Abstract
Lobar cerebral microbleeds (CMBs) and localized non-hemorrhage iron deposits in the basal ganglia have been associated with brain aging, vascular disease and neurodegenerative disorders. Particularly, CMBs are small lesions and require multiple neuroimaging modalities for accurate detection. Quantitative susceptibility mapping (QSM) derived from in vivo magnetic resonance imaging (MRI) is necessary to differentiate between iron content and mineralization. We set out to develop a deep learning-based segmentation method suitable for segmenting both CMBs and iron deposits. We included a convenience sample of 24 participants from the MESA cohort and used T2-weighted images, susceptibility weighted imaging (SWI), and QSM to segment the two types of lesions. We developed a protocol for simultaneous manual annotation of CMBs and non-hemorrhage iron deposits in the basal ganglia. This manual annotation was then used to train a deep convolution neural network (CNN). Specifically, we adapted the U-Net model with a higher number of resolution layers to be able to detect small lesions such as CMBs from standard resolution MRI. We tested different combinations of the three modalities to determine the most informative data sources for the detection tasks. In the detection of CMBs using single class and multiclass models, we achieved an average sensitivity and precision of between 0.84–0.88 and 0.40–0.59, respectively. The same framework detected non-hemorrhage iron deposits with an average sensitivity and precision of about 0.75–0.81 and 0.62–0.75, respectively. Our results showed that deep learning could automate the detection of small vessel disease lesions and including multimodal MR data (particularly QSM) can improve the detection of CMB and non-hemorrhage iron deposits with sensitivity and precision that is compatible with use in large-scale research studies.
Highlights
Lobar cerebral microbleeds (CMBs) and localized non-hemorrhage iron deposits in the basal ganglia have been associated with brain aging, vascular disease and neurodegenerative disorders
While an increase in iron concentration in the basal ganglia is expected in healthy a ging[10], focal accumulation of iron has been associated with neurodegenerative disorders in small scale s tudies[11,12,13]
Our experiments show that incorporating Quantitative susceptibility mapping (QSM) in model training can increase the overall accuracy of CMB and iron deposit detection
Summary
Lobar cerebral microbleeds (CMBs) and localized non-hemorrhage iron deposits in the basal ganglia have been associated with brain aging, vascular disease and neurodegenerative disorders. On magnetic resonance imaging (MRI), tuned to be sensitive for differences in magnetic susceptibility, focal accumulations of iron content can be visible This includes lesions with iron content such as cerebral microbleeds (CMBs) and non-hemorrhage iron deposits in the basal ganglia. The focus in MESA is utilizing non-invasive methods to investigate common risk factors, preclinical disease states and manifest diseases using a standardized imaging protocol, which is applied to all p articipants[34] On one hand, this is providing a unique opportunity to study widely ignored lesions such as iron deposits in vivo using MRI but on the other hand, this comes with additional challenges as such cohorts naturally include largely cognitively normal participants with a low lesion load, resulting in a very challenging task to automate
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