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R. Wolz

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3 papers
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3

YNICL Journal 2018 Journal Article

White matter hyperintensity and stroke lesion segmentation and differentiation using convolutional neural networks

  • R. Guerrero
  • C. Qin
  • O. Oktay
  • C. Bowles
  • L. Chen
  • R. Joules
  • R. Wolz
  • M.C. Valdés-Hernández

White matter hyperintensities (WMH) are a feature of sporadic small vessel disease also frequently observed in magnetic resonance images (MRI) of healthy elderly subjects. The accurate assessment of WMH burden is of crucial importance for epidemiological studies to determine association between WMHs, cognitive and clinical data; their causes, and the effects of new treatments in randomized trials. The manual delineation of WMHs is a very tedious, costly and time consuming process, that needs to be carried out by an expert annotator (e.g. a trained image analyst or radiologist). The problem of WMH delineation is further complicated by the fact that other pathological features (i.e. stroke lesions) often also appear as hyperintense regions. Recently, several automated methods aiming to tackle the challenges of WMH segmentation have been proposed. Most of these methods have been specifically developed to segment WMH in MRI but cannot differentiate between WMHs and strokes. Other methods, capable of distinguishing between different pathologies in brain MRI, are not designed with simultaneous WMH and stroke segmentation in mind. Therefore, a task specific, reliable, fully automated method that can segment and differentiate between these two pathological manifestations on MRI has not yet been fully identified. In this work we propose to use a convolutional neural network (CNN) that is able to segment hyperintensities and differentiate between WMHs and stroke lesions. Specifically, we aim to distinguish between WMH pathologies from those caused by stroke lesions due to either cortical, large or small subcortical infarcts. The proposed fully convolutional CNN architecture, called uResNet, that comprised an analysis path, that gradually learns low and high level features, followed by a synthesis path, that gradually combines and up-samples the low and high level features into a class likelihood semantic segmentation. Quantitatively, the proposed CNN architecture is shown to outperform other well established and state-of-the-art algorithms in terms of overlap with manual expert annotations. Clinically, the extracted WMH volumes were found to correlate better with the Fazekas visual rating score than competing methods or the expert-annotated volumes. Additionally, a comparison of the associations found between clinical risk-factors and the WMH volumes generated by the proposed method, was found to be in line with the associations found with the expert-annotated volumes.

YNIMG Journal 2016 Journal Article

Instantiated mixed effects modeling of Alzheimer's disease markers

  • R. Guerrero
  • A. Schmidt-Richberg
  • C. Ledig
  • T. Tong
  • R. Wolz
  • D. Rueckert

The assessment and prediction of a subject's current and future risk of developing neurodegenerative diseases like Alzheimer's disease are of great interest in both the design of clinical trials as well as in clinical decision making. Exploring the longitudinal trajectory of markers related to neurodegeneration is an important task when selecting subjects for treatment in trials and the clinic, in the evaluation of early disease indicators and the monitoring of disease progression. Given that there is substantial intersubject variability, models that attempt to describe marker trajectories for a whole population will likely lack specificity for the representation of individual patients. Therefore, we argue here that individualized models provide a more accurate alternative that can be used for tasks such as population stratification and a subject-specific prognosis. In the work presented here, mixed effects modeling is used to derive global and individual marker trajectories for a training population. Test subject (new patient) specific models are then instantiated using a stratified “marker signature” that defines a subpopulation of similar cases within the training database. From this subpopulation, personalized models of the expected trajectory of several markers are subsequently estimated for unseen patients. These patient specific models of markers are shown to provide better predictions of time-to-conversion to Alzheimer's disease than population based models.

YNIMG Journal 2014 Journal Article

Manifold population modeling as a neuro-imaging biomarker: Application to ADNI and ADNI-GO

  • R. Guerrero
  • R. Wolz
  • A.W. Rao
  • D. Rueckert

We propose a framework for feature extraction from learned low-dimensional subspaces that represent inter-subject variability. The manifold subspace is built from data-driven regions of interest (ROI). The regions are learned via sparse regression using the mini-mental state examination (MMSE) score as an independent variable which correlates better with the actual disease stage than a discrete class label. The sparse regression is used to perform variable selection along with a re-sampling scheme to reduce sampling bias. We then use the learned manifold coordinates to perform visualization and classification of the subjects. Results of the proposed approach are shown using the ADNI and ADNI-GO datasets. Three types of classification techniques, including a new MRI Disease-State-Score (MRI-DSS) classifier, are tested in conjunction with two learning strategies. In the first case Alzheimer's Disease (AD) and progressive mild cognitive impairment (pMCI) subjects were grouped together, while cognitive normal (CN) and stable mild cognitive impaired (sMCI) subjects were also grouped together. In the second approach, the classifiers are learned using the original class labels (with no grouping). We show results that are comparable to other state-of-the-art methods. A classification rate of 71%, of arguably the most clinically relevant subjects, sMCI and pMCI, is shown. Additionally, we present classification accuracies between CN and early MCI (eMCI) subjects, from the ADNI-GO dataset, of 65%. To our knowledge this is the first time classification accuracies for eMCI patients have been reported.

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