In large-deformation diffeomorphic metric mapping (LDDMM), the diffeomorphic matching of images are modeled as evolution in time, or a flow, of an associated smooth velocity vector field v controlling the evolution. The initial momentum parameterizes the whole geodesic and encodes the shape and form of the target image. Thus, methods such as principal component analysis (PCA) of the initial momentum leads to analysis of anatomical shape and form in target images without being restricted to small-deformation assumption in the analysis of linear displacements. We apply this approach to a study of dementia of the Alzheimer type (DAT). The left hippocampus in the DAT group shows significant shape abnormality while the right hippocampus shows similar pattern of abnormality. Further, PCA of the initial momentum leads to correct classification of 12 out of 18 DAT subjects and 22 out of 26 control subjects.
Dementia of Alzheimer's Type (DAT) is associated with a devastating and irreversible cognitive decline. As a pharmacological intervention has not yet been developed to reverse disease progression, preventive medicine will play a crucial role for patient care and treatment planning. However, predicting which patients will progress to DAT is difficult as patients with Mild Cognitive Impairment (MCI) could either convert to DAT (MCI-C) or not (MCI-NC). In this paper, we develop a deep learning model to address the heterogeneous nature of DAT development. Structural magnetic resonance imaging was utilized as a single biomarker, and a three-dimensional convolutional neural network (3D-CNN) was developed. The 3D-CNN was trained using transfer learning from the classification of Normal Control and DAT scans at the source task. This was applied to the target task of classifying MCI-C and MCI-NC scans. The model results in 82.4% classification accuracy, which outperforms current models in the field. Furthermore, by implementing an occlusion map approach, we visualize key brain regions that significantly contribute to the prediction of MCI-C and MCI-NC. Results show the hippocampus, amygdala, cerebellum, and pons regions as significant to prediction, which are consistent with ; current understanding of disease. Finally, the model's prediction value is significantly correlated with rates of change in clinical assessment scores, indicating the model is able to predict an individual patient's future cognitive decline. This information, in conjunction with the identified anatomical features, will aid in building a personalized therapeutic strategy for individuals with MCI. This model could also be useful for selection of participants for clinical trials.
Fluorodeoxyglucose positron emission tomography (FDG-PET) imaging based 3D topographic brain glucose metabolism patterns from normal controls (NC) and individuals with dementia of Alzheimer's type (DAT) are used to train a novel multi-scale ensemble classification model. This ensemble model outputs a FDG-PET DAT score (FPDS) between 0 and 1 denoting the probability of a subject to be clinically diagnosed with DAT based on their metabolism profile. A novel 7 group image stratification scheme is devised that groups images not only based on their associated clinical diagnosis but also on past and future trajectories of the clinical diagnoses, yielding a more continuous representation of the different stages of DAT spectrum that mimics a real-world clinical setting. The potential for using FPDS as a DAT biomarker was validated on a large number of FDG-PET images (N =2984) obtained from the Alzheimer's Disease Neuroimaging Initiative (ADNI) database taken across the proposed stratification, and a good classification AUC (area under the curve) of 0.78 was achieved in distinguishing between images belonging to subjects on a DAT trajectory and those images taken from subjects not progressing to a DAT diagnosis. Further, the FPDS biomarker achieved state-of-the-art performance on the mild cognitive impairment (MCI) to DAT conversion prediction task with an AUC of 0.81, 0.80, 0.77 for the 2, 3, 5 years to conversion windows respectively.
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