Segmentation of magnetic resonance images for assessing neonatal brain maturation

In this thesis, we aim to investigate the correlation between myelination and the gestational age for preterm infants, with the former being an important developmental process during human brain maturation. Quantification of myelin requires dedicated imaging, but the conventional magnetic resonance images routinely acquired during clinical imaging of neonates carry signatures that are thought to be associated with myelination. This thesis thus focuses on structural segmentation and spatio-temporal modelling of the so-called myelin-like signals on T2-weighted scans for early prognostic evaluation of the preterm brain. The segmentation part poses the major challenges of this task: insufficient spatial prior information of myelination and the presence of substantial partial volume voxels in clinical data. Specific spatial priors for the developing brain are obtained from either probabilistic atlases or manually annotated training images, but none of them currently include myelin as an individual tissue type. This causes further difficulties in partial volume estimation which depends on the probabilistic atlases of the composing pure tissues. Our key contribution is the development of an expectation-maximisation framework that incorporates an explicit partial volume class whose locations are configured in relation to the composing pure tissues in a predefined region of interest via second-order Markov random fields. This approach resolves the above challenges without requiring any probabilistic atlas of myelin. We also investigate atlas-based whole brain segmentation that generates the binary mask for the region of interest. We then construct a spatio-temporal growth model for myelin-like signals using logistic regression based on the automatic segmentations of 114 preterm infants aged between 29 and 44 gestational weeks. Lastly, we demonstrate the ability of age estimation using the normal growth model in a leave-one-out procedure.