KEYWORDS: Brain, Magnetic resonance imaging, Data modeling, Education and training, Dementia, 3D modeling, Neuroimaging, Diffusion, Diffusion weighted imaging, Deep learning
Machine learning methods have been used for over a decade for staging and subtyping a variety of brain diseases, offering fast and objective methods to classify neurodegenerative diseases such as Alzheimer’s disease (AD). Deep learning models based on convolutional neural networks (CNNs) have also been used to infer dementia severity and predict future clinical decline. Most CNN-based deep learning models use T1-weighted brain MRI scans to identify predictive features for these tasks. In contrast, we examine the added value of diffusion-weighted MRI (dMRI) - a variant of MRI, sensitive to microstructural tissue properties - as an additional input in CNN-based models of dementia severity. dMRI is sensitive to microstructural brain abnormalities not evident on standard anatomical MRI. By training CNNs on combined anatomical and diffusion MRI, we hypothesize that we could boost performance when predicting widely-used clinical assessments of dementia severity, such as individuals’ scores on the ADAS11, ADAS13, and MMSE (mini-mental state exam) clinical scales. For benchmarking, we evaluate CNNs that use T1-weighted MRI and dMRI to estimate “brain age” - the task of predicting a person’s chronological age from their neuroimaging data. To assess which dMRI-derived maps were most beneficial, we computed DWI-derived diffusion tensor imaging (DTI) maps of mean and radial diffusivity (MD/RD), axial diffusivity (AD) and fractional anisotropy (FA) for 1198 elderly subjects (age: 74.35 +/- 7.74 yrs.; 600 F/598 M, with a distribution of 636 CN/421 MCI/141 AD) from the Alzheimer’s Disease Neuroimaging Initiative (ADNI). We tested both 2D Slice CNN and 3D CNN neural network models for the above predictive tasks. Our results suggest that for at least some deep learning architectures, diffusion-weighted MRI may enhance performance for several AD-relevant deep learning tasks relative to using T1-weighted images alone.
Diffusion-weighted magnetic resonance imaging (dMRI) is sensitive to microstructural changes in the brain that occur with normal aging and Alzheimer’s disease (AD). There is much interest in which dMRI measures are most strongly correlated with (1) AD diagnosis, (2) clinical measures of AD severity, such as the clinical dementia rating (CDR), and (3) biological processes that may be disrupted in AD, such as brain amyloid load measured using PET. Of these processes, some can be targeted using novel drugs. Since 2016, the Alzheimer’s Disease Neuroimaging Initiative (ADNI) has collected dMRI data from three scanner manufacturers across 58 sites using 7 different protocols that vary in angular resolution, scan duration, and distribution of diffusion-weighted gradients. Here, we assessed dMRI data from 730 of those individuals (447 healthy controls, 214 with mild cognitive impairment, 69 with dementia; age: 74.1±7.9 years; 381 female/349 male). To harmonize data from different protocols, we applied ComBat, ComBat-GAM, and CovBat to dMRI metrics from 28 brain regions of interest. We ranked all dMRI metrics in order of the strength of clinically relevant associations, and assessed how this depended on the harmonization methods employed. dMRI metrics were strongly associated with age and AD severity, but also with amyloid positivity. All harmonization methods gave comparable results when assessing associations with age, dementia and amyloid load, while enabling data integration across multiple scanners and protocols.
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