The challenge: Alzheimer’s disease is a major national issue

The increasing health costs and lost productivity from neurodegenerative diseases such as Alzheimer’s disease (AD), exacerbated by the ageing population, is a major National problem estimated to be $5.6b in 2002, including $3.2b in direct health costs (Access Economics 2005). The population >65 is expected to increase from 13% to 30% by 2040, with 54,000 new AD cases estimated in 2006 alone (of 210,000 new dementias and with 730,000 anticipated by 2040; CEDA). Delaying onset of the major dementia (i.e. AD) by 5 years could reduce new cases by 50% with cumulative health cost savings of up to $13.5 billion by 2020 (Access Economics 2005 estimation).

The causes of dementia are not well understood and current diagnosis is difficult because there are as yet no known biological markers. The relatively advanced loss of cognitive function necessary for current clinical diagnosis of dementia generally results in irreversible neuronal dysfunction. If objective evidence of AD pathological lesions could be found early (before cognitive or behavioural symptoms), appropriate treatment and care could be provided, resulting in delayed onset or prevention of AD.

The Biomedical Informatics Group the Australian e-Health Research Centre (AEHRC) in Brisbane is developing key technologies for in vivo quantitative assessment of Tau and Amyloid-b (Ab) deposition suspected to be an early marker of AD. We are collaborating with AIBL, the Australian Imaging Biomarker and Lifestyle study, and the CRC for Mental Health. The AIBL cohort includes more than 1000 participants comprising healthy volunteers, patients with mild cognitive impairment, and patients suffering from mild Alzheimer’s disease. All those patients with undergo psychocognitive evaluation, blood exams, lifestyle assessment, and imaging. Imaging includes Positron Emission Tomography (PET), and Magnetic Resonance Imaging (MRI).

Magnetic Resonance Imaging includes contrasts for anatomical characterization (T1W, PDW, T2W), structural integrity of the white matter (DWI), and pathological imaging (FLAIR, SWI). Patients will be scanned at the Brain Research Institute and the Austin Health PET Centre in Melbourne, as well as the Royal Perth Hospital. PET imaging includes markers for glucose metabolism FDG, Amyloid and Tau imaging.

Our response: MilxCloud, an online platform for PET/MR quantification

We have developed technologies to predict and monitor neurodegenerative diseases from imaging data. Through our cloud computing platform MilxCloud, MRI and PET scans can be uploaded and processed on our server to generate imaging biomarkers such as cortical thickness or Amyloid load, and clinical friendly reports with Z-Score maps that allow comparison of subjects with a reference healthy population.

The results

MilxCloud is used as the reference quantification method for both MRI and PET in all studies involving AIBL subjects.

The cloud computing platform is being used by 30 labs from 10 different countries, and 3000 images have been analysed using MilxCloud.

Nine brain scans with different colours in differing sections of the brain

Multimodality imaging provides complementary information. From left to right three subjects: healthy, with mild cognitive impairment, and with Alzheimer’s. The three lines show three views of MRI superimposed with Amyloid PET scans.