MedTransformer: Accurate AD Diagnosis for 3D MRI Images through 2D Vision Transformers

Automated diagnosis of AD in brain images is becoming a clinically important technique to support precision and efficient diagnosis and treatment planning. A few efforts have been made to automatically diagnose AD in magnetic resonance imaging (MRI) using three-dimensional CNNs. However, due to the complexity of 3D models, the performance is still unsatisfactory, both in terms of accuracy and efficiency. To overcome the complexities of 3D images and 3D models, in this study, we aim to attack this problem with 2D vision Transformers. We propose a 2D transformer-based medical image model with various transformer attention encoders to diagnose AD in 3D MRI images, by cutting the 3D images into multiple 2D slices.The model consists of four main components: shared encoders across three dimensions, dimension-specific encoders, attention across images from the same dimension, and attention across three dimensions. It is used to obtain attention relationships among multiple sequences from different dimensions (axial, coronal, and sagittal) and multiple slices. We also propose morphology augmentation, an erosion and dilation based method to increase the structural difference between AD and normal images. In this experiment, we use multiple datasets from ADNI, AIBL, MIRAID, OASIS to show the performance of our model. Our proposed MedTransformer demonstrates a strong ability in diagnosing AD. These results demonstrate the effectiveness of MedTransformer in learning from 3D data using a much smaller model and its capability to generalize among different medical tasks, which provides a possibility to help doctors diagnose AD in a simpler way.