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A deformation-based morphometry framework for disentangling Alzheimer’s disease from normal aging using learned normal aging templates
KTH, School of Engineering Sciences in Chemistry, Biotechnology and Health (CBH), Biomedical Engineering and Health Systems, Medical Imaging.ORCID iD: 0000-0003-4175-395X
Division of Clinical Geriatrics, Karolinska Institute, Sweden.ORCID iD: 0000-0001-9522-4338
KTH, School of Engineering Sciences in Chemistry, Biotechnology and Health (CBH), Biomedical Engineering and Health Systems, Medical Imaging.ORCID iD: 0000-0002-7750-1917
KTH, School of Engineering Sciences in Chemistry, Biotechnology and Health (CBH), Biomedical Engineering and Health Systems, Medical Imaging.ORCID iD: 0000-0001-5765-2964
(English)Manuscript (preprint) (Other academic)
Abstract [en]

Alzheimer’s Disease (AD) and normal aging are both characterized by brain atrophy. The question of whether AD-related brain atrophy represents accelerated aging or a neurodegeneration process distinct from that in normal aging remains unresolved. Moreover, precisely disentangling AD-related brain atrophy from normal aging in a clinical context is complex. In this study, we propose a deformation-based morphometry framework to estimate normal aging and AD-specific atrophy patterns of subjects from morphological MRI scans. For this, we first leverage deep-learning-based methods to create age-dependent templates of cognitively normal (CN) subjects. These templates model the normal aging atrophy patterns in a CN population. Then, we use the learned diffeomorphic registration to estimate the one-year normal aging pattern at the voxel level. In the second step, we register the testing image to the 60-year-old CN template. Finally, normal aging and AD-specific scores are estimated by measuring the alignment of this registration with the one-year normal aging pattern. The methodology was developed and evaluated on the OASIS3 dataset with 1,014 T1-weighted MRI scans, which is a unique dataset focused on preclinical cohorts. Of these, 326 scans were from CNsubjects, and 688 scans were from individuals clinically diagnosed with AD at different stages of clinical severity defined by clinical dementia rating (CDR) scores. The results show that ventricles predominantly follow an accelerated normal aging pattern in subjects with AD. In turn, hippocampi and amygdala regions were affected by both normal aging and AD-specific factors. Interestingly, hippocampi and amygdala regions showed more of an accelerated normal aging pattern for subjects during the early clinical stages of the disease, while the AD-specific score increases in later clinical stages. Our code is freely available at https://github.com/Fjr9516/DBM_with_DL.

Keywords [en]
Imaging biomarker, Aging, Alzheimer’s Disease, Deep learning-based brain template, Deformation-based morphometry, Aging score, AD-specific score
National Category
Medical Imaging
Research subject
Technology and Health
Identifiers
URN: urn:nbn:se:kth:diva-356997OAI: oai:DiVA.org:kth-356997DiVA, id: diva2:1916900
Note

QC 20241129

Available from: 2024-11-28 Created: 2024-11-28 Last updated: 2025-02-09Bibliographically approved
In thesis
1. Methods for brain MRI image synthesis and analysis
Open this publication in new window or tab >>Methods for brain MRI image synthesis and analysis
2024 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Magnetic resonance imaging (MRI) technology has made it possible to observe the inside of the brain in vivo, providing a window for researchers to better understand the processes of human brain development and aging, as well as neurological diseases and their underlying mechanisms. With the development of human brain imaging technology and the accumulation of neuroimaging data, the demand for automated computational algorithms has also increased. The success of machine learning technology in the field of computer vision has promoted its application and development in brain imaging. However, the field of medical imaging faces a series of unique challenges that have not been systematically addressed by the broad deep learning research community. In this thesis, the challenges faced in the context of three specific neuroimaging research problems are tackled. For each problem, the specific challenges are first explained, followed by the proposed solutions.

First, I focus on the specific challenges of using neuroimaging for research in the field of Alzheimer's disease (AD). In the study of AD, one difficulty is to distinguish the effects of normal aging and disease on the anatomical structure of the brain to achieve more accurate and earlier identification. Longitudinal data are an important source for understanding how normal aging affects the brain. However, the cost of collecting longitudinal data can be prohibitive, and current public longitudinal datasets still suffer from inconsistent time intervals and missing scans due to logistical constraints. To address this, I propose in the first study a diffeomorphic registration-based approach to fill in missing time points within current longitudinal datasets. To help distinguish between normal aging and disease-induced morphological changes, I propose in the second study a generative framework that can predict future brain MRI changes along healthy or pathological trajectories based on any given MRI scan. This framework is designed with diffeomorphic constraints to ensure the topological consistency of predicted morphological changes. Finally, in the third study I develop and validate a new deformation-based morphometry (DBM) framework that leverages registration-derived deformation fields for comparisons between healthy and AD groups. This new framework explicitly decomposes deformation into components attributable to normal aging and disease, providing a more nuanced understanding of their interaction.

Secondly, I focus on the pressing challenges in pediatric brain tumor segmentation. Due to the rarity of pediatric brain tumors and the high level of expertise required for tumor labeling—especially when multi-modality imaging is necessary—creating accurate automated segmentation algorithms is challenging. In response, I propose in the fourth study an unsupervised domain adaptation (UDA) framework for segmentation, utilizing relatively abundant adult brain tumor data and labels to assist in pediatric tumor segmentation.

Finally, in this thesis, I tackle the challenge of accurately registering longitudinal neuroimaging. Registration is the most fundamental and core task in the neuroimaging analysis pipelines, and its accuracy often has a serious impact on an array of subsequent analysis steps and downstream tasks. In longitudinal neuroimaging analysis, rigid registration is commonly employed to align scans obtained from the same individual. However, the deep learning-based registration community has largely focused on cross-sectional registration applications, with insufficient accuracy observed in longitudinal data. For this reason, I optimize a state-of-the-art model in the fifth study to make it more accurate for longitudinal registration.

Abstract [sv]

Magnetresonanstomografi (MRT) har gjort det möjligt att observera hjärnans inre strukturer i realtid och erbjuder forskare en inblick i hur den mänskliga hjärnan utvecklas och åldras, samt de mekanismer som ligger till grund för neurologiska sjukdomar. Med den tekniska utvecklingen inom hjärnavbildning och ökningen av neuroimagingdata har efterfrågan på automatiserade algoritmer också vuxit. Den snabba utvecklingen inom djupinlärning och datorseende har lett till framsteg även vid dess tillämpning på hjärnavbildning. Medicinsk avbildning har dock sina egna specifika utmaningar, vilka hittills inte systematiskt har behandlats (removed duplicated "har") av generell forskning inom djupinlärning. I denna avhandling är målet att bemöta utmaningarna som uppstår inom tre specifika forskningsproblem inom neuroimaging. För varje problem kommer de specifika utmaningarna först att förklaras och därefter presenteras föreslagna lösningar.

De första studierna behandlar de specifika utmaningar som uppstår vid neuroimaging av Alzheimers patienter. Ett stort problem inom AD-forskning är att kunna särskilja effekterna av normalt åldrande och sjukdomsrelaterade förändringar på hjärnans anatomi för tidigare sjukdomsidentifiering. Longitudinell data är en viktig grund för att förstå hur normalt åldrande påverkar hjärnan. Insamlingen av sådana data är dock ofta mycket kostsam, och många öppna dataset har oregelbundna tidsintervall och avhopp från försökspersoner. I den första studien utvecklades därför en metod baserad på diffeomorfisk registrering för att fylla i saknade tidpunkter i longitudinella dataset. För att ytterligare kunna skilja mellan åldersrelaterade och sjukdomsrelaterade morfologiska förändringar presenterar den andra studien en generativ modell som förutsäger hjärnförändringar baserat på en enda MRI-resultat, enligt antingen frisk eller patologisk utveckling. Modellen är utformad med diffeomorfiska begränsningar för att garantera att de predikterade morfologiska förändringarna överensstämmer med hjärnans topologi. I den tredje studien introduceras och valideras istället ett nytt deformationsbaserat morfometri-framework som använder deformationsfält från registrering för att utföra jämförelser mellan olika grupper. Deformationen delas, i detta framework, upp i komponenter som kan tillskrivas normalt åldrande respektive patologiska förändringar vilket möjliggör en mer nyanserad förståelse av hur de interagerar.

Det andra problemområdet som avhandlingen behandlar är pediatrisk hjärntumörssegmentering. Annoterade dataset för pediatriska hjärntumörer är generellt små eftersom annoteringen kräver hög precision och kompetens vilket leder till att utvecklingen av övervakade segmenteringsalgoritmer är utmanande. I den fjärde studien föreslår vi istället en modell för domänanpassning med annoterad data för vuxna hjärntumörspatienter till den pediatriska kontexten. Modellen tränas utan annoterade pediatriska tumörer. 

Det tredje problemet som avhandlingen behandlar är registrering av longintudinell neuroimagingdata. Registrering är en grundläggande och central uppgift i neuroimaginganalys, och dess noggrannhet har ofta stor påverkan på efterföljande analyser. Vid analys av longitudinella neuroimagingdata kan rigid registrering ofta erhålla högre spatiell precision eftersom datan härrör från samma individ. Tidigare djupinlärningsmetoder för registrering har fokuserat på att registrera grupper av individer till ett gemensamt koordinatrum, vilket har visat sig ge otillräcklig noggrannhet vid longitudinell data. Den femte studien utvidgar därför en befintlig modell för att öka dess noggrannhet vid longitudinell registrering.

Place, publisher, year, edition, pages
Stockholm, Sweden: KTH Royal Institute of Technology, 2024. p. 71
Series
TRITA-CBH-FOU ; 2024:53
Keywords
Brain MRI, Image Registration, Machine Learning, Deep Learning, Aging, Alzheimer’s Disease, Unsupervised Domain Adaptation, Image Segmentation, Hjärn-MRT, Bildregistrering, Maskininlärning, Djupinlärning, Åldrande, Alzheimers sjukdom, Oövervakad domänanpassning, Bildsegmentering
National Category
Medical Imaging
Research subject
Technology and Health
Identifiers
urn:nbn:se:kth:diva-357014 (URN)978-91-8106-139-0 (ISBN)
Public defence
2025-01-10, T1, Hälsovägen 11C, via Zoom: https://kth-se.zoom.us/j/68696837704, Huddinge, 13:00 (English)
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Supervisors
Note

QC 2024-12-02

Available from: 2024-12-02 Created: 2024-12-01 Last updated: 2025-12-03Bibliographically approved

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Fu, JingruSmedby, ÖrjanMoreno, Rodrigo

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