Korean Journal of Radiology

  • 제23권1호
  • /
  • Pages.89-100
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  • 2022
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  • 1229-6929(pISSN)
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  • 2005-8330(eISSN)
대한영상의학회 (The Korean Society of Radiology)
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Prediction of Cognitive Progression in Individuals with Mild Cognitive Impairment Using Radiomics as an Improvement of the ATN System: A Five-Year Follow-Up Study

  • Rao Song (Department of Radiology, the Second Affiliated Hospital of Chongqing Medical University) ;
  • Xiaojia Wu (Department of Radiology, the Second Affiliated Hospital of Chongqing Medical University) ;
  • Huan Liu (GE Healthcare) ;
  • Dajing Guo (Department of Radiology, the Second Affiliated Hospital of Chongqing Medical University) ;
  • Lin Tang (Department of Radiology, the Second Affiliated Hospital of Chongqing Medical University) ;
  • Wei Zhang (Department of Radiology, the Second Affiliated Hospital of Chongqing Medical University) ;
  • Junbang Feng (Department of Radiology, Chongqing Emergency Medical Center) ;
  • Chuanming Li (Department of Radiology, the Second Affiliated Hospital of Chongqing Medical University)
  • 투고 : 2021.04.21
  • 심사 : 2021.08.24
  • 발행 : 2022.01.01
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초록

Objective: To improve the N biomarker in the amyloid/tau/neurodegeneration system by radiomics and study its value for predicting cognitive progression in individuals with mild cognitive impairment (MCI). Materials and Methods: A group of 147 healthy controls (HCs) (72 male; mean age ± standard deviation, 73.7 ± 6.3 years), 197 patients with MCI (114 male; 72.2 ± 7.1 years), and 128 patients with Alzheimer's disease (AD) (74 male; 73.7 ± 8.4 years) were included. Optimal A, T, and N biomarkers for discriminating HC and AD were selected using receiver operating characteristic (ROC) curve analysis. A radiomics model containing comprehensive information of the whole cerebral cortex and deep nuclei was established to create a new N biomarker. Cerebrospinal fluid (CSF) biomarkers were evaluated to determine the optimal A or T biomarkers. All MCI patients were followed up until AD conversion or for at least 60 months. The predictive value of A, T, and the radiomics-based N biomarker for cognitive progression of MCI to AD were analyzed using Kaplan-Meier estimates and the log-rank test. Results: The radiomics-based N biomarker showed an ROC curve area of 0.998 for discriminating between AD and HC. CSF Aβ42 and p-tau proteins were identified as the optimal A and T biomarkers, respectively. For MCI patients on the Alzheimer's continuum, isolated A+ was an indicator of cognitive stability, while abnormalities of T and N, separately or simultaneously, indicated a high risk of progression. For MCI patients with suspected non-Alzheimer's disease pathophysiology, isolated T+ indicated cognitive stability, while the appearance of the radiomics-based N+ indicated a high risk of progression to AD. Conclusion: We proposed a new radiomics-based improved N biomarker that could help identify patients with MCI who are at a higher risk for cognitive progression. In addition, we clarified the value of a single A/T/N biomarker for predicting the cognitive progression of MCI.

키워드

과제정보

We are grateful for the research volunteers, their families, and the investigators at the Alzheimer's Disease Neuroimaging Initiative (ADNI) database. ADNI is funded by the National Institute on Aging, the National Institute of Biomedical Imaging and Bioengineering, and through generous contributions from the following: AbbVie, Alzheimer's Association; Alzheimer's Drug Discovery Foundation; Araclon Biotech; BioClinica, Inc.; Biogen; Bristol Myers Squibb Company; CereSpir, Inc.; Cogstate; Eisai Inc.; Elan Pharmaceuticals, Inc.; Eli Lilly and Company; EuroImmun; F. Hoffmann-La Roche Ltd. and its affiliated company Genentech, Inc.; Fujirebio; GE Healthcare; IXICO Ltd.; Janssen Alzheimer Immunotherapy Research & Development, LLC.; Johnson & Johnson Pharmaceutical Research & Development LLC.; Lumosity; Lundbeck; Merck & Co., Inc.; Meso Scale Diagnostics, LLC.; NeuroRx Research; Neurotrack Technologies; Novartis Pharmaceuticals Corporation; Pfizer Inc.; Piramal Imaging; Servier; Takeda Pharmaceutical Company; and Transition Therapeutics. The Canadian Institutes of Health Research is providing funds to support ADNI clinical sites in Canada. Private sector contributions are facilitated by the Foundation for the National Institutes of Health(www.fnih.org). The grantee organization is the Northern California Institute for Research and Education, and the study is coordinated by the Alzheimer's Therapeutic Research Institute at the University of Southern California. ADNI data are disseminated by the Laboratory for Neuro Imaging at the University of Southern California. The authors thank the application engineers Ying Pei and Huan Liu at GE Medical Systems Corporation for their assistance with MR image postprocessing; and to American Journal Experts (AJE) for their assistance with language editing.

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