Longitudinal biomedical studies monitor individuals over time to capture dynamics in brain development, disease progression, and treatment effects. However, estimating trajectories of brain biomarkers is challenging due to biological variability, inconsistencies in measurement protocols (e.g., differences in MRI scanners) as well as scarcity and irregularity in longitudinal measurements. Herein, we introduce a novel personalized deep kernel regression framework for forecasting brain biomarkers, with application to regional volumetric measurements. Our approach integrates two key components: a population model that captures brain trajectories from a large and diverse cohort, and a subject-specific model that captures individual trajectories. To optimally combine these, we propose Adaptive Shrinkage Estimation, which effectively balances population and subject-specific models. We assess our model’s performance through predictive accuracy metrics, uncertainty quantification, and validation against external clinical studies. Benchmarking against state-of-the-art statistical and machine learning models—including linear mixed effects models, generalized additive models, and deep learning methods—demonstrates the superior predictive performance of our approach. Additionally, we apply our method to predict trajectories of composite neuroimaging biomarkers, which highlights the versatility of our approach in modeling the progression of longitudinal neuroimaging biomarkers. Furthermore, validation on three external neuroimaging studies confirms the robustness of our method across different clinical contexts. We make the code available at https://github.com/vatass/AdaptiveShrinkageDKGP.

We introduce a novel conformal prediction framework for constructing conformal prediction bands with high probability around biomarker trajectories observed at subject-specific, randomly-timed follow-up visits. Existing conformal methods typically assume fixed time grids, limiting their applicability in longitudinal clinical studies. Our approach addresses this limitation by defining a time-varying nonconformity score that normalizes prediction errors using model-derived uncertainty estimates, enabling conformal inference at arbitrary time points. We evaluate our method on two well-established brain biomarkers—hippocampal and ventricular volume—using a range of standard and state-of-the-art predictors. Across models, our conformalized predictors consistently achieve nominal coverage with tighter prediction intervals compared to baseline uncertainty estimates. To further account for population heterogeneity, we develop group-conditional conformal bands with formal coverage guarantees across clinically relevant and high-risk subgroups. Finally, we demonstrate the clinical utility of our approach in identifying subjects at risk of progression to Alzheimer’s disease. We introduce an uncertainty-aware progression metric based on the lower conformal bound and show that it enables the identification of 17.5\% more high-risk subjects compared to standard slope-based methods, highlighting the value of uncertainty calibration in real-world clinical decision making. We make the code available at \href{https://github.com/vatass/ConformalBiomarkerTrajectories}{\texttt{github.com/vatass/ConformalBiomarkerTrajectories}}.

Dimension reduction tools preserving similarity and graph structure such as t-SNE and UMAP can capture complex biological patterns in high-dimensional data. However, these tools typically are not designed to separate effects of interest from unwanted effects due to confounders. We introduce the partial embedding (PARE) framework, which enables removal of confounders from any distance-based dimension reduction method. We then develop partial t-SNE and partial UMAP and apply these methods to genomic and neuroimaging data. For lower-dimensional visualization, our results show that the PARE framework can remove batch effects in single-cell sequencing data as well as separate clinical and technical variability in neuroimaging measures. We demonstrate that the PARE framework extends dimension reduction methods to highlight biological patterns of interest while effectively removing confounding effects.

OBJECTIVE: The objective was to develop a fully automated algorithm for abdominal fat segmentation and to deploy this method at scale in an academic biobank. MATERIALS AND METHODS: We built a fully automated image curation and labeling technique using deep learning and distributive computing to identify subcutaneous and visceral abdominal fat compartments from 52,844 computed tomography scans in 13,502 patients in the Penn Medicine Biobank (PMBB). A classification network identified the inferior and superior borders of the abdomen, and a segmentation network differentiated visceral and subcutaneous fat. Following technical evaluation of our method, we conducted studies to validate known relationships with visceral and subcutaneous fat. RESULTS: When compared with 100 manually annotated cases, the classification network was on average within one 5-mm slice for both the superior (0.4 ± 1.1 slice) and inferior (0.4 ± 0.6 slice) borders. The segmentation network also demonstrated excellent performance with intraclass correlation coefficients of 1.00 (P < 2 × 10-16) for subcutaneous and 1.00 (P < 2 × 10-16) for visceral fat on 100 testing cases. We performed integrative analyses of abdominal fat with the phenome extracted from the electronic health record and found highly significant associations with diabetes mellitus, hypertension, and renal failure, among other phenotypes. CONCLUSIONS: This work presents a fully automated and highly accurate method for the quantification of abdominal fat that can be applied to routine clinical imaging studies to fuel translational scientific discovery.