title: Application of Machine Learning to Arterial Spin Labeling in Mild Cognitive Impairment and Alzheimer Disease.
abstract: Purpose To investigate whether multivariate pattern recognition analysis of arterial spin labeling (ASL) perfusion maps can be used for classification and single-subject prediction of patients with Alzheimer disease (AD) and mild cognitive impairment (MCI) and subjects with subjective cognitive decline (SCD) after using the W score method to remove confounding effects of sex and age. Materials and Methods Pseudocontinuous 3.0-T ASL images were acquired in 100 patients with probable AD; 60 patients with MCI, of whom 12 remained stable, 12 were converted to a diagnosis of AD, and 36 had no follow-up; 100 subjects with SCD; and 26 healthy control subjects. The AD, MCI, and SCD groups were divided into a sex- and age-matched training set (n = 130) and an independent prediction set (n = 130). Standardized perfusion scores adjusted for age and sex (W scores) were computed per voxel for each participant. Training of a support vector machine classifier was performed with diagnostic status and perfusion maps. Discrimination maps were extracted and used for single-subject classification in the prediction set. Prediction performance was assessed with receiver operating characteristic (ROC) analysis to generate an area under the ROC curve (AUC) and sensitivity and specificity distribution. Results Single-subject diagnosis in the prediction set by using the discrimination maps yielded excellent performance for AD versus SCD (AUC, 0.96; P < .01), good performance for AD versus MCI (AUC, 0.89; P < .01), and poor performance for MCI versus SCD (AUC, 0.63; P = .06). Application of the AD versus SCD discrimination map for prediction of MCI subgroups resulted in good performance for patients with MCI diagnosis converted to AD versus subjects with SCD (AUC, 0.84; P < .01) and fair performance for patients with MCI diagnosis converted to AD versus those with stable MCI (AUC, 0.71; P > .05). Conclusion With automated methods, age- and sex-adjusted ASL perfusion maps can be used to classify and predict diagnosis of AD, conversion of MCI to AD, stable MCI, and SCD with good to excellent accuracy and AUC values.©RSNA, 2016.
authors.affiliation: From the Department of Radiology and Nuclear Medicine (L.E.C., F.H., E.J.S.A., B.N.M.v.B., F.B., A.M.W.), Department of Physics and Medical Technology (J.P.A.K.), and Alzheimer Centre and Department of Neurology (R.O., M.R.B., C.M., S.C.J.V., W.M.v.d.F., P.S.), VU University Medical Centre, Boelelaan 1118, 1081 HZ Amsterdam, the Netherlands.
authors.forename: Lyduine E
authors.initials: LE
authors.lastname: Collij
authors.affiliation: From the Department of Radiology and Nuclear Medicine (L.E.C., F.H., E.J.S.A., B.N.M.v.B., F.B., A.M.W.), Department of Physics and Medical Technology (J.P.A.K.), and Alzheimer Centre and Department of Neurology (R.O., M.R.B., C.M., S.C.J.V., W.M.v.d.F., P.S.), VU University Medical Centre, Boelelaan 1118, 1081 HZ Amsterdam, the Netherlands.
authors.forename: Fiona
authors.initials: F
authors.lastname: Heeman
authors.affiliation: From the Department of Radiology and Nuclear Medicine (L.E.C., F.H., E.J.S.A., B.N.M.v.B., F.B., A.M.W.), Department of Physics and Medical Technology (J.P.A.K.), and Alzheimer Centre and Department of Neurology (R.O., M.R.B., C.M., S.C.J.V., W.M.v.d.F., P.S.), VU University Medical Centre, Boelelaan 1118, 1081 HZ Amsterdam, the Netherlands.
authors.forename: Joost P A
authors.initials: JP
authors.lastname: Kuijer
authors.affiliation: From the Department of Radiology and Nuclear Medicine (L.E.C., F.H., E.J.S.A., B.N.M.v.B., F.B., A.M.W.), Department of Physics and Medical Technology (J.P.A.K.), and Alzheimer Centre and Department of Neurology (R.O., M.R.B., C.M., S.C.J.V., W.M.v.d.F., P.S.), VU University Medical Centre, Boelelaan 1118, 1081 HZ Amsterdam, the Netherlands.
authors.forename: Rik
authors.initials: R
authors.lastname: Ossenkoppele
authors.affiliation: From the Department of Radiology and Nuclear Medicine (L.E.C., F.H., E.J.S.A., B.N.M.v.B., F.B., A.M.W.), Department of Physics and Medical Technology (J.P.A.K.), and Alzheimer Centre and Department of Neurology (R.O., M.R.B., C.M., S.C.J.V., W.M.v.d.F., P.S.), VU University Medical Centre, Boelelaan 1118, 1081 HZ Amsterdam, the Netherlands.
authors.forename: Marije R
authors.initials: MR
authors.lastname: Benedictus
authors.affiliation: From the Department of Radiology and Nuclear Medicine (L.E.C., F.H., E.J.S.A., B.N.M.v.B., F.B., A.M.W.), Department of Physics and Medical Technology (J.P.A.K.), and Alzheimer Centre and Department of Neurology (R.O., M.R.B., C.M., S.C.J.V., W.M.v.d.F., P.S.), VU University Medical Centre, Boelelaan 1118, 1081 HZ Amsterdam, the Netherlands.
authors.forename: Christiane
authors.initials: C
authors.lastname: Möller
authors.affiliation: From the Department of Radiology and Nuclear Medicine (L.E.C., F.H., E.J.S.A., B.N.M.v.B., F.B., A.M.W.), Department of Physics and Medical Technology (J.P.A.K.), and Alzheimer Centre and Department of Neurology (R.O., M.R.B., C.M., S.C.J.V., W.M.v.d.F., P.S.), VU University Medical Centre, Boelelaan 1118, 1081 HZ Amsterdam, the Netherlands.
authors.forename: Sander C J
authors.initials: SC
authors.lastname: Verfaillie
authors.affiliation: From the Department of Radiology and Nuclear Medicine (L.E.C., F.H., E.J.S.A., B.N.M.v.B., F.B., A.M.W.), Department of Physics and Medical Technology (J.P.A.K.), and Alzheimer Centre and Department of Neurology (R.O., M.R.B., C.M., S.C.J.V., W.M.v.d.F., P.S.), VU University Medical Centre, Boelelaan 1118, 1081 HZ Amsterdam, the Netherlands.
authors.forename: Ernesto J
authors.initials: EJ
authors.lastname: Sanz-Arigita
authors.affiliation: From the Department of Radiology and Nuclear Medicine (L.E.C., F.H., E.J.S.A., B.N.M.v.B., F.B., A.M.W.), Department of Physics and Medical Technology (J.P.A.K.), and Alzheimer Centre and Department of Neurology (R.O., M.R.B., C.M., S.C.J.V., W.M.v.d.F., P.S.), VU University Medical Centre, Boelelaan 1118, 1081 HZ Amsterdam, the Netherlands.
authors.forename: Bart N M
authors.initials: BN
authors.lastname: van Berckel
authors.affiliation: From the Department of Radiology and Nuclear Medicine (L.E.C., F.H., E.J.S.A., B.N.M.v.B., F.B., A.M.W.), Department of Physics and Medical Technology (J.P.A.K.), and Alzheimer Centre and Department of Neurology (R.O., M.R.B., C.M., S.C.J.V., W.M.v.d.F., P.S.), VU University Medical Centre, Boelelaan 1118, 1081 HZ Amsterdam, the Netherlands.
authors.forename: Wiesje M
authors.initials: WM
authors.lastname: van der Flier
authors.affiliation: From the Department of Radiology and Nuclear Medicine (L.E.C., F.H., E.J.S.A., B.N.M.v.B., F.B., A.M.W.), Department of Physics and Medical Technology (J.P.A.K.), and Alzheimer Centre and Department of Neurology (R.O., M.R.B., C.M., S.C.J.V., W.M.v.d.F., P.S.), VU University Medical Centre, Boelelaan 1118, 1081 HZ Amsterdam, the Netherlands.
authors.forename: Philip
authors.initials: P
authors.lastname: Scheltens
authors.affiliation: From the Department of Radiology and Nuclear Medicine (L.E.C., F.H., E.J.S.A., B.N.M.v.B., F.B., A.M.W.), Department of Physics and Medical Technology (J.P.A.K.), and Alzheimer Centre and Department of Neurology (R.O., M.R.B., C.M., S.C.J.V., W.M.v.d.F., P.S.), VU University Medical Centre, Boelelaan 1118, 1081 HZ Amsterdam, the Netherlands.
authors.forename: Frederik
authors.initials: F
authors.lastname: Barkhof
authors.affiliation: From the Department of Radiology and Nuclear Medicine (L.E.C., F.H., E.J.S.A., B.N.M.v.B., F.B., A.M.W.), Department of Physics and Medical Technology (J.P.A.K.), and Alzheimer Centre and Department of Neurology (R.O., M.R.B., C.M., S.C.J.V., W.M.v.d.F., P.S.), VU University Medical Centre, Boelelaan 1118, 1081 HZ Amsterdam, the Netherlands.
authors.forename: Alle Meije
authors.initials: AM
authors.lastname: Wink
mesh_terms: D000368:Aged; D000544:Alzheimer Disease / Q000175:diagnosis* / Q000503:physiopathology / Q000523:psychology; D019540:Area Under Curve; D060825:Cognitive Dysfunction / Q000175:diagnosis* / Q000503:physiopathology; D042241:Early Diagnosis; D005260:Female; D006801:Humans; D000069550:Machine Learning; D018810:Magnetic Resonance Angiography / Q000379:methods; D008297:Male; D008875:Middle Aged; D010364:Pattern Recognition, Visual; D013113:Spin Labels
chemical_list: D013113:Spin Labels