Diagnostically relevant facial gestalt information from ordinary photos

Craniofacial characteristics are highly informative for clinical geneticists when diagnosing genetic diseases. As a first step towards the high-throughput diagnosis of ultra-rare developmental diseases we introduce an automatic approach that implements recent developments in computer vision. This algorithm extracts phenotypic information from ordinary non-clinical photographs and, using machine learning, models human facial dysmorphisms in a multidimensional 'Clinical Face Phenotype Space'. The space locates patients in the context of known syndromes and thereby facilitates the generation of diagnostic hypotheses. Consequently, the approach will aid clinicians by greatly narrowing (by 27.6-fold) the search space of potential diagnoses for patients with suspected developmental disorders. Furthermore, this Clinical Face Phenotype Space allows the clustering of patients by phenotype even when no known syndrome diagnosis exists, thereby aiding disease identification. We demonstrate that this approach provides a novel method for inferring causative genetic variants from clinical sequencing data through functional genetic pathway comparisons. DOI:http://dx.doi.org/10.7554/eLife.02020.001

[1]  王林,et al.  Orphanet , 2011 .

[2]  Ravi Iyengar,et al.  Mutation of SHOC2 promotes aberrant protein N-myristoylation and causes Noonan-like syndrome with loose anagen hair , 2009 .

[3]  M. Daly,et al.  Proteins Encoded in Genomic Regions Associated with Immune-Mediated Disease Physically Interact and Suggest Underlying Biology , 2011, PLoS genetics.

[4]  B. V. van Bon,et al.  Diagnostic exome sequencing in persons with severe intellectual disability. , 2012, The New England journal of medicine.

[5]  Robin J. Hennessy,et al.  Three-Dimensional Laser Surface Imaging and Geometric Morphometrics Resolve Frontonasal Dysmorphology in Schizophrenia , 2007, Biological Psychiatry.

[6]  J. Waddington,et al.  Facial shape and asymmetry by three-dimensional laser surface scanning covary with cognition in a sexually dimorphic manner. , 2006, The Journal of neuropsychiatry and clinical neurosciences.

[7]  M. Zenker Genetic and Pathogenetic Aspects of Noonan Syndrome and Related Disorders , 2009, Hormone Research in Paediatrics.

[8]  D. Siegel,et al.  Dermatological findings in 61 mutation‐positive individuals with cardiofaciocutaneous syndrome , 2011, The British journal of dermatology.

[9]  Andrew Zisserman,et al.  Taking the bite out of automated naming of characters in TV video , 2009, Image Vis. Comput..

[10]  Claudio Carta,et al.  Diversity, parental germline origin, and phenotypic spectrum of de novo HRAS missense changes in Costello syndrome , 2007, Human mutation.

[11]  S. Ekvall,et al.  Noonan and cardio-facio-cutaneous syndromes: two clinically and genetically overlapping disorders , 2008, Journal of Medical Genetics.

[12]  L. Peruzzi,et al.  Presenting phenotype and clinical evaluation in a cohort of 22 Williams-Beuren syndrome patients. , 2007, European journal of medical genetics.

[13]  S. Knight,et al.  Reduced dosage of ERF causes complex craniosynostosis in humans and mice and links ERK1/2 signaling to regulation of osteogenesis , 2013, Nature Genetics.

[14]  Peter Hammond,et al.  Facial Dysmorphism Across the Fetal Alcohol Spectrum , 2013, Pediatrics.

[15]  Volker Blanz,et al.  Face recognition based on a 3D morphable model , 2006, 7th International Conference on Automatic Face and Gesture Recognition (FGR06).

[16]  D. Horn,et al.  Mutation and phenotypic spectrum in patients with cardio‐facio‐cutaneous and Costello syndrome , 2007, Clinical genetics.

[17]  Mathieu Bastian,et al.  Gephi: An Open Source Software for Exploring and Manipulating Networks , 2009, ICWSM.

[18]  P. Hammond,et al.  Large‐scale objective phenotyping of 3D facial morphology , 2012, Human mutation.

[19]  A. Karmiloff-Smith,et al.  Discriminating power of localized three-dimensional facial morphology. , 2005, American journal of human genetics.

[20]  M. Tartaglia,et al.  Craniosynostosis in patients with Noonan syndrome caused by germline KRAS mutations , 2009, American journal of medical genetics. Part A.

[21]  K. Jones,et al.  Further delineation of the phenotype resulting from BRAF or MEK1 germline mutations helps differentiate cardio‐facio‐cutaneous syndrome from Costello syndrome , 2007, American journal of medical genetics. Part A.

[22]  R. Hopper,et al.  Normalizing Facial Ratios in Apert Syndrome Patients with Le Fort II Midface Distraction and Simultaneous Zygomatic Repositioning , 2013, Plastic and reconstructive surgery.

[23]  M. Oti,et al.  The modular nature of genetic diseases , 2006, Clinical genetics.

[24]  Edsger W. Dijkstra,et al.  A note on two problems in connexion with graphs , 1959, Numerische Mathematik.

[25]  K. Rauen HRAS and the Costello syndrome , 2007, Clinical genetics.

[26]  Jan O. Korbel,et al.  Phenotypic impact of genomic structural variation: insights from and for human disease , 2013, Nature Reviews Genetics.

[27]  W. Kruskal,et al.  Use of Ranks in One-Criterion Variance Analysis , 1952 .

[28]  Leslie G Biesecker,et al.  Next‐generation sequencing demands next‐generation phenotyping , 2012, Human mutation.

[29]  Martin A. Fischler,et al.  The Representation and Matching of Pictorial Structures , 1973, IEEE Transactions on Computers.

[30]  M. Tauber,et al.  Isolated Lymphocytic Infiltration of Pituitary Stalk Preceding the Diagnosis of Germinoma in 2 Prepubertal Children Treated with Growth Hormone , 2009, Hormone Research in Paediatrics.

[31]  P. Claes,et al.  The Facial Evolution: Looking Backward and Moving Forward , 2013, Human mutation.

[32]  Timothy F. Cootes,et al.  Active Appearance Models , 1998, ECCV.

[33]  Kilian Q. Weinberger,et al.  Distance Metric Learning for Large Margin Nearest Neighbor Classification , 2005, NIPS.

[34]  K. Rauen Distinguishing Costello versus cardio‐facio‐cutaneous syndrome: BRAF mutations in patients with a Costello phenotype , 2006, American journal of medical genetics. Part A.

[35]  Christoph von der Malsburg,et al.  Computer-based recognition of dysmorphic faces , 2003, European Journal of Human Genetics.

[36]  Y. Makita,et al.  Leukemia in Cardio-facio-cutaneous (CFC) Syndrome: A Patient With a Germline Mutation in BRAF Proto-oncogene , 2007, Journal of pediatric hematology/oncology.

[37]  Leo Goodstadt,et al.  Ruffus: a lightweight Python library for computational pipelines , 2010, Bioinform..

[38]  J. Sotos Abraham Lincoln's marfanoid mother: the earliest known case of multiple endocrine neoplasia type 2B? , 2012, Clinical dysmorphology.

[39]  Rolf P Wurtz,et al.  Automated syndrome detection in a set of clinical facial photographs , 2011, American journal of medical genetics. Part A.

[40]  Tobias Vollmar,et al.  Syndrome identification based on 2D analysis software , 2006, European Journal of Human Genetics.

[41]  C. Bonferroni Il calcolo delle assicurazioni su gruppi di teste , 1935 .

[42]  Kenny Q. Ye,et al.  An integrated map of genetic variation from 1,092 human genomes , 2012, Nature.

[43]  A. Gordon Abraham Lincoln--a medical appraisal. , 1962, The Journal of the Kentucky Medical Association.

[44]  K. Rauen,et al.  Noonan, Costello and cardio–facio–cutaneous syndromes: dysregulation of the Ras–MAPK pathway , 2008, Expert Reviews in Molecular Medicine.

[45]  Fred L Bookstein,et al.  A three-dimensional morphometric study of craniofacial shape in schizophrenia. , 2005, The American journal of psychiatry.

[46]  H B Newcombe,et al.  Genetic disorders in children and young adults: a population study. , 1988, American journal of human genetics.

[47]  L. Vissers,et al.  Recurrent de novo mutations in PACS1 cause defective cranial-neural-crest migration and define a recognizable intellectual-disability syndrome. , 2012, American journal of human genetics.

[48]  B. Kerr,et al.  RAS-MAPK pathway disorders: important causes of congenital heart disease, feeding difficulties, developmental delay and short stature , 2010, Archives of Disease in Childhood.

[49]  D. Horn,et al.  The face of Noonan syndrome: Does phenotype predict genotype , 2010, American journal of medical genetics. Part A.

[50]  T C Hart,et al.  Genetic studies of craniofacial anomalies: clinical implications and applications. , 2009, Orthodontics & craniofacial research.

[51]  O. Gabrielli,et al.  SOS1 Mutations in Noonan Syndrome: Molecular Spectrum, Structural Insights on Pathogenic Effects, and Genotype–Phenotype Correlations , 2011, Human mutation.

[52]  David J. Kriegman,et al.  Localizing Parts of Faces Using a Consensus of Exemplars , 2011, IEEE Transactions on Pattern Analysis and Machine Intelligence.

[53]  Paul A. Viola,et al.  Rapid object detection using a boosted cascade of simple features , 2001, Proceedings of the 2001 IEEE Computer Society Conference on Computer Vision and Pattern Recognition. CVPR 2001.

[54]  Ashwin B. Dalal,et al.  Morphometric analysis of face in dysmorphology , 2007, Comput. Methods Programs Biomed..

[55]  K. Hirschhorn,et al.  A History of Medical Genetics in Pediatrics , 2004, Pediatric Research.

[56]  Tobias Vollmar,et al.  Impact of geometry and viewing angle on classification accuracy of 2D based analysis of dysmorphic faces. , 2008, European journal of medical genetics.

[57]  Peter Hammond,et al.  The use of 3D face shape modelling in dysmorphology , 2007, Archives of Disease in Childhood.

[58]  Saskia B Wortmann,et al.  Mitochondrial dysfunction and organic aciduria in five patients carrying mutations in the Ras-MAPK pathway , 2011, European Journal of Human Genetics.

[59]  J. Opitz,et al.  The cardiofaciocutaneous syndrome , 2006, Journal of Medical Genetics.

[60]  J. Krieger,et al.  Further evidence of genetic heterogeneity in Costello syndrome: involvement of the KRAS gene , 2007, Journal of Human Genetics.

[61]  Andrew Zisserman,et al.  Fisher Vector Faces in the Wild , 2013, BMVC.

[62]  Jing Xiao,et al.  Multi-View AAM Fitting and Construction , 2008, International Journal of Computer Vision.

[63]  Ye Duan,et al.  Facial phenotypes in subgroups of prepubertal boys with autism spectrum disorders are correlated with clinical phenotypes , 2011, Molecular autism.