Anatomical Grounding and Leakage-Aware Multimodal Contrastive Learning for Alzheimer's Disease Classification from Structural MRI
Study of label leakage and anatomical grounding in multimodal MRI models for Alzheimer's staging shows cognitive-score fusion accuracy of 87.3% is leakage-driven.
The authors train a ResNet18 slice-based encoder with a one-layer Transformer on 1,075 ADNI-1 T1 MRI scans, using FastSurfer segmentations and YOLOv8 localization (mAP_50 above 0.96) as anatomical reference. Grad-CAM shows the image-only classifier often attends to skull and background rather than disease-relevant structures. A CLIP-style image-tabular contrastive framework organized along a label-leakage spectrum yields 87.3% three-way accuracy with cognitive scores versus 73.0% with regional volumes, and cropping to the medial temporal lobe raises image-only accuracy from 58.7% to 65.1%. Results come from single runs on a small balanced test set with reported confidence intervals.
- Cognitive-score fusion accuracy of 87.3% treated as label-leakage upper bound, not imaging signal
- Contrastive target choice shifts image-only MCI-vs-CN accuracy between 52.4% and 73.8%
- Grad-CAM reveals classifiers attending to skull, orbits, and background regions
- Medial temporal lobe cropping improves image-only three-way accuracy from 58.7% to 65.1%
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Deep networks trained on structural MRI for Alzheimer's disease (AD) staging often reach reasonable accuracy while attending to anatomically irrelevant regions, and multimodal models that add clinical tables frequently rely on variables that were used to assign the diagnostic label in the first place. We study both issues with a deliberately lightweight slice-based encoder (ResNet18 with a one-layer Transformer over slices) on 1,075 baseline T1-weighted scans from ADNI-1. First, we use FastSurfer segmentations as an anatomical reference: YOLOv8 models trained on segmentation-derived labels localize Alzheimer-relevant structures with mAP_50 above 0.96, and a Grad-CAM comparison shows that the image-only classifier frequently attends to the skull, orbits and background. Second, we adapt a CLIP-style image - tabular contrastive framework and organize ADNIMERGE variables along a label-leakage spectrum. Fusion with cognitive scores yields 87.3% three-way accuracy, which we treat as a leakage-driven upper bound rather than an imaging result; fusion with regional volumes yields 73.0%. We observe that the choice of contrastive target changes what the image encoder learns: on MCI vs. CN, the image-only head reaches 52.4% when the encoder is aligned to cognitive scores and 73.8\% when aligned to volumes, although no tabular input is used at inference. Third, restricting the input to a per-subject crop of the medial temporal lobe raises image-only three-way accuracy from 58.7% to 65.1%. All results come from single runs on a small balanced test set, and we report confidence intervals and the protocol differences that prevent direct comparison with published numbers.
Text extracted automatically; images, tables and formatting may be missing. Original: https://arxiv.org/abs/2609.15888