Alzheimer's Disease (AD) is a progressive disease preceded by Mild Cognitive Impairment (MCI). Early detection of AD is crucial for making treatment decisions. However, most of the literature on computer-assisted detection of AD focuses on classifying brain images into one of three major categories: healthy, MCI, and AD; or categorizing MCI patients into (1) progressive: those who progress from MCI to AD at a future examination time, and (2) stable: those who stay as MCI and never progress to AD. This misses the opportunity to accurately identify the trajectory of progressive MCI patients. In this paper, we revisit the brain image classification task for AD identification and re-frame it as an ordinal classification task to predict how close a patient is to the severe AD stage. To this end, we select progressive MCI patients from the Alzheimer's Disease Neuroimaging Initiative (ADNI) dataset and construct an ordinal dataset with a prediction target that indicates the time to progression to AD. We train a Siamese network model to predict the time to onset of AD based on MRI brain images. We also propose a Weighted variety of Siamese network and compare its performance to a baseline model. Our evaluations show that incorporating a weighting factor to Siamese networks brings considerable performance gain at predicting how close input brain MRI images are to progressing to AD. Moreover, we complement our results with an interpretation of the learned embedding space of the Siamese networks using a model explainability technique.
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