum).

CONCLUSIONS

This study provides evidence of a correlation between procedural memory impairment and striatal dopaminergic dysfunction in early PD.

A Heavy Tailed Expectation Maximization Hidden Markov Random Field Model with Applications to Segmentation of MRI

A wide range of segmentation approaches assumes that intensity histograms extracted from magnetic resonance images (MRI) have a distribution for each brain tissue that can be modeled by a Gaussian distribution or a mixture of them. Nevertheless, intensity histograms of White Matter and Gray Matter are not symmetric and they exhibit heavy tails. In this work, we present a hidden Markov random field model with expectation maximization (EM-HMRF) modeling the components using the α-stable distribution. The proposed model is a generalization of the widely used EM-HMRF algorithm with Gaussian distributions. We test the α-stable EM-HMRF model in synthetic data and brain MRI data. The proposed methodology presents two main advantages: Firstly, it is more robust to outliers. Secondly, we obtain similar results than using Gaussian when the Gaussian assumption holds. This approach is able to model the spatial dependence between neighboring voxels in tomographic brain MRI.

Functional Brain Imaging Synthesis Based on Image Decomposition and Kernel Modeling: Application to Neurodegenerative Diseases

The rise of neuroimaging in research and clinical practice, together with the development of new machine learning techniques has strongly encouraged the Computer Aided Diagnosis (CAD) of different diseases and disorders. However, these algorithms are often tested in proprietary datasets to which the access is limited and, therefore, a direct comparison between CAD procedures is not possible. Furthermore, the sample size is often small for developing accurate machine learning methods. Multi-center initiatives are currently a very useful, although limited, tool in the recruitment of large populations and standardization of CAD evaluation. Conversely, we propose a brain image synthesis procedure intended to generate a new image set that share characteristics with an original one. Our system focuses on nuclear imaging modalities such as PET or SPECT brain images. We analyze the dataset by applying PCA to the original dataset, and then model the distribution of samples in the projected eigenbrain space using a Probability Density Function (PDF) estimator. Once the model has been built, we can generate new coordinates on the eigenbrain space belonging to the same class, which can be then projected back to the image space. The system has been evaluated on different functional neuroimaging datasets assessing the: resemblance of the synthetic images with the original ones, the differences between them, their generalization ability and the independence of the synthetic dataset with respect to the original. The synthetic images maintain the differences between groups found at the original dataset, with no significant differences when comparing them to real-world samples. Furthermore, they featured a similar performance and generalization capability to that of the original dataset. These results prove that these images are suitable for standardizing the evaluation of CAD pipelines, and providing data augmentation in machine learning systems -e.g. in deep learning-, or even to train future professionals at medical school.

Comparison between Different Intensity Normalization Methods in 123I-Ioflupane Imaging for the Automatic Detection of Parkinsonism

Intensity normalization is an important pre-processing step in the study and analysis of DaTSCAN SPECT imaging. As most automatic supervised image segmentation and classification methods base their assumptions regarding the intensity distributions on a standardized intensity range, intensity normalization takes on a very significant role. In this work, a comparison between different novel intensity normalization methods is presented. These proposed methodologies are based on Gaussian Mixture Model (GMM) image filtering and mean-squared error (MSE) optimization. The GMM-based image filtering method is achieved according to a probability threshold that removes the clusters whose likelihood are negligible in the non-specific regions. The MSE optimization method consists of a linear transformation that is obtained by minimizing the MSE in the non-specific region between the intensity normalized image and the template. The proposed intensity normalization methods are compared to: i) a standard approach based on the specific-to-non-specific binding ratio that is widely used, and ii) a linear approach based on the α-stable distribution. This comparison is performed on a DaTSCAN image database comprising analysis and classification stages for the development of a computer aided diagnosis (CAD) system for Parkinsonian syndrome (PS) detection. In addition, these proposed methods correct spatially varying artifacts that modulate the intensity of the images. Finally, using the leave-one-out cross-validation technique over these two approaches, the system achieves results up to a 92.91% of accuracy, 94.64% of sensitivity and 92.65 % of specificity, outperforming previous approaches based on a standard and a linear approach, which are used as a reference. The use of advanced intensity normalization techniques, such as the GMM-based image filtering and the MSE optimization improves the diagnosis of PS.