Multi-task learning for the automatic grading of enlarged perivascular space burden using MRI

Enlarged perivascular spaces (PVS) visible in brain magnetic resonance imaging (MRI) are increasingly thought to be linked to poor brain health. PVS are elongated structures of less than 3 mm in diameter and can be numerous. To reflect the incidence of PVS, radiologists visually score their burden following a clinical grading scale - a task that would benefit from automation to accelerate analyses and overcome the influence of inter-observer differences. We developed and evaluated methods for training machine learning models to score PVS incidence in the basal ganglia (BG) and centrum semiovale (CSO) leveraging the Potters/Wardlaw scale. The novelty in our work lies in the use of imperfect, semi-automatically generated "silver-standard" PVS segmentation masks during training, in addition to PVS radiological scores. We comparatively evaluated a conditional convolutional neural network (CNN) which accepts PVS masks as an extra input channel, a multi-task CNN which performs both PVS segmentation and scoring, and a logistic regression model which utilises features derived from PVS masks to predict PVS scores. Multi-task learning was the most effective method, achieving a mean average precision of 64.08% compared to 60.22% for the conditional CNN, 52.11% for a baseline CNN trained only to predict PVS scores, and 49.32% for the logistic regression model. The multi-task model showed an ability to localise individual PVS not shown by the other CNNs, and behaved in a probabilistically sensible way, predicting with lower confidence on inherently harder classes. Age, sex, hypertension status, white matter hyperintensity volume, and ischaemic stroke lesion status were shown to be associated with the multi-task model's PVS score predictions and the ground truth in a similar way.