Deep learning-based BMI inference from structural brain MRI reflects brain alterations following lifestyle intervention.

Obesity is associated with negative effects on the brain. We exploit Artificial Intelligence (AI) tools to explore whether differences in clinical measurements following lifestyle interventions in overweight population could be reflected in brain morphology. In the DIRECT-PLUS clinical trial, participants with criterion for metabolic syndrome underwent an 18-month lifestyle intervention. Structural brain MRIs were acquired before and after the intervention. We utilized an ensemble learning framework to predict Body-Mass Index (BMI) scores, which correspond to adiposity-related clinical measurements from brain MRIs. We revealed that patient-specific reduction in BMI predictions was associated with actual weight loss and was significantly higher in active diet groups compared to a control group. Moreover, explainable AI (XAI) maps highlighted brain regions contributing to BMI predictions that were distinct from regions associated with age prediction. Our DIRECT-PLUS analysis results imply that predicted BMI and its reduction are unique neural biomarkers for obesity-related brain modifications and weight loss.

Subsampled brain MRI reconstruction by generative adversarial neural networks.

A main challenge in magnetic resonance imaging (MRI) is speeding up scan time. Beyond improving patient experience and reducing operational costs, faster scans are essential for time-sensitive imaging, such as fetal, cardiac, or functional MRI, where temporal resolution is important and target movement is unavoidable, yet must be reduced. Current MRI acquisition methods speed up scan time at the expense of lower spatial resolution and costlier hardware. We introduce a practical, software-only framework, based on deep learning, for accelerating MRI acquisition, while maintaining anatomically meaningful imaging. This is accomplished by MRI subsampling followed by estimating the missing k-space samples via generative adversarial neural networks. A generator-discriminator interplay enables the introduction of an adversarial cost in addition to fidelity and image-quality losses used for optimizing the reconstruction. Promising reconstruction results are obtained from feasible sampling patterns of up to a fivefold acceleration of diverse brain MRIs, from a large publicly available dataset of healthy adult scans as well as multimodal acquisitions of multiple sclerosis patients and dynamic contrast-enhanced MRI (DCE-MRI) sequences of stroke and tumor patients. Clinical usability of the reconstructed MRI scans is assessed by performing either lesion or healthy tissue segmentation and comparing the results to those obtained by using the original, fully sampled images. Reconstruction quality and usability of the DCE-MRI sequences is demonstrated by calculating the pharmacokinetic (PK) parameters. The proposed MRI reconstruction approach is shown to outperform state-of-the-art methods for all datasets tested in terms of the peak signal-to-noise ratio (PSNR), the structural similarity index (SSIM), as well as either the mean squared error (MSE) with respect to the PK parameters, calculated for the fully sampled DCE-MRI sequences, or the segmentation compatibility, measured in terms of Dice scores and Hausdorff distance. The code is available on GitHub.

Slow blood-to-brain transport underlies enduring barrier dysfunction in American football players.

Repetitive mild traumatic brain injury in American football players has garnered increasing public attention following reports of chronic traumatic encephalopathy, a progressive tauopathy. While the mechanisms underlying repetitive mild traumatic brain injury-induced neurodegeneration are unknown and antemortem diagnostic tests are not available, neuropathology studies suggest a pathogenic role for microvascular injury, specifically blood-brain barrier dysfunction. Thus, our main objective was to demonstrate the effectiveness of a modified dynamic contrast-enhanced MRI approach we have developed to detect impairments in brain microvascular function. To this end, we scanned 42 adult male amateur American football players and a control group comprising 27 athletes practicing a non-contact sport and 26 non-athletes. MRI scans were also performed in 51 patients with brain pathologies involving the blood-brain barrier, namely malignant brain tumours, ischaemic stroke and haemorrhagic traumatic contusion. Based on data from prolonged scans, we generated maps that visualized the permeability value for each brain voxel. Our permeability maps revealed an increase in slow blood-to-brain transport in a subset of amateur American football players, but not in sex- and age-matched controls. The increase in permeability was region specific (white matter, midbrain peduncles, red nucleus, temporal cortex) and correlated with changes in white matter, which were confirmed by diffusion tensor imaging. Additionally, increased permeability persisted for months, as seen in players who were scanned both on- and off-season. Examination of patients with brain pathologies revealed that slow tracer accumulation characterizes areas surrounding the core of injury, which frequently shows fast blood-to-brain transport. Next, we verified our method in two rodent models: rats and mice subjected to repeated mild closed-head impact injury, and rats with vascular injury inflicted by photothrombosis. In both models, slow blood-to-brain transport was observed, which correlated with neuropathological changes. Lastly, computational simulations and direct imaging of the transport of Evans blue-albumin complex in brains of rats subjected to recurrent seizures or focal cerebrovascular injury suggest that increased cellular transport underlies the observed slow blood-to-brain transport. Taken together, our findings suggest dynamic contrast-enhanced-MRI can be used to diagnose specific microvascular pathology after traumatic brain injury and other brain pathologies.

Miswiring of Frontostriatal Projections in Schizophrenia.

We investigated brain wiring in chronic schizophrenia and healthy controls in frontostriatal circuits using diffusion magnetic resonance imaging tractography in a novel way. We extracted diffusion streamlines in 27 chronic schizophrenia and 26 healthy controls connecting 4 frontal subregions to the striatum. We labeled the projection zone striatal surface voxels into 2 subtypes: dominant-input from a single cortical subregion, and, functionally integrative, with mixed-input from diverse cortical subregions. We showed: 1) a group difference for total striatal surface voxel number (P = .045) driven by fewer mixed-input voxels in the left (P  = .007), but not right, hemisphere; 2) a group by hemisphere interaction for the ratio quotient between voxel subtypes (P  = .04) with a left (P  = .006), but not right, hemisphere increase in schizophrenia, also reflecting fewer mixed-input voxels; and 3) fewer mixed-input voxel counts in schizophrenia (P  = .045) driven by differences in left hemisphere limbic (P  = .007) and associative (P  = .01), but not sensorimotor, striatum. These results demonstrate a less integrative pattern of frontostriatal structural connectivity in chronic schizophrenia. A diminished integrative pattern yields a less complex input pattern to the striatum from the cortex with less circuit integration at the level of the striatum. Further, as brain wiring occurs during early development, aberrant brain wiring could serve as a developmental biomarker for schizophrenia.

Fully unsupervised symmetry-based mitosis detection in time-lapse cell microscopy.

MOTIVATION: Cell microscopy datasets have great diversity due to variability in cell types, imaging techniques and protocols. Existing methods are either tailored to specific datasets or are based on supervised learning, which requires comprehensive manual annotations. Using the latter approach, however, poses a significant difficulty due to the imbalance between the number of mitotic cells with respect to the entire cell population in a time-lapse microscopy sequence. RESULTS: We present a fully unsupervised framework for both mitosis detection and mother-daughters association in fluorescence microscopy data. The proposed method accommodates the difficulty of the different cell appearances and dynamics. Addressing symmetric cell divisions, a key concept is utilizing daughters' similarity. Association is accomplished by defining cell neighborhood via a stochastic version of the Delaunay triangulation and optimization by dynamic programing. Our framework presents promising detection results for a variety of fluorescence microscopy datasets of different sources, including 2D and 3D sequences from the Cell Tracking Challenge. AVAILABILITY AND IMPLEMENTATION: Code is available in github (github.com/topazgl/mitodix). SUPPLEMENTARY INFORMATION: Supplementary data are available at Bioinformatics online.

A probabilistic approach to joint cell tracking and segmentation in high-throughput microscopy videos.

We present a novel computational framework for the analysis of high-throughput microscopy videos of living cells. The proposed framework is generally useful and can be applied to different datasets acquired in a variety of laboratory settings. This is accomplished by tying together two fundamental aspects of cell lineage construction, namely cell segmentation and tracking, via a Bayesian inference of dynamic models. In contrast to most existing approaches, which aim to be general, no assumption of cell shape is made. Spatial, temporal, and cross-sectional variation of the analysed data are accommodated by two key contributions. First, time series analysis is exploited to estimate the temporal cell shape uncertainty in addition to cell trajectory. Second, a fast marching (FM) algorithm is used to integrate the inferred cell properties with the observed image measurements in order to obtain image likelihood for cell segmentation, and association. The proposed approach has been tested on eight different time-lapse microscopy data sets, some of which are high-throughput, demonstrating promising results for the detection, segmentation and association of planar cells. Our results surpass the state of the art for the Fluo-C2DL-MSC data set of the Cell Tracking Challenge (Maska et al., 2014).

Multidimensional co-segmentation of longitudinal brain MRI ensembles in the presence of a neurodegenerative process.

MRI Segmentation of a pathological brain poses a significant challenge, as the available anatomical priors that provide top-down information to aid segmentation are inadequate in the presence of abnormalities. This problem is further complicated for longitudinal data capturing impaired brain development or neurodegenerative conditions, since the dynamic of brain atrophies has to be considered as well. For these cases, the absence of compatible annotated training examples renders the commonly used multi-atlas or machine-learning approaches impractical. We present a novel segmentation approach that accounts for the lack of labeled data via multi-region multi-subject co-segmentation (MMCoSeg) of longitudinal MRI sequences. The underlying, unknown anatomy is learned throughout an iterative process, in which the segmentation of a region is supported both by the segmentation of the neighboring regions, which share common boundaries, and by the segmentation of corresponding regions, in the other jointly segmented images. A 4D multi-region atlas that models the spatio-temporal deformations and can be adapted to different subjects undergoing similar degeneration processes is reconstructed concurrently. An inducible mouse model of p25 accumulation (the CK-p25 mouse) that displays key pathological hallmarks of Alzheimer disease (AD) is used as a gold-standard to test the proposed algorithm by providing a conditional control of rapid neurodegeneration. Applying the MMCoSeg to a cohort of CK-p25 mice and littermate controls yields promising segmentation results that demonstrate high compatibility with expertise manual annotations. An extensive comparative analysis with respect to current well-established, atlas-based segmentation methods highlights the advantage of the proposed approach, which provides accurate segmentation of longitudinal brain MRIs in pathological conditions, where only very few annotated examples are available.

A Generative Probabilistic Model and Discriminative Extensions for Brain Lesion Segmentation--With Application to Tumor and Stroke.

We introduce a generative probabilistic model for segmentation of brain lesions in multi-dimensional images that generalizes the EM segmenter, a common approach for modelling brain images using Gaussian mixtures and a probabilistic tissue atlas that employs expectation-maximization (EM), to estimate the label map for a new image. Our model augments the probabilistic atlas of the healthy tissues with a latent atlas of the lesion. We derive an estimation algorithm with closed-form EM update equations. The method extracts a latent atlas prior distribution and the lesion posterior distributions jointly from the image data. It delineates lesion areas individually in each channel, allowing for differences in lesion appearance across modalities, an important feature of many brain tumor imaging sequences. We also propose discriminative model extensions to map the output of the generative model to arbitrary labels with semantic and biological meaning, such as "tumor core" or "fluid-filled structure", but without a one-to-one correspondence to the hypo- or hyper-intense lesion areas identified by the generative model. We test the approach in two image sets: the publicly available BRATS set of glioma patient scans, and multimodal brain images of patients with acute and subacute ischemic stroke. We find the generative model that has been designed for tumor lesions to generalize well to stroke images, and the extended discriminative -discriminative model to be one of the top ranking methods in the BRATS evaluation.

Shape analysis, a field in need of careful validation.

In the last two decades, the statistical analysis of shape has become an actively studied field and finds applications in a wide range of areas. In addition to algorithmic development, many researchers have distributed end-user orientated toolboxes, which further enable the utilization of the algorithms in an "off the shelf" fashion. However, there is little work on the evaluation and validation of these techniques, which poses a rather serious challenge when interpreting their results. To address this lack of validation, we design a validation framework and then use it to test some of the most widely used toolboxes. Our initial results show inconsistencies and disagreement among four different methods. We believe this type of analysis to be critical not only for the community of algorithm designers but also perhaps more importantly to researchers who use these tools without knowing the algorithm details and seek objective criteria for tool selection.

A spatio-temporal latent atlas for semi-supervised learning of fetal brain segmentations and morphological age estimation.

Prenatal neuroimaging requires reference models that reflect the normal spectrum of fetal brain development, and summarize observations from a representative sample of individuals. Collecting a sufficiently large data set of manually annotated data to construct a comprehensive in vivo atlas of rapidly developing structures is challenging but necessary for large population studies and clinical application. We propose a method for the semi-supervised learning of a spatio-temporal latent atlas of fetal brain development, and corresponding segmentations of emerging cerebral structures, such as the ventricles or cortex. The atlas is based on the annotation of a few examples, and a large number of imaging data without annotation. It models the morphological and developmental variability across the population. Furthermore, it serves as basis for the estimation of a structures' morphological age, and its deviation from the nominal gestational age during the assessment of pathologies. Experimental results covering the gestational period of 20-30 gestational weeks demonstrate segmentation accuracy achievable with minimal annotation, and precision of morphological age estimation. Age estimation results on fetuses suffering from lissencephaly demonstrate that they detect significant differences in the age offset compared to a control group.

An image analysis toolbox for high-throughput C. elegans assays.

We present a toolbox for high-throughput screening of image-based Caenorhabditis elegans phenotypes. The image analysis algorithms measure morphological phenotypes in individual worms and are effective for a variety of assays and imaging systems. This WormToolbox is available through the open-source CellProfiler project and enables objective scoring of whole-worm high-throughput image-based assays of C. elegans for the study of diverse biological pathways that are relevant to human disease.

Segmentation of image ensembles via latent atlases.

Spatial priors, such as probabilistic atlases, play an important role in MRI segmentation. However, the availability of comprehensive, reliable and suitable manual segmentations for atlas construction is limited. We therefore propose a method for joint segmentation of corresponding regions of interest in a collection of aligned images that does not require labeled training data. Instead, a latent atlas, initialized by at most a single manual segmentation, is inferred from the evolving segmentations of the ensemble. The algorithm is based on probabilistic principles but is solved using partial differential equations (PDEs) and energy minimization criteria. We evaluate the method on two datasets, segmenting subcortical and cortical structures in a multi-subject study and extracting brain tumors in a single-subject multi-modal longitudinal experiment. We compare the segmentation results to manual segmentations, when those exist, and to the results of a state-of-the-art atlas-based segmentation method. The quality of the results supports the latent atlas as a promising alternative when existing atlases are not compatible with the images to be segmented.

RESOLVING CLUSTERED WORMS VIA PROBABILISTIC SHAPE MODELS.

The roundworm Caenorhabditis elegans is an effective model system for biological processes such as immunity, behavior, and metabolism. Robotic sample preparation together with automated microscopy and image analysis has recently enabled high-throughput screening experiments using C. elegans. So far, such experiments have been limited to per-image measurements due to the tendency of the worms to cluster, which prevents extracting features from individual animals.We present a novel approach for the extraction of individual C. elegans from clusters of worms in high-throughput microscopy images. The key ideas are the construction of a low-dimensional shape-descriptor space and the definition of a probability measure on it. Promising segmentation results are shown.

On symmetry, perspectivity, and level-set-based segmentation.

We introduce a novel variational method for the extraction of objects with either bilateral or rotational symmetry in the presence of perspective distortion. Information on the symmetry axis of the object and the distorting transformation is obtained as a by--product of the segmentation process. The key idea is the use of a flip or a rotation of the image to segment as if it were another view of the object. We call this generated image the symmetrical counterpart image. We show that the symmetrical counterpart image and the source image are related by planar projective homography. This homography is determined by the unknown planar projective transformation that distorts the object symmetry. The proposed segmentation method uses a level-set-based curve evolution technique. The extraction of the object boundaries is based on the symmetry constraint and the image data. The symmetrical counterpart of the evolving level-set function provides a dynamic shape prior. It supports the segmentation by resolving possible ambiguities due to noise, clutter, occlusions, and assimilation with the background. The homography that aligns the symmetrical counterpart to the source level-set is recovered via a registration process carried out concurrently with the segmentation. Promising segmentation results of various images of approximately symmetrical objects are shown.