A Deep Learning Model to Predict a Diagnosis of Alzheimer Disease by Using F-FDG PET of the Brain.

Journal: Radiology
Published Date: Nov 6, 2018

Abstract

Purpose To develop and validate a deep learning algorithm that predicts the final diagnosis of Alzheimer disease (AD), mild cognitive impairment, or neither at fluorine 18 (F) fluorodeoxyglucose (FDG) PET of the brain and compare its performance to that of radiologic readers. Materials and Methods Prospective F-FDG PET brain images from the Alzheimer's Disease Neuroimaging Initiative (ADNI) (2109 imaging studies from 2005 to 2017, 1002 patients) and retrospective independent test set (40 imaging studies from 2006 to 2016, 40 patients) were collected. Final clinical diagnosis at follow-up was recorded. Convolutional neural network of InceptionV3 architecture was trained on 90% of ADNI data set and tested on the remaining 10%, as well as the independent test set, with performance compared to radiologic readers. Model was analyzed with sensitivity, specificity, receiver operating characteristic (ROC), saliency map, and t-distributed stochastic neighbor embedding. Results The algorithm achieved area under the ROC curve of 0.98 (95% confidence interval: 0.94, 1.00) when evaluated on predicting the final clinical diagnosis of AD in the independent test set (82% specificity at 100% sensitivity), an average of 75.8 months prior to the final diagnosis, which in ROC space outperformed reader performance (57% [four of seven] sensitivity, 91% [30 of 33] specificity; P < .05). Saliency map demonstrated attention to known areas of interest but with focus on the entire brain. Conclusion By using fluorine 18 fluorodeoxyglucose PET of the brain, a deep learning algorithm developed for early prediction of Alzheimer disease achieved 82% specificity at 100% sensitivity, an average of 75.8 months prior to the final diagnosis. © RSNA, 2018 Online supplemental material is available for this article. See also the editorial by Larvie in this issue.

Authors

  • Yiming Ding
    From the Department of Radiology and Biomedical Imaging (Y.D., J.H.S., H.T., R.H., N.W.J., T.P.C., M.S.A., C.M.A., S.C.B., R.R.F., S.Y.H., Y.S., R.A.H., M.H.P., B.L.F.) and Institute for Computational Health Sciences (J.H.S., M.G.K., H.T., D.L., K.A.Z., D.H.), University of California, San Francisco, 550 Parnassus Ave, San Francisco, CA 94143; Department of Electrical Engineering and Computer Sciences, University of California, Berkeley, Berkeley, Calif (Y.D.); and Department of Radiology, University of California, Davis, Sacramento, Calif (L.N.).
  • Jae Ho Sohn
    Radiology & Biomedical Imaging, UCSF Medical Center, 505 Parnassus Ave, San Francisco, CA, 94158, USA. sohn87@gmail.com.
  • Michael G Kawczynski
    From the Department of Radiology and Biomedical Imaging (Y.D., J.H.S., H.T., R.H., N.W.J., T.P.C., M.S.A., C.M.A., S.C.B., R.R.F., S.Y.H., Y.S., R.A.H., M.H.P., B.L.F.) and Institute for Computational Health Sciences (J.H.S., M.G.K., H.T., D.L., K.A.Z., D.H.), University of California, San Francisco, 550 Parnassus Ave, San Francisco, CA 94143; Department of Electrical Engineering and Computer Sciences, University of California, Berkeley, Berkeley, Calif (Y.D.); and Department of Radiology, University of California, Davis, Sacramento, Calif (L.N.).
  • Hari Trivedi
    Department of Radiology, Medical College of Georgia at Augusta University, 1120 15th St, Augusta, GA 30912 (Y.T.); and Department of Radiology, Emory University, Atlanta, Ga (B.V., E.K., A.P., J.G., N.S., H.T.).
  • Roy Harnish
    From the Department of Radiology and Biomedical Imaging (Y.D., J.H.S., H.T., R.H., N.W.J., T.P.C., M.S.A., C.M.A., S.C.B., R.R.F., S.Y.H., Y.S., R.A.H., M.H.P., B.L.F.) and Institute for Computational Health Sciences (J.H.S., M.G.K., H.T., D.L., K.A.Z., D.H.), University of California, San Francisco, 550 Parnassus Ave, San Francisco, CA 94143; Department of Electrical Engineering and Computer Sciences, University of California, Berkeley, Berkeley, Calif (Y.D.); and Department of Radiology, University of California, Davis, Sacramento, Calif (L.N.).
  • Nathaniel W Jenkins
    From the Department of Radiology and Biomedical Imaging (Y.D., J.H.S., H.T., R.H., N.W.J., T.P.C., M.S.A., C.M.A., S.C.B., R.R.F., S.Y.H., Y.S., R.A.H., M.H.P., B.L.F.) and Institute for Computational Health Sciences (J.H.S., M.G.K., H.T., D.L., K.A.Z., D.H.), University of California, San Francisco, 550 Parnassus Ave, San Francisco, CA 94143; Department of Electrical Engineering and Computer Sciences, University of California, Berkeley, Berkeley, Calif (Y.D.); and Department of Radiology, University of California, Davis, Sacramento, Calif (L.N.).
  • Dmytro Lituiev
    From the Department of Radiology and Biomedical Imaging (Y.D., J.H.S., H.T., R.H., N.W.J., T.P.C., M.S.A., C.M.A., S.C.B., R.R.F., S.Y.H., Y.S., R.A.H., M.H.P., B.L.F.) and Institute for Computational Health Sciences (J.H.S., M.G.K., H.T., D.L., K.A.Z., D.H.), University of California, San Francisco, 550 Parnassus Ave, San Francisco, CA 94143; Department of Electrical Engineering and Computer Sciences, University of California, Berkeley, Berkeley, Calif (Y.D.); and Department of Radiology, University of California, Davis, Sacramento, Calif (L.N.).
  • Timothy P Copeland
    From the Department of Radiology and Biomedical Imaging (Y.D., J.H.S., H.T., R.H., N.W.J., T.P.C., M.S.A., C.M.A., S.C.B., R.R.F., S.Y.H., Y.S., R.A.H., M.H.P., B.L.F.) and Institute for Computational Health Sciences (J.H.S., M.G.K., H.T., D.L., K.A.Z., D.H.), University of California, San Francisco, 550 Parnassus Ave, San Francisco, CA 94143; Department of Electrical Engineering and Computer Sciences, University of California, Berkeley, Berkeley, Calif (Y.D.); and Department of Radiology, University of California, Davis, Sacramento, Calif (L.N.).
  • Mariam S Aboian
    From the Department of Radiology and Biomedical Imaging (Y.D., J.H.S., H.T., R.H., N.W.J., T.P.C., M.S.A., C.M.A., S.C.B., R.R.F., S.Y.H., Y.S., R.A.H., M.H.P., B.L.F.) and Institute for Computational Health Sciences (J.H.S., M.G.K., H.T., D.L., K.A.Z., D.H.), University of California, San Francisco, 550 Parnassus Ave, San Francisco, CA 94143; Department of Electrical Engineering and Computer Sciences, University of California, Berkeley, Berkeley, Calif (Y.D.); and Department of Radiology, University of California, Davis, Sacramento, Calif (L.N.).
  • Carina Mari Aparici
    From the Department of Radiology and Biomedical Imaging (Y.D., J.H.S., H.T., R.H., N.W.J., T.P.C., M.S.A., C.M.A., S.C.B., R.R.F., S.Y.H., Y.S., R.A.H., M.H.P., B.L.F.) and Institute for Computational Health Sciences (J.H.S., M.G.K., H.T., D.L., K.A.Z., D.H.), University of California, San Francisco, 550 Parnassus Ave, San Francisco, CA 94143; Department of Electrical Engineering and Computer Sciences, University of California, Berkeley, Berkeley, Calif (Y.D.); and Department of Radiology, University of California, Davis, Sacramento, Calif (L.N.).
  • Spencer C Behr
    From the Department of Radiology and Biomedical Imaging (Y.D., J.H.S., H.T., R.H., N.W.J., T.P.C., M.S.A., C.M.A., S.C.B., R.R.F., S.Y.H., Y.S., R.A.H., M.H.P., B.L.F.) and Institute for Computational Health Sciences (J.H.S., M.G.K., H.T., D.L., K.A.Z., D.H.), University of California, San Francisco, 550 Parnassus Ave, San Francisco, CA 94143; Department of Electrical Engineering and Computer Sciences, University of California, Berkeley, Berkeley, Calif (Y.D.); and Department of Radiology, University of California, Davis, Sacramento, Calif (L.N.).
  • Robert R Flavell
    From the Department of Radiology and Biomedical Imaging (Y.D., J.H.S., H.T., R.H., N.W.J., T.P.C., M.S.A., C.M.A., S.C.B., R.R.F., S.Y.H., Y.S., R.A.H., M.H.P., B.L.F.) and Institute for Computational Health Sciences (J.H.S., M.G.K., H.T., D.L., K.A.Z., D.H.), University of California, San Francisco, 550 Parnassus Ave, San Francisco, CA 94143; Department of Electrical Engineering and Computer Sciences, University of California, Berkeley, Berkeley, Calif (Y.D.); and Department of Radiology, University of California, Davis, Sacramento, Calif (L.N.).
  • Shih-Ying Huang
    From the Department of Radiology and Biomedical Imaging (Y.D., J.H.S., H.T., R.H., N.W.J., T.P.C., M.S.A., C.M.A., S.C.B., R.R.F., S.Y.H., Y.S., R.A.H., M.H.P., B.L.F.) and Institute for Computational Health Sciences (J.H.S., M.G.K., H.T., D.L., K.A.Z., D.H.), University of California, San Francisco, 550 Parnassus Ave, San Francisco, CA 94143; Department of Electrical Engineering and Computer Sciences, University of California, Berkeley, Berkeley, Calif (Y.D.); and Department of Radiology, University of California, Davis, Sacramento, Calif (L.N.).
  • Kelly A Zalocusky
    From the Department of Radiology and Biomedical Imaging (Y.D., J.H.S., H.T., R.H., N.W.J., T.P.C., M.S.A., C.M.A., S.C.B., R.R.F., S.Y.H., Y.S., R.A.H., M.H.P., B.L.F.) and Institute for Computational Health Sciences (J.H.S., M.G.K., H.T., D.L., K.A.Z., D.H.), University of California, San Francisco, 550 Parnassus Ave, San Francisco, CA 94143; Department of Electrical Engineering and Computer Sciences, University of California, Berkeley, Berkeley, Calif (Y.D.); and Department of Radiology, University of California, Davis, Sacramento, Calif (L.N.).
  • Lorenzo Nardo
    From the Department of Radiology and Biomedical Imaging (Y.D., J.H.S., H.T., R.H., N.W.J., T.P.C., M.S.A., C.M.A., S.C.B., R.R.F., S.Y.H., Y.S., R.A.H., M.H.P., B.L.F.) and Institute for Computational Health Sciences (J.H.S., M.G.K., H.T., D.L., K.A.Z., D.H.), University of California, San Francisco, 550 Parnassus Ave, San Francisco, CA 94143; Department of Electrical Engineering and Computer Sciences, University of California, Berkeley, Berkeley, Calif (Y.D.); and Department of Radiology, University of California, Davis, Sacramento, Calif (L.N.).
  • Youngho Seo
    Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, California.
  • Randall A Hawkins
    From the Department of Radiology and Biomedical Imaging (Y.D., J.H.S., H.T., R.H., N.W.J., T.P.C., M.S.A., C.M.A., S.C.B., R.R.F., S.Y.H., Y.S., R.A.H., M.H.P., B.L.F.) and Institute for Computational Health Sciences (J.H.S., M.G.K., H.T., D.L., K.A.Z., D.H.), University of California, San Francisco, 550 Parnassus Ave, San Francisco, CA 94143; Department of Electrical Engineering and Computer Sciences, University of California, Berkeley, Berkeley, Calif (Y.D.); and Department of Radiology, University of California, Davis, Sacramento, Calif (L.N.).
  • Miguel Hernandez Pampaloni
    From the Department of Radiology and Biomedical Imaging (Y.D., J.H.S., H.T., R.H., N.W.J., T.P.C., M.S.A., C.M.A., S.C.B., R.R.F., S.Y.H., Y.S., R.A.H., M.H.P., B.L.F.) and Institute for Computational Health Sciences (J.H.S., M.G.K., H.T., D.L., K.A.Z., D.H.), University of California, San Francisco, 550 Parnassus Ave, San Francisco, CA 94143; Department of Electrical Engineering and Computer Sciences, University of California, Berkeley, Berkeley, Calif (Y.D.); and Department of Radiology, University of California, Davis, Sacramento, Calif (L.N.).
  • Dexter Hadley
    Institute for Computational Health Sciences, University of California, San Francisco.
  • Benjamin L Franc
    From the Department of Radiology and Biomedical Imaging (Y.D., J.H.S., H.T., R.H., N.W.J., T.P.C., M.S.A., C.M.A., S.C.B., R.R.F., S.Y.H., Y.S., R.A.H., M.H.P., B.L.F.) and Institute for Computational Health Sciences (J.H.S., M.G.K., H.T., D.L., K.A.Z., D.H.), University of California, San Francisco, 550 Parnassus Ave, San Francisco, CA 94143; Department of Electrical Engineering and Computer Sciences, University of California, Berkeley, Berkeley, Calif (Y.D.); and Department of Radiology, University of California, Davis, Sacramento, Calif (L.N.).

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