본문 바로가기
KERD
논문KCI 등재

A Case-Control Clinical Trial on a Deep Learning-Based Classification System for Diagnosis of Amyloid-Positive Alzheimer’s Disease

3

조회

0

다운로드

0

인용

0

참고문헌

키워드

주제분류정신과학

초록

Objective A deep learning-based classification system (DLCS) which uses structural brain magnetic resonance imaging (MRI) to diagnose Alzheimer’s disease (AD) was developed in a previous recent study. Here, we evaluate its performance by conducting a single-center, case-control clinical trial.Methods We retrospectively collected T1-weighted brain MRI scans of subjects who had an accompanying measure of amyloid-beta (Aβ) positivity based on a 18F-florbetaben positron emission tomography scan. The dataset included 188 Aβ-positive patients with mild cognitive impairment or dementia due to AD, and 162 Aβ-negative controls with normal cognition. We calculated the sensitivity, specificity, positive predictive value, negative predictive value, and area under the receiver operating characteristic curve (AUC) of the DLCS in the classification of Aβ-positive AD patients from Aβ-negative controls.Results The DLCS showed excellent performance, with sensitivity, specificity, positive predictive value, negative predictive value, and AUC of 85.6% (95% confidence interval [CI], 79.8–90.0), 90.1% (95% CI, 84.5–94.2), 91.0% (95% CI, 86.3–94.1), 84.4% (95% CI, 79.2–88.5), and 0.937 (95% CI, 0.911–0.963), respectively.Conclusion The DLCS shows promise in clinical settings where it could be routinely applied to MRI scans regardless of original scan purpose to improve the early detection of AD.

Abstract

Objective A deep learning-based classification system (DLCS) which uses structural brain magnetic resonance imaging (MRI) to diagnose Alzheimer’s disease (AD) was developed in a previous recent study. Here, we evaluate its performance by conducting a single-center, case-control clinical trial.Methods We retrospectively collected T1-weighted brain MRI scans of subjects who had an accompanying measure of amyloid-beta (Aβ) positivity based on a 18F-florbetaben positron emission tomography scan. The dataset included 188 Aβ-positive patients with mild cognitive impairment or dementia due to AD, and 162 Aβ-negative controls with normal cognition. We calculated the sensitivity, specificity, positive predictive value, negative predictive value, and area under the receiver operating characteristic curve (AUC) of the DLCS in the classification of Aβ-positive AD patients from Aβ-negative controls.Results The DLCS showed excellent performance, with sensitivity, specificity, positive predictive value, negative predictive value, and AUC of 85.6% (95% confidence interval [CI], 79.8–90.0), 90.1% (95% CI, 84.5–94.2), 91.0% (95% CI, 86.3–94.1), 84.4% (95% CI, 79.2–88.5), and 0.937 (95% CI, 0.911–0.963), respectively.Conclusion The DLCS shows promise in clinical settings where it could be routinely applied to MRI scans regardless of original scan purpose to improve the early detection of AD.

참고문헌 (37)

  1. World Alzheimer Report 2015 - The Global Impact of Dementia: An analysis of prevalence, incidence, cost and trends, "Alzheimer’s Disease International", Alzheimer’s Disease International, ~ (2015)
  2. Kim KW, "A nationwide survey on the prevalence of dementia and mild cognitive impairment in South Korea", J Alzheimers Dis, 23, pp.281~291 (2011)
  3. Lang L, "Prevalence and determinants of undetected dementia in the community : a systematic literature review and a meta-analysis", BMJ Open, 7, pp.e011146~ (2017)
  4. Jack CR Jr, "Introduction to the recommendations from the National Institute on Aging-Alzheimer’s Association workgroups on diagnostic guidelines for Alzheimer’s disease", Alzheimers Dement, 7, pp.257~262 (2011)
  5. Albert MS, "The diagnosis of mild cognitive impairment due to Alzheimer’s disease : recommendations from the National Institute on Aging-Alzheimer’s Association workgroups on diagnostic guidelines for Alzheimer’s disease", Alzheimers Dement, 7, pp.270~279 (2011)
  6. Sperling RA, "Toward defining the preclinical stages of Alzheimer’s disease : recommendations from the National Institute on Aging-Alzheimer’s Association workgroups on diagnostic guidelines for Alzheimer’s disease", Alzheimers Dement, 7, pp.280~292 (2011)
  7. McKhann GM, "The diagnosis of dementia due to Alzheimer’s disease : recommendations from the National Institute on Aging-Alzheimer’s Association workgroups on diagnostic guidelines for Alzheimer’s disease", Alzheimers Dement, 7, pp.263~269 (2011)
  8. Li H, "A deep learning model for early prediction of Alzheimer’s disease dementia based on hippocampal magnetic resonance imaging data", Alzheimers Dement, 15, pp.1059~1070 (2019)
  9. Li F, "Alzheimer’s disease diagnosis based on multiple cluster dense convolutional networks", Comput Med Imaging Graph, 70, pp.101~110 (2018)
  10. Luo S, "Automatic Alzheimer’s disease recognition from MRI data using deep learning method", J Appl Math Phys, 5, pp.1892~1898 (2017)
  11. Liu M, "Landmark-based deep multi-instance learning for brain disease diagnosis", Med Image Anal, 43, pp.157~168 (2018)
  12. Basaia S, "Automated classification of Alzheimer’s disease and mild cognitive impairment using a single MRI and deep neural networks", Neuroimage Clin, 21, pp.101645~ (2019)
  13. Lu D, "Multimodal and multiscale deep neural networks for the early diagnosis of Alzheimer’s disease using structural MR and FDG-PET images", Sci Rep, 8, pp.5697~ (2018)
  14. Bae JB, "Identification of Alzheimer’s disease using a convolutional neural network model based on T1-weighted magnetic resonance imaging", Sci Rep, 10, pp.22252~ (2020)
  15. Ossenkoppele R, "Prevalence of amyloid PET positivity in dementia syndromes : a meta-analysis", JAMA, 313, pp.1939~1949 (2015)
  16. Jansen WJ, "Prevalence of cerebral amyloid pathology in persons without dementia : a meta-analysis", JAMA, 313, pp.1924~1938 (2015)
  17. Ji Won Han, "Overview of the Korean Longitudinal Study on Cognitive Aging and Dementia", PSYCHIATRY INVESTIGATION, 15(8), pp.767~774 (2018), 대한신경정신의학회[DOI]
  18. DeLong ER, "Comparing the areas under two or more correlated receiver operating characteristic curves : a nonparametric approach", Biometrics, 44, pp.837~845 (1988)
  19. Szegedy C, "Inception-v4, inception-ResNet and the impact of residual connections on learning", Thirty-First AAAI Conference on Artificial Intelligence (AAAI-17), pp.4278~4284 (2017), AAAI Press
  20. Deng J, "ImageNet: a largescale hierarchical image database", 2009 IEEE Conference on Computer Vision and Pattern Recognition, pp.248~255 (2009), IEEE
  21. Clopper CJ, "The use of confidence or fiducial limits illustrated in the case of the binomial", Biometrika, 26, pp.404~413 (1934)
  22. McNemar Q, "Note on the sampling error of the difference between correlated proportions or percentages", Psychometrika, 12, pp.153~157 (1947)
  23. General Assembly of the World Medical Association, "World Medical Association Declaration of Helsinki : ethical principles for medical research involving human subjects", J Am Coll Dent, 81, pp.14~18 (2014)
  24. The Ronald and Nancy Reagan Research Institute of the Alzheimer’s Association, "Consensus report of the Working Group on : "Molecular and biochemical markers of Alzheimer’s disease"", Neurobiol Aging, 19, pp.109~116 (1998)
  25. Beach TG, "Accuracy of the clinical diagnosis of Alzheimer disease at National Institute on Aging Alzheimer Disease Centers, 2005-2010", J Neuropathol Exp Neurol, 71, pp.266~273 (2012)
  26. Jagust W, "What does fluorodeoxyglucose PET imaging add to a clinical diagnosis of dementia?", Neurology, 69, pp.871~877 (2007)
  27. Nadebaum DP, "Head-to-head comparison of cerebral blood flow single-photon emission computed tomography and(18)F-fluoro-2-deoxyglucose positron emission tomography in the diagnosis of Alzheimer disease", Intern Med J, 51, pp.1243~1250 (2021)
  28. Jagust W, "SPECT perfusion imaging in the diagnosis of Alzheimer’s disease : a clinical-pathologic study", Neurology, 56, pp.950~956 (2001)
  29. Sternberg SA, "Undetected dementia in community-dwelling older people : the Canadian Study of Health and Aging", J Am Geriatr Soc, 48, pp.1430~1434 (2000)
  30. PIBPET Centiloid values and postmortem measures of Alzheimer’s disease neuropathology, "Alzheimers Dement", 2019, 205~216
  31. Laforce R, "Canadian consensus guidelines on use of amyloid imaging in Canada : update and future directions from the specialized task force on amyloid imaging in Canada", Can J Neurol Sci, 43, pp.503~512 (2016)
  32. Dickerson BC, "The cortical signature of Alzheimer’s disease : regionally specific cortical thinning relates to symptom severity in very mild to mild AD dementia and is detectable in asymptomatic amyloid-positive individuals", Cereb Cortex, 19, pp.497~510 (2009)
  33. Fox NC, "Presymptomatic hippocampal atrophy in Alzheimer’s disease. A longitudinal MRI study", Brain, 119, pp.2001~2007 (1996)
  34. Gerardin E, "Multidimensional classification of hippocampal shape features discriminates Alzheimer’s disease and mild cognitive impairment from normal aging", Neuroimage, 47, pp.1476~1486 (2009)
  35. Lee S, "Magnetic resonance imaging texture predicts progression to dementia due to Alzheimer disease earlier than hippocampal volume", J Psychiatry Neurosci, 45, pp.7~14 (2020)
  36. Bocchetta M, "The use of biomarkers for the etiologic diagnosis of MCI in Europe : an EADC survey", Alzheimers Dement, 11, pp.195~206 (2015)
  37. Tjoa E, "A survey on explainable artificial intelligence(XAI) : toward medical XAI", IEEE Trans Neural Netw Learn Syst, 32, pp.4793~4813 (2020)

이 간행물의 다른 논문 (12건)

Problematic Use of Internet Among Indonesia University Students: Psychometric Evaluation of Bergen Social Media Addiction Scale and Internet Gaming Disorder Scale-Short FormYung-Ning Yang, Yan-Li Siaw, Wan Ying Gan, Serene En Hui Tung, Siti R. Nadhiroh, Iqbal Pramukti, Chung-Ying Lin, Mark D. Griffiths, Ira Nurmala, Amir H. Pakpourpp. 1103-1111Comparative Safety of Long-Acting Injectable Antipsychotics: A Systematic Review and Network Meta-AnalysisSandra Sabrina Rojo-Garza, Erasmo Saucedo Uribe, Samuel Enrique Olivares Mundo, Raul Ricardo Medrano Garza, Fernando Diaz Gonzalez-Colmenero, Lorena Martinez Sanchez, Cesar Bigran Espinosa Cantu, Martin Moreno Arellano, Yessica Yaneth Herrera Montemayor, Patricia Lizeth Castillo Morales, Samantha Berenice Medrano Juarezpp. 1112-1125Association Between Executive Dysfunction-Related Activities of Daily Living Disability and Clinical Dementia Rating Domain Patterns in Patients With Vascular Dementia and Age-Matched Patients With Alzheimer’s DementiaByoung Sun Jun, Hyun Ju Yang, Kyung Min Kim, 박준혁pp. 1126-1132Effectiveness of a Community-Based Intensive Case Management Model on Reducing Hospitalization for People With Severe Mental Illness in SeoulEun Soo Kim, Hwo Yeon Seo, Seung Yeon Lee, Sung Joon Cho, Hyun Kim, 박지은, Jee Hoon Sohn, Yoomi Park, Bong Jin Hahm, Hae Woo Leepp. 1133-1141Evaluation of Asymmetric Dimethylarginine, Malondialdehyde, and Vitamin Levels of Borderline Personality Disorder Patients With and Without Self-MutilationSelda Telo, Sema Baykarapp. 1142-1147