No Arabic abstract
We perform unsupervised analysis of image-derived shape and motion features extracted from 3822 cardiac 4D MRIs of the UK Biobank. First, with a feature extraction method previously published based on deep learning models, we extract from each case 9 feature values characterizing both the cardiac shape and motion. Second, a feature selection is performed to remove highly correlated feature pairs. Third, clustering is carried out using a Gaussian mixture model on the selected features. After analysis, we identify two small clusters which probably correspond to two pathological categories. Further confirmation using a trained classification model and dimensionality reduction tools is carried out to support this discovery. Moreover, we examine the differences between the other large clusters and compare our measures with the ground-truth.
UK Biobank (UKB) conducts large-scale examinations of more than half a million volunteers, collecting health-related information on genetics, lifestyle, blood biochemistry, and more. Medical imaging of 100,000 subjects, with 70,000 follow-up sessions, enables measurements of organs, muscle, and body composition. With up to 170,000 mounting MR images, various methodologies are accordingly engaged in large-scale image analysis. This work presents an experimental inference engine that can automatically predict a comprehensive profile of subject metadata from UKB neck-to-knee body MRI. It was evaluated in cross-validation for baseline characteristics such as age, height, weight, and sex, but also measurements of body composition, organ volumes, and abstract properties like grip strength, pulse rate, and type 2 diabetic status. It predicted subsequently released test data covering twelve body composition metrics with a 3% median error. The proposed system can automatically analyze one thousand subjects within ten minutes, providing individual confidence intervals. The underlying methodology utilizes convolutional neural networks for image-based mean-variance regression on two-dimensional representations of the MRI data. This work aims to make the proposed system available for free to researchers, who can use it to obtain fast and fully-automated estimates of 72 different measurements immediately upon release of new UKB image data.
Background: The trend towards large-scale studies including population imaging poses new challenges in terms of quality control (QC). This is a particular issue when automatic processing tools, e.g. image segmentation methods, are employed to derive quantitative measures or biomarkers for later analyses. Manual inspection and visual QC of each segmentation isnt feasible at large scale. However, its important to be able to automatically detect when a segmentation method fails so as to avoid inclusion of wrong measurements into subsequent analyses which could lead to incorrect conclusions. Methods: To overcome this challenge, we explore an approach for predicting segmentation quality based on Reverse Classification Accuracy, which enables us to discriminate between successful and failed segmentations on a per-cases basis. We validate this approach on a new, large-scale manually-annotated set of 4,800 cardiac magnetic resonance scans. We then apply our method to a large cohort of 7,250 cardiac MRI on which we have performed manual QC. Results: We report results used for predicting segmentation quality metrics including Dice Similarity Coefficient (DSC) and surface-distance measures. As initial validation, we present data for 400 scans demonstrating 99% accuracy for classifying low and high quality segmentations using predicted DSC scores. As further validation we show high correlation between real and predicted scores and 95% classification accuracy on 4,800 scans for which manual segmentations were available. We mimic real-world application of the method on 7,250 cardiac MRI where we show good agreement between predicted quality metrics and manual visual QC scores. Conclusions: We show that RCA has the potential for accurate and fully automatic segmentation QC on a per-case basis in the context of large-scale population imaging as in the UK Biobank Imaging Study.
Psoas muscle measurements are frequently used as markers of sarcopenia and predictors of health. Manually measured cross-sectional areas are most commonly used, but there is a lack of consistency regarding the position of the measurementand manual annotations are not practical for large population studies. We have developed a fully automated method to measure iliopsoas muscle volume (comprised of the psoas and iliacus muscles) using a convolutional neural network. Magnetic resonance images were obtained from the UK Biobank for 5,000 male and female participants, balanced for age, gender and BMI. Ninety manual annotations were available for model training and validation. The model showed excellent performance against out-of-sample data (dice score coefficient of 0.912 +/- 0.018). Iliopsoas muscle volumes were successfully measured in all 5,000 participants. Iliopsoas volume was greater in male compared with female subjects. There was a small but significant asymmetry between left and right iliopsoas muscle volumes. We also found that iliopsoas volume was significantly related to height, BMI and age, and that there was an acceleration in muscle volume decrease in men with age. Our method provides a robust technique for measuring iliopsoas muscle volume that can be applied to large cohorts.
The UK Biobank Imaging Study has acquired medical scans of more than 40,000 volunteer participants. The resulting wealth of anatomical information has been made available for research, together with extensive metadata including measurements of liver fat. These values play an important role in metabolic disease, but are only available for a minority of imaged subjects as their collection requires the careful work of image analysts on dedicated liver MRI. Another UK Biobank protocol is neck-to-knee body MRI for analysis of body composition. The resulting volumes can also quantify fat fractions, even though they were reconstructed with a two- instead of a three-point Dixon technique. In this work, a novel framework for automated inference of liver fat from UK Biobank neck-to-knee body MRI is proposed. A ResNet50 was trained for regression on two-dimensional slices from these scans and the reference values as target, without any need for ground truth segmentations. Once trained, it performs fast, objective, and fully automated predictions that require no manual intervention. On the given data, it closely emulates the reference method, reaching a level of agreement comparable to different gold standard techniques. The network learned to rectify non-linearities in the fat fraction values and identified several outliers in the reference. It outperformed a multi-atlas segmentation baseline and inferred new estimates for all imaged subjects lacking reference values, expanding the total number of liver fat measurements by factor six.
Along with rich health-related metadata, medical images have been acquired for over 40,000 male and female UK Biobank participants, aged 44-82, since 2014. Phenotypes derived from these images, such as measurements of body composition from MRI, can reveal new links between genetics, cardiovascular disease, and metabolic conditions. In this work, six measurements of body composition and adipose tissues were automatically estimated by image-based, deep regression with ResNet50 neural networks from neck-to-knee body MRI. Despite the potential for high speed and accuracy, these networks produce no output segmentations that could indicate the reliability of individual measurements. The presented experiments therefore examine uncertainty quantification with mean-variance regression and ensembling to estimate individual measurement errors and thereby identify potential outliers, anomalies, and other failure cases automatically. In 10-fold cross-validation on data of about 8,500 subjects, mean-variance regression and ensembling showed complementary benefits, reducing the mean absolute error across all predictions by 12%. Both improved the calibration of uncertainties and their ability to identify high prediction errors. With intra-class correlation coefficients (ICC) above 0.97, all targets except the liver fat content yielded relative measurement errors below 5%. Testing on another 1,000 subjects showed consistent performance, and the method was finally deployed for inference to 30,000 subjects with missing reference values. The results indicate that deep regression ensembles could ultimately provide automated, uncertainty-aware measurements of body composition for more than 120,000 UK Biobank neck-to-knee body MRI that are to be acquired within the coming years.