Medical Image Analysis in Quantitative Analysis of Motivation Data in R Task View

Case Studies fMRI DTI PET Brandon Whitcher

Opportunities Mango Solutions End London, United Kingdom www.mango-solutions.com [email protected] @MangoImaging

24 November 2011 – Neuroimaging and Statistics Medical Image Analysis in R Outline

Motivation

Task View

Case Studies 1 Motivation fMRI DTI PET 2 Medical Imaging Task View Opportunities

End 3 Case Studies Functional MRI Diffusion Tensor Imaging Positron Emission Tomography

4 Opportunities

5 Conclusions Medical Image Analysis in R The Drug Development Process

Motivation

Task View

Case Studies fMRI DTI PET

Opportunities

End • New drug development can take from 10-20 years with an estimated average of about 9-12 years. • The best estimate of the costs of drug R&D today is likely to be that from the most recently available well-designed study; that is, USD 802 million.

Dickson & Gagnon (2009; Discovery Medicine) Medical Image Analysis in R Medical Image Analysis for Drug Development

Motivation • Quantitative image analysis and statistical inference. Task View • Application development, validation and deployment. Case Studies fMRI • Translational imaging: pre-clinical and clinical studies. DTI PET • Work with clinical scientists to determine suitable Opportunities imaging biomarkers. End • Work with medical physicists to determine appropriate image acquisition guidelines.

Three stages of a clinical imaging study.

• Setup • Operations • Analysis Medical Image Analysis in R The R Project for Statistical Computing

Motivation • R is a free environment for statistical Task View computing and graphics. Case Studies • R compiles and runs on a wide variety of UNIX fMRI DTI platforms, Windows and MacOS. PET

Opportunities • Package development places the burden on the

End developer, not the user. How do you analyze your data?

• Free / . • The best tool for the job. • Write it yourself.

Programming environments?

• Matlab ITK Python IDL R C++ Fortran C# Medical Image Analysis in R Medical Imaging Task View

Motivation • Operational for 3+ years now Task View • 15 packages Case Studies fMRI • 3 projects DTI PET • Modalities = EEG, MRI, PET and data formats Opportunities

End Volume 44 of the Journal of Statistical Software Special volume on “Magnetic Resonance Imaging in R” • 13 articles on structural fMRI, fMRI, DTI, DCE-MRI, connectivity, etc. • www.jstatsoft.org/v44

• New packages are always welcome! Medical Image Analysis in R Outline

Motivation

Task View

Case Studies 1 Motivation fMRI DTI PET 2 Medical Imaging Task View Opportunities

End 3 Case Studies Functional MRI Diffusion Tensor Imaging Positron Emission Tomography

4 Opportunities

5 Conclusions Medical Image Analysis in R Functional MRI: Example

Motivation

Task View

Case Studies fMRI DTI PET

Opportunities

End

Junior et al. (2009; J Epilepsy Clin Neurophysiol) Medical Image Analysis in R Functional MRI: fmri example

Motivation

Task View

Case Studies fMRI Package fmri using different DTI PET smoothing methods Opportunities (corrected p-value = 0.05). End • a) No smoothing • b) Gaussian smoothing • c) Structural adaptive smoothing and Random Field Theory • d) Structural adaptive segmentation

Tabelow et al. (2011; NeuroImage) Medical Image Analysis in R Functional MRI: Software

Motivation

Task View The Big Guns

Case Studies fMRI • DTI FMRIB Software Library (FSL) [license?] PET • Statistical Parametric Mapping (SPM) [GPL ≥ 2] Opportunities

End • Analysis of Functional NeuroImages (AFNI) [GPL ≥ 2]

Medical Imaging Task View

• AnalyzeFMRI • arf • cudaBayesreg • fmri • neuroim Medical Image Analysis in R Outline

Motivation

Task View

Case Studies 1 Motivation fMRI DTI PET 2 Medical Imaging Task View Opportunities

End 3 Case Studies Functional MRI Diffusion Tensor Imaging Positron Emission Tomography

4 Opportunities

5 Conclusions Medical Image Analysis in R Diffusion Tensor Imaging: Example

Motivation

Task View

Case Studies fMRI DTI PET

Opportunities

End

Polzehl and Tabelow (forthcoming) Medical Image Analysis in R Tractography: Example

Motivation

Task View

Case Studies fMRI DTI PET STR CG Opportunities SLF End CC SFO

CST ILF MCP

ML CPT

Polzehl and Tabelow (forthcoming) Medical Image Analysis in R Diffusion Tensor Imaging: Software

Motivation The Medium-Sized Guns Task View

Case Studies fMRI • FMRIB Software Library (FSL) [license?] DTI PET • SPM Extension(s) Opportunities • AFNI plugin? End • Camino Diffusion MRI Toolkit [license?] • DTIStudio [license?] • (please do not be offended if your software is not listed)

Medical Imaging Task View

• dti • tractor.base (part of TractoR project) Medical Image Analysis in R Outline

Motivation

Task View

Case Studies 1 Motivation fMRI DTI PET 2 Medical Imaging Task View Opportunities

End 3 Case Studies Functional MRI Diffusion Tensor Imaging Positron Emission Tomography

4 Opportunities

5 Conclusions Medical Image Analysis in R Compartmental Models in PET

Motivation

Task View

Case Studies fMRI DTI PET

Opportunities

End Medical Image Analysis in R FDG-PET

Motivation The Sokoloff Deoxyglucose Model Task View Case Studies [glucose] K1k3 [glucose] fMRI CMRglu = × = × Ki DTI LC k2 + k3 LC PET

Opportunities End • [glucose] = circulating glucose level (µmoles/ml) • LC = “lump constant”

The lumped constant (Sokoloff et al. 1977) accounts for the differences in transport and phosphorylation rates between D-glucose and 2-fluoro-2-deoxy-D-glucose. Medical Image Analysis in R FDG-PET & Dementia

Motivation

Task View

Case Studies fMRI DTI PET

Opportunities

End

Figure 2. FDG PET images showing patterns of metabolic activity that are characteristic of patients with Alzheimer’s disease, Pick’s disease (fronto-temporal dementia) and elderly individuals with no dementia. Red, high FDG uptake, Blue, low FDG uptake.

Miller (2004; Radiology Rounds) Medical Image Analysis in R FDG-PET vs. [11C]PiB-PET

Motivation

Task View

Case Studies fMRI DTI PET

Opportunities

End

Patel (2011; Presentation) Medical Image Analysis in R Positron Emission Tomography: Software

Motivation Where is my gun? Task View

Case Studies fMRI • Statistical Parametric Mapping (SPM) DTI PET • PMOD (http://www.pmod.com) [proprietary] Opportunities

End Medical Imaging Task View

• PET (reconstruction only) • oro.pet (not yet released) Medical Image Analysis in R Image Analysis

Motivation • Pre-processing Task View • (Non)Linear Registration (RNiftyReg) Case Studies fMRI • Segmentation, Normalization DTI PET Opportunities Third-Party Libraries? End • Insight Segmentation and Registration Toolkit (ITK) • Visualization Toolkit (VTK) • NiftyReg

R Gurus wanted to help create RITK package

• SimpleITK is a new C++ layer on top of ITK • If interested, please contact me! Medical Image Analysis in R Data Formats

Motivation Task View • R packages that access DICOM / ANALYZE / NIfTI Case Studies • AnalyzeFMRI fMRI DTI • fmri PET • oro., oro.nifti Opportunities • Rniftilib End • tractor.base

Question #1 What are the (dis)advantages to having a single that performs input / output for medical imaging data?

Question #2 Should R packages be discouraged from writing output in formats other than ANALYZE or NIfTI? Medical Image Analysis in R Summary

Motivation • Open-source / public-domain software and data sets

Task View are key to incrementally improving the quality of the

Case Studies methodology and implementation of algorithms applied fMRI to (pre-)clinical studies. DTI PET • Clinical research Opportunities • Drug development End • Medical image analysis benefits from statisticians and physicists working together. • Signal processing & Image processing • Group-level analysis & Statistical inference • Genetics + Neuroimaging • New methodology versus basic functionality • Intended audience? • Purpose of the software? • Please consider R for future research and software development. Medical Image Analysis in R

Motivation Task View I would like to thank Case Studies fMRI • R-core team, CRAN, R-Forge, R-community, ... DTI PET • Current members of the Medical Imaging Task View Opportunities • Future members of the Medical Imaging Task View End • My collaborators

Thank-you