Cloud-Based Brain Magnetic Resonance Image Segmentation and Parcellation System for Individualized Prediction of Cognitive Worsening
JournalJournal of Healthcare Engineering
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AbstractFor patients with cognitive disorders and dementia, accurate prognosis of cognitive worsening is critical to their ability to prepare for the future, in collaboration with health-care providers. Despite multiple efforts to apply computational brain magnetic resonance image (MRI) analysis in predicting cognitive worsening, with several successes, brain MRI is not routinely quantified in clinical settings to guide prognosis and clinical decision-making. To encourage the clinical use of a cutting-edge image segmentation method, we developed a prediction model as part of an established web-based cloud platform, MRICloud. The model was built in a training dataset from Alzheimer's Disease Neuroimaging Initiative (ADNI) where baseline MRI scans were combined with clinical data over time. Each MRI was parcellated into 265 anatomical units based on the MRICloud fully automated image segmentation function, to measure the volume of each parcel. The Mini Mental State Examination (MMSE) was used as a measure of cognitive function. The normalized volume of 265 parcels, combined with baseline MMSE score, age, and sex were input variables for a Least Absolute Shrinkage and Selection Operator (LASSO) regression analysis, with MMSE change in the subsequent two years as the target for prediction. A leave-one-out analysis performed on the training dataset estimated a correlation coefficient of 0.64 between true and predicted MMSE change. A receiver operating characteristic (ROC) analysis estimated a sensitivity of 0.88 and a specificity of 0.76 in predicting substantial cognitive worsening after two years, defined as MMSE decline of ?4 points. This MRICloud prediction model was then applied to a test dataset of clinically acquired MRIs from the Johns Hopkins Memory and Alzheimer's Treatment Center (MATC), a clinical care setting. In the latter setting, the model had both sensitivity and specificity of 1.0 in predicting substantial cognitive worsening. While the MRICloud prediction model demonstrated promise as a platform on which computational MRI findings can easily be extended to clinical use, further study with a larger number of patients is needed for validation. ©2019 Ryo Sakamoto et al.
SponsorsDr. Oishi is a consultant for AnatomyWorks. Dr. Mori is a Chief Executive Officer of AnatomyWorks. +e terms of these arrangements are being managed by the Johns Hopkins University in accordance with its conflicts of interest policies. Dr. Lyketsos has received support from the following organizations: Associated Jewish Federation of Baltimore, Weinberg Foundation, Forest, Glaxo-Smith-Kline, Eisai, Pfizer, Astra-Zeneca, Lilly, Ortho-McNeil, Bristol-Myers, and Novartis. CGL has served as a consultant/advisor for Astra-Zeneca, Glaxo-Smith-Kline, Eisai, Novartis, Forest, Supernus, Adlyfe, Takeda, Wyeth, Lundbeck, Merz, Lilly, and Genentech. CGL has received honorarium or travel support from Pfizer, Forest, Glaxo-Smith-Kline, and Health Monitor. +is arrangement has been approved by the Johns Hopkins University in accordance with its conflicts of interest policies.
Identifier to cite or link to this itemhttps://www.scopus.com/inward/record.uri?eid=2-s2.0-85061658172&doi=10.1155%2f2019%2f9507193&partnerID=40&md5=15d8a6e9d71bde2039794422dd13bc2b; http://hdl.handle.net/10713/8640
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