Region-informed machine learning model for choroid plexus segmentation in Alzheimer’s disease

IntroductionThe choroid plexus (CP), a critical structure for cerebrospinal fluid (CSF) production, has been increasingly recognized for its involvement in Alzheimer’s disease (AD). Accurate segmentation of CP from magnetic resonance imaging (MRI) remains challenging due to its irregular shape, vari...

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Main Authors: Liangdong Zhou, Tracy A. Butler, Xiuyuan H. Wang, Samantha A. Keil, Seyed Hani Hojjati, Tsung-Wei Hu, Mélissa Savard, Firoza Z. Lussier, Pedro Rosa-Neto, Lidia Glodzik, Mony J. de Leon, Gloria C. Chiang, Yi Li
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Language:English
Published: Frontiers Media S.A. 2025-07-01
Series:Frontiers in Aging Neuroscience
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Online Access:https://www.frontiersin.org/articles/10.3389/fnagi.2025.1613320/full
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author Liangdong Zhou
Tracy A. Butler
Xiuyuan H. Wang
Samantha A. Keil
Seyed Hani Hojjati
Tsung-Wei Hu
Mélissa Savard
Firoza Z. Lussier
Pedro Rosa-Neto
Lidia Glodzik
Mony J. de Leon
Gloria C. Chiang
Yi Li
author_facet Liangdong Zhou
Tracy A. Butler
Xiuyuan H. Wang
Samantha A. Keil
Seyed Hani Hojjati
Tsung-Wei Hu
Mélissa Savard
Firoza Z. Lussier
Pedro Rosa-Neto
Lidia Glodzik
Mony J. de Leon
Gloria C. Chiang
Yi Li
author_sort Liangdong Zhou
collection DOAJ
description IntroductionThe choroid plexus (CP), a critical structure for cerebrospinal fluid (CSF) production, has been increasingly recognized for its involvement in Alzheimer’s disease (AD). Accurate segmentation of CP from magnetic resonance imaging (MRI) remains challenging due to its irregular shape, variable MR signal, and proximity to the lateral ventricles. This study aimed to develop and evaluate a region-informed Gaussian Mixture Model (One-GMM) for automatic CP segmentation using anatomical priors derived from FreeSurfer (FS) software and compare it with manual, FS, and one previous GMM-based (Two-GMM) methods.Materials and methodsT1-weighted (T1w) and T2-fluid-attenuated inversion recovery (FLAIR) MRI scans were acquired from 38 participants [19 cognitively normal (CN)], 11 with mild cognitive impairment (MCI), and 8 with AD. Manual segmentations served as ground truth. A GMM was applied within an anatomically constrained region combining the lateral ventricles and CP derived from FS reconstruction. The segmentation accuracy was assessed using the dice similarity coefficient (DSC), the 95th percentile Hausdorff distance (HD95), and volume difference percentage (VD%). Results were compared with those from FS and one previous GMM method-based segmentations across diagnostic groups.ResultsThe region-informed One-GMM achieved significantly higher accuracy compared to FS and Two-GMM, with a mean DSC of 0.82 ± 0.05 for One-GMM versus 0.24 ± 0.11 for FS (p  <  0.001), and 0.66 ± 0.10 for Two-GMM (p < 0.001), lower HD95 (One-GMM: 6.06 ± 10.32 mm vs. FS: 26.21 ± 7.32 mm vs. Two-GMM: 10.58 ± 6.47 mm), and comparable volume difference (One-GMM: 20.97 ± 9.53% vs. FS: 24.32 ± 28.13% vs. Two-GMM: 24.27 ± 22.10, p = 0.87). Segmentation accuracy of our proposed method was consistent across all diagnostic groups. Clinical analysis showed that there is no diagnostic group difference in CP volume obtained from manual, FS, Two-GMM, and our proposed One-GMM methods. In the whole cohort, there are also no age and sex effects of CP volume with all methods. Restricting to the CN group, CP volume from both manual (p = 0.03), Two-GMM (p < 0.01) and the proposed One-GMM (p = 0.05), methods show an aging effect, but not for the FS segmented CP volume (p = 0.22).ConclusionA region-informed One-GMM method significantly improved CP segmentation accuracy over FS, providing a practical and accessible tool for CP quantification in AD and other research studies. Within this small cohort, no diagnostic group difference in CP volume was observed. An aging effect of CP volume was found within the CN group.
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spelling doaj-art-c47e21cd1e1e4705a3bbe20a1c671ed52025-08-20T03:25:59ZengFrontiers Media S.A.Frontiers in Aging Neuroscience1663-43652025-07-011710.3389/fnagi.2025.16133201613320Region-informed machine learning model for choroid plexus segmentation in Alzheimer’s diseaseLiangdong Zhou0Tracy A. Butler1Xiuyuan H. Wang2Samantha A. Keil3Seyed Hani Hojjati4Tsung-Wei Hu5Mélissa Savard6Firoza Z. Lussier7Pedro Rosa-Neto8Lidia Glodzik9Mony J. de Leon10Gloria C. Chiang11Yi Li12Department of Radiology, Brain Health Imaging Institute, Weill Cornell Medicine, New York, NY, United StatesDepartment of Radiology, Brain Health Imaging Institute, Weill Cornell Medicine, New York, NY, United StatesDepartment of Radiology, Brain Health Imaging Institute, Weill Cornell Medicine, New York, NY, United StatesDepartment of Radiology, Brain Health Imaging Institute, Weill Cornell Medicine, New York, NY, United StatesDepartment of Radiology, Brain Health Imaging Institute, Weill Cornell Medicine, New York, NY, United StatesDepartment of Radiology, Brain Health Imaging Institute, Weill Cornell Medicine, New York, NY, United StatesDouglas Hospital Research Centre, Douglas Mental Health University Institute, Montreal, QC, CanadaDepartment of Psychiatry, University of Pittsburgh, Pittsburgh, PA, United StatesDepartments of Neurology and Neurosurgery and Psychiatry, McGill University, Montreal, QC, CanadaDepartment of Radiology, Brain Health Imaging Institute, Weill Cornell Medicine, New York, NY, United StatesDepartment of Radiology, Brain Health Imaging Institute, Weill Cornell Medicine, New York, NY, United StatesDepartment of Radiology, Brain Health Imaging Institute, Weill Cornell Medicine, New York, NY, United StatesDepartment of Radiology, Brain Health Imaging Institute, Weill Cornell Medicine, New York, NY, United StatesIntroductionThe choroid plexus (CP), a critical structure for cerebrospinal fluid (CSF) production, has been increasingly recognized for its involvement in Alzheimer’s disease (AD). Accurate segmentation of CP from magnetic resonance imaging (MRI) remains challenging due to its irregular shape, variable MR signal, and proximity to the lateral ventricles. This study aimed to develop and evaluate a region-informed Gaussian Mixture Model (One-GMM) for automatic CP segmentation using anatomical priors derived from FreeSurfer (FS) software and compare it with manual, FS, and one previous GMM-based (Two-GMM) methods.Materials and methodsT1-weighted (T1w) and T2-fluid-attenuated inversion recovery (FLAIR) MRI scans were acquired from 38 participants [19 cognitively normal (CN)], 11 with mild cognitive impairment (MCI), and 8 with AD. Manual segmentations served as ground truth. A GMM was applied within an anatomically constrained region combining the lateral ventricles and CP derived from FS reconstruction. The segmentation accuracy was assessed using the dice similarity coefficient (DSC), the 95th percentile Hausdorff distance (HD95), and volume difference percentage (VD%). Results were compared with those from FS and one previous GMM method-based segmentations across diagnostic groups.ResultsThe region-informed One-GMM achieved significantly higher accuracy compared to FS and Two-GMM, with a mean DSC of 0.82 ± 0.05 for One-GMM versus 0.24 ± 0.11 for FS (p  <  0.001), and 0.66 ± 0.10 for Two-GMM (p < 0.001), lower HD95 (One-GMM: 6.06 ± 10.32 mm vs. FS: 26.21 ± 7.32 mm vs. Two-GMM: 10.58 ± 6.47 mm), and comparable volume difference (One-GMM: 20.97 ± 9.53% vs. FS: 24.32 ± 28.13% vs. Two-GMM: 24.27 ± 22.10, p = 0.87). Segmentation accuracy of our proposed method was consistent across all diagnostic groups. Clinical analysis showed that there is no diagnostic group difference in CP volume obtained from manual, FS, Two-GMM, and our proposed One-GMM methods. In the whole cohort, there are also no age and sex effects of CP volume with all methods. Restricting to the CN group, CP volume from both manual (p = 0.03), Two-GMM (p < 0.01) and the proposed One-GMM (p = 0.05), methods show an aging effect, but not for the FS segmented CP volume (p = 0.22).ConclusionA region-informed One-GMM method significantly improved CP segmentation accuracy over FS, providing a practical and accessible tool for CP quantification in AD and other research studies. Within this small cohort, no diagnostic group difference in CP volume was observed. An aging effect of CP volume was found within the CN group.https://www.frontiersin.org/articles/10.3389/fnagi.2025.1613320/fullchoroid plexusAlzheimer’s diseasecerebrospinal fluidneurofluidsbrain clearanceGaussian mixture model
spellingShingle Liangdong Zhou
Tracy A. Butler
Xiuyuan H. Wang
Samantha A. Keil
Seyed Hani Hojjati
Tsung-Wei Hu
Mélissa Savard
Firoza Z. Lussier
Pedro Rosa-Neto
Lidia Glodzik
Mony J. de Leon
Gloria C. Chiang
Yi Li
Region-informed machine learning model for choroid plexus segmentation in Alzheimer’s disease
Frontiers in Aging Neuroscience
choroid plexus
Alzheimer’s disease
cerebrospinal fluid
neurofluids
brain clearance
Gaussian mixture model
title Region-informed machine learning model for choroid plexus segmentation in Alzheimer’s disease
title_full Region-informed machine learning model for choroid plexus segmentation in Alzheimer’s disease
title_fullStr Region-informed machine learning model for choroid plexus segmentation in Alzheimer’s disease
title_full_unstemmed Region-informed machine learning model for choroid plexus segmentation in Alzheimer’s disease
title_short Region-informed machine learning model for choroid plexus segmentation in Alzheimer’s disease
title_sort region informed machine learning model for choroid plexus segmentation in alzheimer s disease
topic choroid plexus
Alzheimer’s disease
cerebrospinal fluid
neurofluids
brain clearance
Gaussian mixture model
url https://www.frontiersin.org/articles/10.3389/fnagi.2025.1613320/full
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