Sanjay Kalra

Rafsanjany Kushol, Collin C. Luk, Avyarthana Dey et al.

Amyotrophic Lateral Sclerosis (ALS) is a complex neurodegenerative disorder involving motor neuron degeneration. Significant research has begun to establish brain magnetic resonance imaging (MRI) as a potential biomarker to diagnose and monitor the state of the disease. Deep learning has turned into a prominent class of machine learning programs in computer vision and has been successfully employed to solve diverse medical image analysis tasks. However, deep learning-based methods applied to neuroimaging have not achieved superior performance in ALS patients classification from healthy controls due to having insignificant structural changes correlated with pathological features. Therefore, the critical challenge in deep models is to determine useful discriminative features with limited training data. By exploiting the long-range relationship of image features, this study introduces a framework named SF2Former that leverages vision transformer architecture's power to distinguish the ALS subjects from the control group. To further improve the network's performance, spatial and frequency domain information are combined because MRI scans are captured in the frequency domain before being converted to the spatial domain. The proposed framework is trained with a set of consecutive coronal 2D slices, which uses the pre-trained weights on ImageNet by leveraging transfer learning. Finally, a majority voting scheme has been employed to those coronal slices of a particular subject to produce the final classification decision. Our proposed architecture has been thoroughly assessed with multi-modal neuroimaging data using two well-organized versions of the Canadian ALS Neuroimaging Consortium (CALSNIC) multi-center datasets. The experimental results demonstrate the superiority of our proposed strategy in terms of classification accuracy compared with several popular deep learning-based techniques.

Christian Marius Lillelund, Sanjay Kalra, Russell Greiner

Amyotrophic lateral sclerosis (ALS) is a degenerative disorder of the motor neurons that causes progressive paralysis in patients. Current treatment options aim to prolong survival and improve quality of life. However, due to the heterogeneity of the disease, it is often difficult to determine the optimal time for potential therapies or medical interventions. In this study, we propose a novel method to predict the time until a patient with ALS experiences significant functional impairment (ALSFRS-R <= 2) for each of five common functions: speaking, swallowing, handwriting, walking, and breathing. We formulate this task as a multi-event survival problem and validate our approach in the PRO-ACT dataset (N = 3220) by training five covariate-based survival models to estimate the probability of each event over the 500 days following the baseline visit. We then predict five event-specific individual survival distributions (ISDs) for a patient, each providing an interpretable estimate of when that event is likely to occur. The results show that covariate-based models are superior to the Kaplan-Meier estimator at predicting time-to-event outcomes in the PRO-ACT dataset. Additionally, our method enables practitioners to make individual counterfactual predictions -- where certain covariates can be changed -- to estimate their effect on the predicted outcome. In this regard, we find that Riluzole has little or no impact on predicted functional decline. However, for patients with bulbar-onset ALS, our model predicts significantly shorter time-to-event estimates for loss of speech and swallowing function compared to patients with limb-onset ALS (log-rank p<0.001, Bonferroni-adjusted alpha=0.01). The proposed method can be applied to current clinical examination data to assess the risk of functional decline and thus allow more personalized treatment planning.

G M Mashrur E Elahi, Sanjay Kalra, Yee-Hong Yang

Texture analysis is a well-known research topic in computer vision and image processing and has many applications. Gradient-based texture methods have become popular in classification problems. For the first time we extend a well-known gradient-based method, Co-occurrence Histograms of Oriented Gradients (CoHOG) to extract texture features from 2D Magnetic Resonance Images (MRI). Unlike the original CoHOG method, we use the whole image instead of sub-regions for feature calculation. Also, we use a larger neighborhood size. Gradient orientations of the image pixels are calculated using Sobel, Gaussian Derivative (GD) and Local Frequency Descriptor Gradient (LFDG) operators. The extracted feature vector size is very large and classification using a large number of similar features does not provide the best results. In our proposed method, for the first time to our best knowledge, only a minimum number of significant features are selected using area under the receiver operator characteristic (ROC) curve (AUC) thresholds with <= 0.01. In this paper, we apply the proposed method to classify Amyotrophic Lateral Sclerosis (ALS) patients from the controls. It is observed that selected texture features from downsampled images are significantly different between patients and controls. These features are used in a linear support vector machine (SVM) classifier to determine the classification accuracy. Optimal sensitivity and specificity are also calculated. Three different cohort datasets are used in the experiments. The performance of the proposed method using three gradient operators and two different neighborhood sizes is analyzed. Region based analysis is performed to demonstrate that significant changes between patients and controls are limited to the motor cortex.