用深度学习精准定位脑白质病变区域,提升阿尔茨海默病早期诊断能力
Deep Learning-Based Regional White Matter Hyperintensity Mapping as a Robust Biomarker for Alzheimer's Disease
- 基于深度学习的区域化白质病变分割框架,兼顾空间分布与全局负荷
- 区域病变体积比整体负荷更优,联合萎缩指标可达到AUC 0.97
- 前部白质束区域病变与疾病状态高度相关,适合临床分层与早期预警
白质高信号(WMH)是认知老化、阿尔茨海默病(AD)及相关痴呆的重要影像标志。尽管自动分割技术已进步,多数方法仅提供全局病灶负荷,忽略其在不同白质区域的空间分布。本文提出一种深度学习框架,用于稳健的WMH分割与定位,在公开数据集及独立的阿尔茨海默病神经影像计划(ADNI)队列中评估。结果表明,预测病灶负荷与参考值一致,对病灶负荷、扫描参数和人口学差异均具鲁棒性。除精确分割外,我们量化了解剖定义区域内病灶体积,并结合脑结构体积评估诊断价值。区域病灶体积始终优于全局负荷,与脑萎缩指标融合后性能进一步提升,最高达曲线下面积(AUC)0.97。多个空间分离区域(尤其前部白质束)与诊断状态显著相关,提示AD中存在局部易感性。这些结果凸显区域化定量分析的价值。将局部病灶指标与萎缩标记结合,有望增强神经退行性疾病早期诊断与分层能力。
原文摘要 · Abstract (English)
White matter hyperintensities (WMH) are key imaging markers in cognitive aging, Alzheimer's disease (AD), and related dementias. Although automated methods for WMH segmentation have advanced, most provide only global lesion load and overlook their spatial distribution across distinct white matter regions. We propose a deep learning framework for robust WMH segmentation and localization, evaluated across public datasets and an independent Alzheimer's Disease Neuroimaging Initiative (ADNI) cohort. Our results show that the predicted lesion loads are in line with the reference WMH estimates, confirming the robustness to variations in lesion load, acquisition, and demographics. Beyond accurate segmentation, we quantify WMH load within anatomically defined regions and combine these measures with brain structure volumes to assess diagnostic value. Regional WMH volumes consistently outperform global lesion burden for disease classification, and integration with brain atrophy metrics further improves performance, reaching area under the curve (AUC) values up to 0.97. Several spatially distinct regions, particularly within anterior white matter tracts, are reproducibly associated with diagnostic status, indicating localized vulnerability in AD. These results highlight the added value of regional WMH quantification. Incorporating localized lesion metrics alongside atrophy markers may enhance early diagnosis and stratification in neurodegenerative disorders.
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