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Bilgic B, Costagli M, Chan KS, Duyn J, Langkammer C, Lee J, Li X, Liu C, Marques JP, Milovic C, Robinson SD, Schweser F, Shmueli K, Spincemaille P, Straub S, van Zijl P, Wang Y. Recommended implementation of quantitative susceptibility mapping for clinical research in the brain: A consensus of the ISMRM electro-magnetic tissue properties study group. Magn Reson Med 2024; 91:1834-1862. [PMID: 38247051 PMCID: PMC10950544 DOI: 10.1002/mrm.30006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Revised: 10/31/2023] [Accepted: 12/14/2023] [Indexed: 01/23/2024]
Abstract
This article provides recommendations for implementing QSM for clinical brain research. It is a consensus of the International Society of Magnetic Resonance in Medicine, Electro-Magnetic Tissue Properties Study Group. While QSM technical development continues to advance rapidly, the current QSM methods have been demonstrated to be repeatable and reproducible for generating quantitative tissue magnetic susceptibility maps in the brain. However, the many QSM approaches available have generated a need in the neuroimaging community for guidelines on implementation. This article outlines considerations and implementation recommendations for QSM data acquisition, processing, analysis, and publication. We recommend that data be acquired using a monopolar 3D multi-echo gradient echo (GRE) sequence and that phase images be saved and exported in Digital Imaging and Communications in Medicine (DICOM) format and unwrapped using an exact unwrapping approach. Multi-echo images should be combined before background field removal, and a brain mask created using a brain extraction tool with the incorporation of phase-quality-based masking. Background fields within the brain mask should be removed using a technique based on SHARP or PDF, and the optimization approach to dipole inversion should be employed with a sparsity-based regularization. Susceptibility values should be measured relative to a specified reference, including the common reference region of the whole brain as a region of interest in the analysis. The minimum acquisition and processing details required when reporting QSM results are also provided. These recommendations should facilitate clinical QSM research and promote harmonized data acquisition, analysis, and reporting.
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Affiliation(s)
- Berkin Bilgic
- Martinos Center for Biomedical Imaging, Massachusetts General Hospital and Harvard Medical School, Charlestown, Massachusetts, USA
| | - Mauro Costagli
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Sciences (DINOGMI), University of Genoa, Genoa, Italy
- Laboratory of Medical Physics and Magnetic Resonance, IRCCS Stella Maris, Pisa, Italy
| | - Kwok-Shing Chan
- Martinos Center for Biomedical Imaging, Massachusetts General Hospital and Harvard Medical School, Charlestown, Massachusetts, USA
- Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, The Netherlands
| | - Jeff Duyn
- Advanced MRI Section, NINDS, National Institutes of Health, Bethesda, Maryland, USA
| | | | - Jongho Lee
- Department of Electrical and Computer Engineering, Seoul National University, Seoul, Republic of Korea
| | - Xu Li
- Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
- F.M. Kirby Research Center for Functional Brain Imaging, Kennedy Krieger Institute, Baltimore, Maryland, USA
| | - Chunlei Liu
- Department of Electrical Engineering and Computer Sciences, University of California, Berkeley, California, USA
- Helen Wills Neuroscience Institute, University of California, Berkeley, California, USA
| | - José P Marques
- Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, The Netherlands
| | - Carlos Milovic
- School of Electrical Engineering (EIE), Pontificia Universidad Catolica de Valparaiso, Valparaiso, Chile
| | - Simon Daniel Robinson
- High Field MR Centre, Department of Biomedical Imaging and Image-Guided Therapy, Medical University of Vienna, Vienna, Austria
- Centre of Advanced Imaging, University of Queensland, Brisbane, Australia
| | - Ferdinand Schweser
- Buffalo Neuroimaging Analysis Center, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences at the University at Buffalo, Buffalo, New York, USA
- Center for Biomedical Imaging, Clinical and Translational Science Institute at the University at Buffalo, Buffalo, New York, USA
| | - Karin Shmueli
- Department of Medical Physics and Biomedical Engineering, University College London, London, UK
| | - Pascal Spincemaille
- MRI Research Institute, Department of Radiology, Weill Cornell Medicine, New York, New York, USA
| | - Sina Straub
- Department of Radiology, Mayo Clinic, Jacksonville, Florida, USA
| | - Peter van Zijl
- Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
- F.M. Kirby Research Center for Functional Brain Imaging, Kennedy Krieger Institute, Baltimore, Maryland, USA
| | - Yi Wang
- MRI Research Institute, Departments of Radiology and Biomedical Engineering, Cornell University, New York, New York, USA
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Storelli L, Pagani E, Pantano P, Piervincenzi C, Tedeschi G, Gallo A, De Stefano N, Battaglini M, Rocca MA, Filippi M. Methods for Brain Atrophy MR Quantification in Multiple Sclerosis: Application to the Multicenter INNI Dataset. J Magn Reson Imaging 2023; 58:1221-1231. [PMID: 36661195 DOI: 10.1002/jmri.28616] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Revised: 01/11/2023] [Accepted: 01/12/2023] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND Current therapeutic strategies in multiple sclerosis (MS) target neurodegeneration. However, the integration of atrophy measures into the clinical scenario is still an unmet need. PURPOSE To compare methods for whole-brain and gray matter (GM) atrophy measurements using the Italian Neuroimaging Network Initiative (INNI) dataset. STUDY TYPE Retrospective (data available from INNI). POPULATION A total of 466 patients with relapsing-remitting MS (mean age = 37.3 ± 10 years, 323 women) and 279 healthy controls (HC; mean age = 38.2 ± 13 years, 164 women). FIELD STRENGTH/SEQUENCE A 3.0-T, T1-weighted (spin echo and gradient echo without gadolinium injection) and T2-weighted spin echo scans at baseline and after 1 year (170 MS, 48 HC). ASSESSMENT Structural Image Evaluation using Normalization of Atrophy (SIENA-X/XL; version 5.0.9), Statistical Parametric Mapping (SPM-v12); and Jim-v8 (Xinapse Systems, Colchester, UK) software were applied to all subjects. STATISTICAL TESTS In MS and HC, we evaluated the intraclass correlation coefficient (ICC) among FSL-SIENA(XL), SPM-v12, and Jim-v8 for cross-sectional whole-brain and GM tissue volumes and their longitudinal changes, the effect size according to the Cohen's d at baseline and the sample size requirement for whole-brain and GM atrophy progression at different power levels (lowest = 0.7, 0.05 alpha level). False discovery rate (Benjamini-Hochberg procedure) correction was applied. A P value <0.05 was considered statistically significant. RESULTS SPM-v12 and Jim-v8 showed significant agreement for cross-sectional whole-brain (ICC = 0.93 for HC and ICC = 0.84 for MS) and GM volumes (ICC = 0.66 for HC and ICC = 0.90) and longitudinal assessment of GM atrophy (ICC = 0.35 for HC and ICC = 0.59 for MS), while no significant agreement was found in the comparisons between whole-brain and GM volumes for SIENA-X/XL and both SPM-v12 (P = 0.19 and P = 0.29, respectively) and Jim-v8 (P = 0.21 and P = 0.32, respectively). SPM-v12 and Jim-v8 showed the highest effect size for cross-sectional GM atrophy (Cohen's d = -0.63 and -0.61). Jim-v8 and SIENA(XL) showed the smallest sample size requirements for whole-brain (58) and GM atrophy (152), at 0.7 power level. DATA CONCLUSION The findings obtained in this study should be considered when selecting the appropriate brain atrophy pipeline for MS studies. EVIDENCE LEVEL 4. TECHNICAL EFFICACY Stage 1.
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Affiliation(s)
- Loredana Storelli
- Neuroimaging Research Unit, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Elisabetta Pagani
- Neuroimaging Research Unit, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Patrizia Pantano
- Department of Human Neurosciences, Sapienza University of Rome, Rome, Italy
- IRCCS NEUROMED, Pozzilli, Italy
| | | | - Gioacchino Tedeschi
- Department of Advanced Medical and Surgical Sciences, and 3T MRI-Center, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Antonio Gallo
- Department of Advanced Medical and Surgical Sciences, and 3T MRI-Center, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Nicola De Stefano
- Department of Medicine, Surgery and Neuroscience, University of Siena, Siena, Italy
| | - Marco Battaglini
- Department of Medicine, Surgery and Neuroscience, University of Siena, Siena, Italy
| | - Maria A Rocca
- Neuroimaging Research Unit, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy
- Neurology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
- Vita-Salute San Raffaele University, Milan, Italy
| | - Massimo Filippi
- Neuroimaging Research Unit, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy
- Neurology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
- Vita-Salute San Raffaele University, Milan, Italy
- Neurorehabilitation Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
- Neurophysiology Service, IRCCS San Raffaele Scientific Institute, Milan, Italy
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Li G, Tong R, Zhang M, Gillen KM, Jiang W, Du Y, Wang Y, Li J. Age-dependent changes in brain iron deposition and volume in deep gray matter nuclei using quantitative susceptibility mapping. Neuroimage 2023; 269:119923. [PMID: 36739101 DOI: 10.1016/j.neuroimage.2023.119923] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Revised: 01/10/2023] [Accepted: 02/01/2023] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Microstructural changes in deep gray matter (DGM) nuclei are related to physiological behavior, cognition, and memory. Therefore, it is critical to study age-dependent trajectories of biomarkers in DGM nuclei for understanding brain development and aging, as well as predicting cognitive or neurodegenerative diseases. OBJECTIVES We aimed to (1) characterize age-dependent trajectories of mean susceptibility, adjusted volume, and total iron content simultaneously in DGM nuclei using quantitative susceptibility mapping (QSM); (2) examine potential contributions of sex related effects to the different age-dependence trajectories of volume and iron deposition; and (3) evaluate the ability of brain age prediction by combining mean magnetic susceptibility and volume of DGM nuclei. METHODS Magnetic susceptibilities and volumetric values of DGM nuclei were obtained from 220 healthy participants (aged 10-70 years) scanned on a 3T MRI system. Regions of interest (ROIs) were drawn manually on the QSM images. Univariate regression analysis between age and each of the MRI measurements in a single ROI was performed. Pearson correlation coefficients were calculated between magnetic susceptibility and adjusted volume in a single ROI. The statistical significance of sex differences in age-dependent trajectories of magnetic susceptibilities and adjusted volumes were determined using one-way ANCOVA. Multiple regression analysis was used to evaluate the ability to estimate brain age using a combination of the mean susceptibilities and adjusted volumes in multiple DGM nuclei. RESULTS Mean susceptibility and total iron content increased linearly, quadratically, or exponentially with age in all six DGM nuclei. Negative linear correlation was observed between adjusted volume and age in the head of the caudate nucleus (CN; R2 = 0.196, p < 0.001). Quadratic relationships were found between adjusted volume and age in the putamen (PUT; R2 = 0.335, p < 0.001), globus pallidus (GP; R2 = 0.062, p = 0.001), and dentate nucleus (DN; R2 = 0.077, p < 0.001). Males had higher mean magnetic susceptibility than females in the PUT (p = 0.001), red nucleus (RN; p = 0.002), and substantia nigra (SN; p < 0.001). Adjusted volumes of the CN (p < 0.001), PUT (p = 0.030), GP (p = 0.007), SN (p = 0.021), and DN (p < 0.001) were higher in females than those in males throughout the entire age range (10-70 years old). The total iron content of females was higher than that of males in the CN (p < 0.001), but lower than that of males in the PUT (p = 0.014) and RN (p = 0.043) throughout the entire age range (10-70 years old). Multiple regression analyses revealed that the combination of the mean susceptibility value of the PUT, and the volumes of the CN and PUT had the strongest associations with brain age (R2 = 0.586). CONCLUSIONS QSM can be used to simultaneously investigate age- and sex- dependent changes in magnetic susceptibility and volume of DGM nuclei, thus enabling a comprehensive understanding of the developmental trajectories of iron accumulation and volume in DGM nuclei during brain development and aging.
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Affiliation(s)
- Gaiying Li
- Shanghai Key Laboratory of Magnetic Resonance, School of Physics and Electronic Science, East China Normal University, 3663 North Zhongshan Road, Shanghai, China 200062
| | - Rui Tong
- Shanghai Key Laboratory of Magnetic Resonance, School of Physics and Electronic Science, East China Normal University, 3663 North Zhongshan Road, Shanghai, China 200062
| | - Miao Zhang
- Shanghai Key Laboratory of Magnetic Resonance, School of Physics and Electronic Science, East China Normal University, 3663 North Zhongshan Road, Shanghai, China 200062
| | - Kelly M Gillen
- Department of Radiology, Weill Medical College of Cornell University, 407 East 61st St., New York, New York, United States 10065
| | - Wenqing Jiang
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, 600 South Wanping Road, Shanghai, China 200030
| | - Yasong Du
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, 600 South Wanping Road, Shanghai, China 200030
| | - Yi Wang
- Department of Radiology, Weill Medical College of Cornell University, 407 East 61st St., New York, New York, United States 10065
| | - Jianqi Li
- Shanghai Key Laboratory of Magnetic Resonance, School of Physics and Electronic Science, East China Normal University, 3663 North Zhongshan Road, Shanghai, China 200062; Institute of Brain and Education Innovation, East China Normal University, 3663 North Zhongshan Road, Shanghai, China 200062.
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Rothstein TL. Cortical Grey matter volume depletion links to neurological sequelae in post COVID-19 "long haulers". BMC Neurol 2023; 23:22. [PMID: 36647063 PMCID: PMC9843113 DOI: 10.1186/s12883-023-03049-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Accepted: 01/02/2023] [Indexed: 01/18/2023] Open
Abstract
OBJECTIVE COVID-19 (SARS-CoV-2) has been associated with neurological sequelae even in those patients with mild respiratory symptoms. Patients experiencing cognitive symptoms such as "brain fog" and other neurologic sequelae for 8 or more weeks define "long haulers". There is limited information regarding damage to grey matter (GM) structures occurring in COVID-19 "long haulers". Advanced imaging techniques can quantify brain volume depletions related to COVID-19 infection which is important as conventional Brain MRI often fails to identify disease correlates. 3-dimensional voxel-based morphometry (3D VBM) analyzes, segments and quantifies key brain volumes allowing comparisons between COVID-19 "long haulers" and normative data drawn from healthy controls, with values based on percentages of intracranial volume. METHODS This is a retrospective single center study which analyzed 24 consecutive COVID-19 infected patients with long term neurologic symptoms. Each patient underwent Brain MRI with 3D VBM at median time of 85 days following laboratory confirmation. All patients had relatively mild respiratory symptoms not requiring oxygen supplementation, hospitalization, or assisted ventilation. 3D VBM was obtained for whole brain and forebrain parenchyma, cortical grey matter (CGM), hippocampus, and thalamus. RESULTS The results demonstrate a statistically significant depletion of CGM volume in 24 COVID-19 infected patients. Reduced CGM volume likely influences their long term neurological sequelae and may impair post COVID-19 patient's quality of life and productivity. CONCLUSION This study contributes to understanding effects of COVID-19 infection on patient's neurocognitive and neurological function, with potential for producing serious long term personal and economic consequences, and ongoing challenges to public health systems.
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Affiliation(s)
- Ted L. Rothstein
- grid.253615.60000 0004 1936 9510Department of Neurology, George Washington University, Washington, DC USA
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Kim YS, Lee JH, Gahm JK. Automated Differentiation of Atypical Parkinsonian Syndromes Using Brain Iron Patterns in Susceptibility Weighted Imaging. Diagnostics (Basel) 2022; 12:diagnostics12030637. [PMID: 35328190 PMCID: PMC8946947 DOI: 10.3390/diagnostics12030637] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Revised: 02/23/2022] [Accepted: 03/02/2022] [Indexed: 12/10/2022] Open
Abstract
In recent studies, iron overload has been reported in atypical parkinsonian syndromes. The topographic patterns of iron distribution in deep brain nuclei vary by each subtype of parkinsonian syndrome, which is affected by underlying disease pathologies. In this study, we developed a novel framework that automatically analyzes the disease-specific patterns of iron accumulation using susceptibility weighted imaging (SWI). We constructed various machine learning models that can classify diseases using radiomic features extracted from SWI, representing distinctive iron distribution patterns for each disorder. Since radiomic features are sensitive to the region of interest, we used a combination of T1-weighted MRI and SWI to improve the segmentation of deep brain nuclei. Radiomics was applied to SWI from 34 patients with a parkinsonian variant of multiple system atrophy, 21 patients with cerebellar variant multiple system atrophy, 17 patients with progressive supranuclear palsy, and 56 patients with Parkinson’s disease. The machine learning classifiers that learn the radiomic features extracted from iron-reflected segmentation results produced an average area under receiver operating characteristic curve (AUC) of 0.8607 on the training data and 0.8489 on the testing data, which is superior to the conventional classifier with segmentation using only T1-weighted images. Our radiomic model based on the hybrid images is a promising tool for automatically differentiating atypical parkinsonian syndromes.
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Affiliation(s)
- Yun Soo Kim
- Department of Information Convergence Engineering, Pusan National University, Busan 46241, Korea;
| | - Jae-Hyeok Lee
- Department of Neurology, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, Yangsan 50612, Korea;
| | - Jin Kyu Gahm
- School of Computer Science and Engineering, Pusan National University, Busan 46241, Korea
- Correspondence: ; Tel.: +82-51-510-2292
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Age-related changes in multiple sclerosis and experimental autoimmune encephalomyelitis. Semin Immunol 2022; 59:101631. [PMID: 35752572 DOI: 10.1016/j.smim.2022.101631] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Revised: 06/03/2022] [Accepted: 06/13/2022] [Indexed: 01/15/2023]
Abstract
A better understanding of the pathological mechanisms that drive neurodegeneration in people living with multiple sclerosis (MS) is needed to design effective therapies to treat and/or prevent disease progression. We propose that CNS-intrinsic inflammation and re-modelling of the sub-arachnoid space of the leptomeninges sets the stage for neurodegeneration from the earliest stages of MS. While neurodegenerative processes are clinically silent early in disease, ageing results in neurodegenerative changes that become clinically manifest as progressive disability. Here we review pathological correlates of MS disease progression, highlight emerging mouse models that mimic key progressive changes in MS, and provide new perspectives on therapeutic approaches to protect against MS-associated neurodegeneration.
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Yee E, Ma D, Popuri K, Chen S, Lee H, Chow V, Ma C, Wang L, Beg MF. 3D hemisphere-based convolutional neural network for whole-brain MRI segmentation. Comput Med Imaging Graph 2021; 95:102000. [PMID: 34839147 PMCID: PMC10116838 DOI: 10.1016/j.compmedimag.2021.102000] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Revised: 09/30/2021] [Accepted: 10/04/2021] [Indexed: 10/19/2022]
Abstract
Whole-brain segmentation is a crucial pre-processing step for many neuroimaging analyses pipelines. Accurate and efficient whole-brain segmentations are important for many neuroimage analysis tasks to provide clinically relevant information. Several recently proposed convolutional neural networks (CNN) perform whole brain segmentation using individual 2D slices or 3D patches as inputs due to graphical processing unit (GPU) memory limitations, and use sliding windows to perform whole brain segmentation during inference. However, these approaches lack global and spatial information about the entire brain and lead to compromised efficiency during both training and testing. We introduce a 3D hemisphere-based CNN for automatic whole-brain segmentation of T1-weighted magnetic resonance images of adult brains. First, we trained a localization network to predict bounding boxes for both hemispheres. Then, we trained a segmentation network to segment one hemisphere, and segment the opposing hemisphere by reflecting it across the mid-sagittal plane. Our network shows high performance both in terms of segmentation efficiency and accuracy (0.84 overall Dice similarity and 6.1 mm overall Hausdorff distance) in segmenting 102 brain structures. On multiple independent test datasets, our method demonstrated a competitive performance in the subcortical segmentation task and a high consistency in volumetric measurements of intra-session scans.
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Affiliation(s)
- Evangeline Yee
- School of Engineering Science, Simon Fraser University, Canada
| | - Da Ma
- School of Engineering Science, Simon Fraser University, Canada
| | - Karteek Popuri
- School of Engineering Science, Simon Fraser University, Canada
| | - Shuo Chen
- School of Engineering Science, Simon Fraser University, Canada
| | - Hyunwoo Lee
- School of Engineering Science, Simon Fraser University, Canada; Division of Neurology, Department of Medicine, University of British Columbia, Canada
| | - Vincent Chow
- School of Engineering Science, Simon Fraser University, Canada
| | - Cydney Ma
- School of Engineering Science, Simon Fraser University, Canada
| | - Lei Wang
- Department of Psychiatry and Behavioral Health, College of Medicine, The Ohio State University, Canada; Feinberg School of Medicine, Northwest University, Canada
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Droby A, Thaler A, Giladi N, Hutchison RM, Mirelman A, Ben Bashat D, Artzi M. Whole brain and deep gray matter structure segmentation: Quantitative comparison between MPRAGE and MP2RAGE sequences. PLoS One 2021; 16:e0254597. [PMID: 34358242 PMCID: PMC8345829 DOI: 10.1371/journal.pone.0254597] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Accepted: 06/29/2021] [Indexed: 11/29/2022] Open
Abstract
Objective T1-weighted MRI images are commonly used for volumetric assessment of brain structures. Magnetization prepared 2 rapid gradient echo (MP2RAGE) sequence offers superior gray (GM) and white matter (WM) contrast. This study aimed to quantitatively assess the agreement of whole brain tissue and deep GM (DGM) volumes obtained from MP2RAGE compared to the widely used MP-RAGE sequence. Methods Twenty-nine healthy participants were included in this study. All subjects underwent a 3T MRI scan acquiring high-resolution 3D MP-RAGE and MP2RAGE images. Twelve participants were re-scanned after one year. The whole brain, as well as DGM segmentation, was performed using CAT12, volBrain, and FSL-FAST automatic segmentation tools based on the acquired images. Finally, contrast-to-noise ratio between WM and GM (CNRWG), the agreement between the obtained tissue volumes, as well as scan-rescan variability of both sequences were explored. Results Significantly higher CNRWG was detected in MP2RAGE vs. MP-RAGE (Mean ± SD = 0.97 ± 0.04 vs. 0.8 ± 0.1 respectively; p<0.0001). Significantly higher total brain GM, and lower cerebrospinal fluid volumes were obtained from MP2RAGE vs. MP-RAGE based on all segmentation methods (p<0.05 in all cases). Whole-brain voxel-wise comparisons revealed higher GM tissue probability in the thalamus, putamen, caudate, lingual gyrus, and precentral gyrus based on MP2RAGE compared with MP-RAGE. Moreover, significantly higher WM probability was observed in the cerebellum, corpus callosum, and frontal-and-temporal regions in MP2RAGE vs. MP-RAGE. Finally, MP2RAGE showed a higher mean percentage of change in total brain GM compared to MP-RAGE. On the other hand, MP-RAGE demonstrated a higher overtime percentage of change in WM and DGM volumes compared to MP2RAGE. Conclusions Due to its higher CNR, MP2RAGE resulted in reproducible brain tissue segmentation, and thus is a recommended method for volumetric imaging biomarkers for the monitoring of neurological diseases.
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Affiliation(s)
- Amgad Droby
- Laboratory for Early Markers of Neurodegeneration (LEMON), Neurological Institute, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
- Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
- Sagol Brain Institute, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
- * E-mail:
| | - Avner Thaler
- Laboratory for Early Markers of Neurodegeneration (LEMON), Neurological Institute, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
- Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
- Sagol Brain Institute, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Nir Giladi
- Laboratory for Early Markers of Neurodegeneration (LEMON), Neurological Institute, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
- Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
- Sagol Brain Institute, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | | | - Anat Mirelman
- Laboratory for Early Markers of Neurodegeneration (LEMON), Neurological Institute, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
- Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
- Sagol Brain Institute, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Dafna Ben Bashat
- Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
- Sagol Brain Institute, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
- Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel
| | - Moran Artzi
- Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
- Sagol Brain Institute, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
- Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel
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Koch MW, Mostert J, Repovic P, Bowen JD, Strijbis E, Uitdehaag B, Cutter G. MRI brain volume loss, lesion burden, and clinical outcome in secondary progressive multiple sclerosis. Mult Scler 2021; 28:561-572. [PMID: 34304609 PMCID: PMC8961253 DOI: 10.1177/13524585211031801] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Magnetic resonance imaging (MRI) of brain volume measures are widely used outcomes in secondary progressive multiple sclerosis (SPMS), but it is unclear whether they are associated with physical and cognitive disability. OBJECTIVE To investigate the association between MRI outcomes and physical and cognitive disability worsening in people with SPMS. METHODS We used data from ASCEND, a large randomized controlled trial (n = 889). We investigated the association of change in whole brain and gray matter volume, contrast enhancing lesions, and T2 lesions with significant worsening on the Expanded Disability Status Scale (EDSS), Timed 25-Foot Walk (T25FW), Nine-Hole Peg Test (NHPT), and Symbol Digit Modalities Test (SDMT) with logistic regression models. RESULTS We found no association between MRI measures and EDSS or SDMT worsening. T25FW worsening at 48 and 96 weeks, and NHPT worsening at 96 weeks were associated with cumulative new or newly enlarging T2 lesions at 96 weeks. NHPT worsening at 48 and 96 weeks was associated with normalized brain volume loss at 48 weeks, but not with other MRI outcomes. CONCLUSION The association of standard MRI outcomes and disability was noticeably weak and inconsistent over 2 years of follow-up. These MRI outcomes may not be useful surrogates of disability measures in SPMS.
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Affiliation(s)
- Marcus W Koch
- Department of Clinical Neurosciences, University of Calgary, Calgary, AB, Canada/Department of Community Health Sciences, University of Calgary, Calgary, AB, Canada
| | - Jop Mostert
- Department of Neurology, Rijnstate Hospital, Arnhem, The Netherlands
| | - Pavle Repovic
- Multiple Sclerosis Center, Swedish Neuroscience Institute, Seattle, WA, USA
| | - James D Bowen
- Multiple Sclerosis Center, Swedish Neuroscience Institute, Seattle, WA, USA
| | - Eva Strijbis
- Department of Neurology, MS Center Amsterdam, Amsterdam University Medical Centers, Amsterdam, The Netherlands
| | - Bernard Uitdehaag
- Department of Neurology, MS Center Amsterdam, Amsterdam University Medical Centers, Amsterdam, The Netherlands
| | - Gary Cutter
- Department of Biostatistics, The University of Alabama at Birmingham, Birmingham, AL, USA
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de Sitter A, Burggraaff J, Bartel F, Palotai M, Liu Y, Simoes J, Ruggieri S, Schregel K, Ropele S, Rocca MA, Gasperini C, Gallo A, Schoonheim MM, Amann M, Yiannakas M, Pareto D, Wattjes MP, Sastre-Garriga J, Kappos L, Filippi M, Enzinger C, Frederiksen J, Uitdehaag B, Guttmann CRG, Barkhof F, Vrenken H. Development and evaluation of a manual segmentation protocol for deep grey matter in multiple sclerosis: Towards accelerated semi-automated references. NEUROIMAGE-CLINICAL 2021; 30:102659. [PMID: 33882422 PMCID: PMC8082260 DOI: 10.1016/j.nicl.2021.102659] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/04/2020] [Revised: 03/19/2021] [Accepted: 03/31/2021] [Indexed: 10/25/2022]
Abstract
BACKGROUND Deep grey matter (dGM) structures, particularly the thalamus, are clinically relevant in multiple sclerosis (MS). However, segmentation of dGM in MS is challenging; labeled MS-specific reference sets are needed for objective evaluation and training of new methods. OBJECTIVES This study aimed to (i) create a standardized protocol for manual delineations of dGM; (ii) evaluate the reliability of the protocol with multiple raters; and (iii) evaluate the accuracy of a fast-semi-automated segmentation approach (FASTSURF). METHODS A standardized manual segmentation protocol for caudate nucleus, putamen, and thalamus was created, and applied by three raters on multi-center 3D T1-weighted MRI scans of 23 MS patients and 12 controls. Intra- and inter-rater agreement was assessed through intra-class correlation coefficient (ICC); spatial overlap through Jaccard Index (JI) and generalized conformity index (CIgen). From sparse delineations, FASTSURF reconstructed full segmentations; accuracy was assessed both volumetrically and spatially. RESULTS All structures showed excellent agreement on expert manual outlines: intra-rater JI > 0.83; inter-rater ICC ≥ 0.76 and CIgen ≥ 0.74. FASTSURF reproduced manual references excellently, with ICC ≥ 0.97 and JI ≥ 0.92. CONCLUSIONS The manual dGM segmentation protocol showed excellent reproducibility within and between raters. Moreover, combined with FASTSURF a reliable reference set of dGM segmentations can be produced with lower workload.
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Affiliation(s)
- Alexandra de Sitter
- Radiology and Nuclear Medicine, MS Center Amsterdam, Amsterdam Neuroscience, Amsterdam UMC, Location VUmc, Amsterdam, NL, Netherlands
| | - Jessica Burggraaff
- Department of Neurology, MS Center Amsterdam, Amsterdam Neuroscience, Amsterdam UMC, Location VUmc, Amsterdam, NL, Netherlands.
| | - Fabian Bartel
- Radiology and Nuclear Medicine, MS Center Amsterdam, Amsterdam Neuroscience, Amsterdam UMC, Location VUmc, Amsterdam, NL, Netherlands
| | - Miklos Palotai
- Center for Neurological Imaging, Department of radiology, Brigham and Women's Hospital, Harvard Medical School Boston, MA, USA
| | - Yaou Liu
- Radiology and Nuclear Medicine, MS Center Amsterdam, Amsterdam Neuroscience, Amsterdam UMC, Location VUmc, Amsterdam, NL, Netherlands
| | - Jorge Simoes
- Radiology and Nuclear Medicine, MS Center Amsterdam, Amsterdam Neuroscience, Amsterdam UMC, Location VUmc, Amsterdam, NL, Netherlands
| | - Serena Ruggieri
- Department of Human Neurosciences, "Sapienza" University of Rome, Rome, IT, Italy; Department of Neurosciences, San Camillo Forlanini Hospital, Rome, IT, Italy
| | - Katharina Schregel
- Center for Neurological Imaging, Department of radiology, Brigham and Women's Hospital, Harvard Medical School Boston, MA, USA; Institute of Neuroradiology, University Medical Center Goettingen, Goettingen, DE, Germany
| | - Stefan Ropele
- Department of Neurology, Medical University of Graz, Graz, AT, Austria
| | - Maria A Rocca
- Neuroimaging Research Unit, Institute of Experimental Neurology, Division of Neuroscience, United States; Neurology Unit, San Raffaele Scientific Institute, UniSR, Milan, IT, Italy
| | - Claudio Gasperini
- Department of Neurosciences, San Camillo Forlanini Hospital, Rome, IT, Italy
| | - Antonio Gallo
- Division of Neurology and 3T MRI Research Center, Department of Advanced Medical and Surgical Sciences, University of Campania "Luigi Vanvitelli", Naples, IT, Italy
| | - Menno M Schoonheim
- Department of Anatomy and Neurosciences, MS Center Amsterdam, Amsterdam Neuroscience, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, NL, Netherlands
| | - Michael Amann
- Medical Image Analysis Center (MIAC), United States; Neurologic Clinic and Policlinic and Neuroradiology, Department of Biomedical Engineering, University Hospital Basel, Basel, CH, Switzerland
| | - Marios Yiannakas
- Department of Neuroinflammation, Institute of Neurology, UCL, London, UK
| | - Deborah Pareto
- Section of Neuroradiology and MRI Unit, Department of Radiology, University Hospital Valld'Hebron, Autonomous University of Barcelona, Barcelona, ES, Spain
| | - Mike P Wattjes
- Radiology and Nuclear Medicine, MS Center Amsterdam, Amsterdam Neuroscience, Amsterdam UMC, Location VUmc, Amsterdam, NL, Netherlands; Deptartment of Diagnostic and Interventional Neuroradiology, Hannover Medical School, Hannover, DE, Germany
| | - Jaume Sastre-Garriga
- Department of Neurology, University Hospital iValld'Hebron, Autonomous University of Barcelona, Barcelona, ES, Spain
| | - Ludwig Kappos
- Neurologic Clinic and Policlinic and Neuroradiology, Department of Biomedical Engineering, University Hospital Basel, Basel, CH, Switzerland
| | - Massimo Filippi
- Neuroimaging Research Unit, Institute of Experimental Neurology, Division of Neuroscience, United States; Neurology Unit, San Raffaele Scientific Institute, UniSR, Milan, IT, Italy; Neurophysiology Unit, San Raffaele Scientific Institute, Italy; Vita-Salute San Raffaele University, Milan, IT, Italy
| | - Christian Enzinger
- Division of Neuroradiology, Vascular and Interventional Radiology, Department of Radiology, Medical University of Graz, Graz, AT, Austria
| | - Jette Frederiksen
- Department of Neurology, Glostrup University Hospital, Copenhagen, DK, Denmark
| | - Bernard Uitdehaag
- Department of Neurology, MS Center Amsterdam, Amsterdam Neuroscience, Amsterdam UMC, Location VUmc, Amsterdam, NL, Netherlands
| | - Charles R G Guttmann
- Center for Neurological Imaging, Department of radiology, Brigham and Women's Hospital, Harvard Medical School Boston, MA, USA
| | - Frederik Barkhof
- Radiology and Nuclear Medicine, MS Center Amsterdam, Amsterdam Neuroscience, Amsterdam UMC, Location VUmc, Amsterdam, NL, Netherlands; Institutes of Neurology & Healthcare Engineering, UCL, London, UK
| | - Hugo Vrenken
- Radiology and Nuclear Medicine, MS Center Amsterdam, Amsterdam Neuroscience, Amsterdam UMC, Location VUmc, Amsterdam, NL, Netherlands
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11
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Schweser F, Hagemeier J, Dwyer MG, Bergsland N, Hametner S, Weinstock-Guttman B, Zivadinov R. Decreasing brain iron in multiple sclerosis: The difference between concentration and content in iron MRI. Hum Brain Mapp 2020; 42:1463-1474. [PMID: 33378095 PMCID: PMC7927296 DOI: 10.1002/hbm.25306] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Revised: 10/21/2020] [Accepted: 11/20/2020] [Indexed: 12/11/2022] Open
Abstract
Increased brain iron concentration is often reported concurrently with disease development in multiple sclerosis (MS) and other neurodegenerative diseases. However, it is unclear whether the higher iron concentration in patients stems from an influx of iron into the tissue or a relative reduction in tissue compartments without much iron. By taking into account structural volume, we investigated tissue iron content in the deep gray matter (DGM) over 2 years, and compared findings to previously reported changes in iron concentration. 120 MS patients and 40 age‐ and sex‐matched healthy controls were included. Clinical testing and MRI were performed both at baseline and after 2 years. Overall, iron content was calculated from structural MRI and quantitative susceptibility mapping in the thalamus, caudate, putamen, and globus pallidus. MS patients had significantly lower iron content than controls in the thalamus, with progressive MS patients demonstrating lower iron content than relapsing–remitting patients. Over 2 years, iron content decreased in the DGM of patients with MS, while it tended to increase or remain stable among controls. In the thalamus, decreasing iron content over 2 years was associated with disability progression. Our study showed that temporally increasing magnetic susceptibility in MS should not be considered as evidence for iron influx because it may be explained, at least partially, by disease‐related atrophy. Declining DGM iron content suggests that, contrary to the current understanding, iron is being removed from the DGM in patients with MS.
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Affiliation(s)
- Ferdinand Schweser
- Buffalo Neuroimaging Analysis Center, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, The State University of New York, Buffalo, New York, USA.,Center for Biomedical Imaging, Clinical and Translational Science Institute, University at Buffalo, The State University of New York, Buffalo, New York, USA
| | - Jesper Hagemeier
- Buffalo Neuroimaging Analysis Center, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, The State University of New York, Buffalo, New York, USA
| | - Michael G Dwyer
- Buffalo Neuroimaging Analysis Center, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, The State University of New York, Buffalo, New York, USA.,Center for Biomedical Imaging, Clinical and Translational Science Institute, University at Buffalo, The State University of New York, Buffalo, New York, USA
| | - Niels Bergsland
- Buffalo Neuroimaging Analysis Center, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, The State University of New York, Buffalo, New York, USA.,IRCCS, Fondazione Don Carlo Gnocchi ONLUS, Milan, Italy
| | - Simon Hametner
- Department of Neuroimmunology, Center for Brain Research, Medical University of Vienna, Vienna, Austria
| | - Bianca Weinstock-Guttman
- Jacobs Multiple Sclerosis Center, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, The State University of New York, Buffalo, New York, USA
| | - Robert Zivadinov
- Buffalo Neuroimaging Analysis Center, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, The State University of New York, Buffalo, New York, USA.,Center for Biomedical Imaging, Clinical and Translational Science Institute, University at Buffalo, The State University of New York, Buffalo, New York, USA
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12
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Burggraaff J, Liu Y, Prieto JC, Simoes J, de Sitter A, Ruggieri S, Brouwer I, Lissenberg-Witte BI, Rocca MA, Valsasina P, Ropele S, Gasperini C, Gallo A, Pareto D, Sastre-Garriga J, Enzinger C, Filippi M, De Stefano N, Ciccarelli O, Hulst HE, Wattjes MP, Barkhof F, Uitdehaag BMJ, Vrenken H, Guttmann CRG. Manual and automated tissue segmentation confirm the impact of thalamus atrophy on cognition in multiple sclerosis: A multicenter study. NEUROIMAGE-CLINICAL 2020; 29:102549. [PMID: 33401136 PMCID: PMC7787946 DOI: 10.1016/j.nicl.2020.102549] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Revised: 12/09/2020] [Accepted: 12/20/2020] [Indexed: 01/05/2023]
Abstract
BACKGROUND AND RATIONALE Thalamus atrophy has been linked to cognitive decline in multiple sclerosis (MS) using various segmentation methods. We investigated the consistency of the association between thalamus volume and cognition in MS for two common automated segmentation approaches, as well as fully manual outlining. METHODS Standardized neuropsychological assessment and 3-Tesla 3D-T1-weighted brain MRI were collected (multi-center) from 57 MS patients and 17 healthy controls. Thalamus segmentations were generated manually and using five automated methods. Agreement between the algorithms and manual outlines was assessed with Bland-Altman plots; linear regression assessed the presence of proportional bias. The effect of segmentation method on the separation of cognitively impaired (CI) and preserved (CP) patients was investigated through Generalized Estimating Equations; associations with cognitive measures were investigated using linear mixed models, for each method and vendor. RESULTS In smaller thalami, automated methods systematically overestimated volumes compared to manual segmentations [ρ=(-0.42)-(-0.76); p-values < 0.001). All methods significantly distinguished CI from CP MS patients, except manual outlines of the left thalamus (p = 0.23). Poorer global neuropsychological test performance was significantly associated with smaller thalamus volumes bilaterally using all methods. Vendor significantly affected the findings. CONCLUSION Automated and manual thalamus segmentation consistently demonstrated an association between thalamus atrophy and cognitive impairment in MS. However, a proportional bias in smaller thalami and choice of MRI acquisition system might impact the effect size of these findings.
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Affiliation(s)
- Jessica Burggraaff
- Department of Neurology, MS Center Amsterdam, Amsterdam Neuroscience, Amsterdam UMC, Location VUmc, De Boelelaan 1117, 1118, 1081 HV Amsterdam, The Netherlands.
| | - Yao Liu
- Department of Radiology and Nuclear Medicine, MS Center Amsterdam, Amsterdam Neuroscience, Amsterdam UMC, Location VUmc, De Boelelaan 1117, 1118, 1081 HV Amsterdam, The Netherlands.
| | - Juan C Prieto
- Center for Neurological Imaging, Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, 1249 Boylston Street, Boston, MA 02215, USA.
| | - Jorge Simoes
- Department of Neurology, MS Center Amsterdam, Amsterdam Neuroscience, Amsterdam UMC, Location VUmc, De Boelelaan 1117, 1118, 1081 HV Amsterdam, The Netherlands.
| | - Alexandra de Sitter
- Department of Radiology and Nuclear Medicine, MS Center Amsterdam, Amsterdam Neuroscience, Amsterdam UMC, Location VUmc, De Boelelaan 1117, 1118, 1081 HV Amsterdam, The Netherlands.
| | - Serena Ruggieri
- Department of Human Neurosciences, "Sapienza" University of Rome, Piazzale Aldo Moro, 5, 00185 Roma RM, Italy; Department of Neurosciences, San Camillo Forlanini Hospital, Circonvallazione Gianicolense, 87, 00152 Roma RM, Italy.
| | - Iman Brouwer
- Department of Radiology and Nuclear Medicine, MS Center Amsterdam, Amsterdam Neuroscience, Amsterdam UMC, Location VUmc, De Boelelaan 1117, 1118, 1081 HV Amsterdam, The Netherlands.
| | - Birgit I Lissenberg-Witte
- Department of Epidemiology and Biostatistics, Amsterdam UMC, Location VUmc, De Boelelaan 1089a, 1081 HV Amsterdam, the Netherlands.
| | - Mara A Rocca
- Neuroimaging Research Unit, Institute of Experimental Neurology, Division of Neuroscience, and Neurology Unit, San Raffaele Scientific Institute, Via Olgettina, 58, 20132 Milano MI, Italy; Neurology Unit, San Raffaele Scientific Institute, Via Olgettina, 58, 20132 Milano MI, Italy.
| | - Paola Valsasina
- Neuroimaging Research Unit, Institute of Experimental Neurology, Division of Neuroscience, and Neurology Unit, San Raffaele Scientific Institute, Via Olgettina, 58, 20132 Milano MI, Italy.
| | - Stefan Ropele
- Department of Neurology, Medical University of Graz, Auenbruggerplatz 22, 8036 Graz, Austria.
| | - Claudio Gasperini
- Department of Neurosciences, San Camillo Forlanini Hospital, Circonvallazione Gianicolense, 87, 00152 Roma RM, Italy.
| | - Antonio Gallo
- Division of Neurology and 3T MRI Research Center, Department of Advanced Medical and Surgical Sciences, University of Campania "Luigi Vanvitelli", Viale Abramo Lincoln, 5, 81100 Caserta, CE, Napoli, Italy.
| | - Deborah Pareto
- Section of Neuroradiology and MRI Unit, Department of Radiology, University Hospital iValld'Hebron, Autonomous University of Barcelona, Passeig de la Vall d'Hebron 119-129, 08035 Barcelona, Spain.
| | - Jaume Sastre-Garriga
- Department of Neurology, University Hospital iValld'Hebron, Autonomous University of Barcelona, Passeig de la Vall d'Hebron 119-129, 08035 Barcelona, Spain.
| | - Christian Enzinger
- Division of Neuroradiology, Vascular and Interventional Radiology, Department of Radiology, Medical University of Graz, Auenbruggerplatz 22, 8036 Graz, Austria.
| | - Massimo Filippi
- Neuroimaging Research Unit, Institute of Experimental Neurology, Division of Neuroscience, and Neurology Unit, San Raffaele Scientific Institute, Via Olgettina, 58, 20132 Milano MI, Italy; Neurology Unit, San Raffaele Scientific Institute, Via Olgettina, 58, 20132 Milano MI, Italy; Neurophysiology Unit, San Raffaele Scientific Institute, and (14)Vita-Salute San Raffaele University, Via Olgettina, 58, 20132 Milano, MI, Italy; Department of Neurological and Behavioural Sciences, University of Siena, 53100 Siena SI, Italy.
| | - Nicola De Stefano
- Department of Neurological and Behavioural Sciences, University of Siena, 53100 Siena SI, Italy.
| | - Olga Ciccarelli
- Department of Neuroinflammation UCL, Queen Square Institute of Neurology UCL, Queen Square, London WC1N 3BG, United Kingdom.
| | - Hanneke E Hulst
- Department of Anatomy and Neurosciences, Amsterdam Neuroscience, MS Center Amsterdam, Amsterdam UMC, Vrije Universiteit Amsterdam, De Boelelaan 1108, P.O. Box 7057, 1007 MB, Amsterdam, The Netherlands.
| | - Mike P Wattjes
- Department of Radiology and Nuclear Medicine, MS Center Amsterdam, Amsterdam Neuroscience, Amsterdam UMC, Location VUmc, De Boelelaan 1117, 1118, 1081 HV Amsterdam, The Netherlands; Department of Diagnostic and Interventional Neuroradiology, Hannover Medical School, Hannover, Carl-Neuberg-Straße, 30625 Hannover, Germany.
| | - Frederik Barkhof
- Department of Radiology and Nuclear Medicine, MS Center Amsterdam, Amsterdam Neuroscience, Amsterdam UMC, Location VUmc, De Boelelaan 1117, 1118, 1081 HV Amsterdam, The Netherlands; Institutes of Neurology & Healthcare Engineering, UCL, 235 Euston Rd, Bloomsbury, London NW1 2BU, United Kingdom.
| | - Bernard M J Uitdehaag
- Department of Neurology, MS Center Amsterdam, Amsterdam Neuroscience, Amsterdam UMC, Location VUmc, De Boelelaan 1117, 1118, 1081 HV Amsterdam, The Netherlands.
| | - Hugo Vrenken
- Department of Radiology and Nuclear Medicine, MS Center Amsterdam, Amsterdam Neuroscience, Amsterdam UMC, Location VUmc, De Boelelaan 1117, 1118, 1081 HV Amsterdam, The Netherlands.
| | - Charles R G Guttmann
- Center for Neurological Imaging, Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, 1249 Boylston Street, Boston, MA 02215, USA.
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13
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Rothstein TL. Gray Matter Matters: A Longitudinal Magnetic Resonance Voxel-Based Morphometry Study of Primary Progressive Multiple Sclerosis. Front Neurol 2020; 11:581537. [PMID: 33281717 PMCID: PMC7689315 DOI: 10.3389/fneur.2020.581537] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Accepted: 10/14/2020] [Indexed: 12/31/2022] Open
Abstract
Background: Multiple Sclerosis (MS) lesions in white matter (WM) are easily detected with conventional MRI which induce inflammation thereby generating contrast. WM lesions do not consistently explain the extent of clinical disability, cognitive impairment, or the source of an exacerbation. Gray matter (GM) structures including the cerebral cortex and various deep nuclei are known to be affected early in Primary Progressive Multiple Sclerosis (PPMS) and drive disease progression, disability, fatigue, and cognitive dysfunction. However, little is known about how rapidly GM lesions develop and accumulate over time. Objective: The purpose of this study is to analyze the degree and rate of progression in 25 patients with PPMS using voxel-based automated volumetric quantitation. Methods: This is a retrospective single-center study which includes a cohort of 25 patients with PPMS scanned utilizing NeuroQuant® 3 dimensional voxel-based morphometry (3D VBM) automated analysis and database and restudied after a period of ~1 year (11–14 months). Comparisons with normative data were acquired for whole brain, forebrain parenchyma, cortical GM, hippocampus, thalamus, superior and inferior lateral ventricles. GM volume changes were correlated with their clinical motor and cognitive scores using Extended Disability Status Scales (EDSS) and Montreal Cognitive Assessments (MoCA). Results: Steep reductions occurred in cerebral cortical GM and deep GM nuclei volumes which correlated with each patient's clinical and cognitive impairment. The median observed percentile volume losses were statistically significant compared with the 50th percentile for each GM component. Longitudinal assessments of an unselected sample of one dozen patients involved in the PPMS study showed prominent losses occurring mainly in cortical GM and hippocampus which were reflected in their EDSS and MoCA. The longitudinal results were compared with a similar sample of patients having Relapsing MS (RMS) whose GM values were largely in normal range, annualized volume GM changes were much less, while WM hyperintensities were in abnormal range in half the unselected cases. Conclusions: Knowledge of the degree and rapidity with which cortical atrophy and deep GM volume loss develops clarifies the source of progressive cognitive and clinical decline in PPMS.
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Affiliation(s)
- Ted L Rothstein
- Department of Neurology, Multiple Sclerosis Clinical Care and Research Center, George Washington University School of Medicine, Washington, DC, United States
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14
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Reduced accuracy of MRI deep grey matter segmentation in multiple sclerosis: an evaluation of four automated methods against manual reference segmentations in a multi-center cohort. J Neurol 2020; 267:3541-3554. [PMID: 32621103 PMCID: PMC7674567 DOI: 10.1007/s00415-020-10023-1] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Revised: 06/22/2020] [Accepted: 06/23/2020] [Indexed: 12/22/2022]
Abstract
Background Deep grey matter (DGM) atrophy in multiple sclerosis (MS) and its relation to cognitive and clinical decline requires accurate measurements. MS pathology may deteriorate the performance of automated segmentation methods. Accuracy of DGM segmentation methods is compared between MS and controls, and the relation of performance with lesions and atrophy is studied. Methods On images of 21 MS subjects and 11 controls, three raters manually outlined caudate nucleus, putamen and thalamus; outlines were combined by majority voting. FSL-FIRST, FreeSurfer, Geodesic Information Flow and volBrain were evaluated. Performance was evaluated volumetrically (intra-class correlation coefficient (ICC)) and spatially (Dice similarity coefficient (DSC)). Spearman's correlations of DSC with global and local lesion volume, structure of interest volume (ROIV), and normalized brain volume (NBV) were assessed. Results ICC with manual volumes was mostly good and spatial agreement was high. MS exhibited significantly lower DSC than controls for thalamus and putamen. For some combinations of structure and method, DSC correlated negatively with lesion volume or positively with NBV or ROIV. Lesion-filling did not substantially change segmentations. Conclusions Automated methods have impaired performance in patients. Performance generally deteriorated with higher lesion volume and lower NBV and ROIV, suggesting that these may contribute to the impaired performance. Electronic supplementary material The online version of this article (10.1007/s00415-020-10023-1) contains supplementary material, which is available to authorized users.
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15
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Naji N, Sun H, Wilman AH. On the value of QSM from MPRAGE for segmenting and quantifying iron‐rich deep gray matter. Magn Reson Med 2020; 84:1486-1500. [DOI: 10.1002/mrm.28226] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2019] [Revised: 01/20/2020] [Accepted: 02/03/2020] [Indexed: 01/10/2023]
Affiliation(s)
- Nashwan Naji
- Department of Biomedical Engineering University of Alberta Edmonton Alberta Canada
| | - Hongfu Sun
- School of Information Technology and Electrical Engineering University of Queensland Brisbane Queensland Australia
| | - Alan H. Wilman
- Department of Biomedical Engineering University of Alberta Edmonton Alberta Canada
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16
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Spatial normalization of multiple sclerosis brain MRI data depends on analysis method and software package. Magn Reson Imaging 2020; 68:83-94. [PMID: 32007558 DOI: 10.1016/j.mri.2020.01.016] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2019] [Revised: 01/25/2020] [Accepted: 01/26/2020] [Indexed: 12/21/2022]
Abstract
BACKGROUND Spatially normalizing brain MRI data to a template is commonly performed to facilitate comparisons between individuals or groups. However, the presence of multiple sclerosis (MS) lesions and other MS-related brain pathologies may compromise the performance of automated spatial normalization procedures. We therefore aimed to systematically compare five commonly used spatial normalization methods for brain MRI - including linear (affine), and nonlinear MRIStudio (LDDMM), FSL (FNIRT), ANTs (SyN), and SPM (CAT12) algorithms - to evaluate their performance in the presence of MS-related pathologies. METHODS 3 Tesla MRI images (T1-weighted and T2-FLAIR) were obtained for 20 participants with MS from an ongoing cohort study (used to assess a real dataset) and 1 healthy control participant (used to create a simulated lesion dataset). Both raw and lesion-filled versions of each participant's T1-weighted brain images were warped to the Montreal Neurological Institute (MNI) template using all five normalization approaches for the real dataset, and the same procedure was then repeated using the simulated lesion dataset (i.e., total of 400 spatial normalizations). As an additional quality-assurance check, the resulting deformations were also applied to the corresponding lesion masks to evaluate how each processing pipeline handled focal white matter lesions. For each normalization approach, inter-subject variability (across normalized T1-weighted images) was quantified using both mutual information (MI) and coefficient of variation (COV), and the corresponding normalized lesion volumes were evaluated using paired-sample t-tests. RESULTS All four nonlinear warping methods outperformed conventional linear normalization, with SPM (CAT12) yielding the highest MI values, lowest COV values, and proportionately-scaled lesion volumes. Although lesion-filling improved spatial normalization accuracy for each of the methods tested, these effects were small compared to differences between normalization algorithms. CONCLUSIONS SPM (CAT12) warping, ideally combined with lesion-filling, is recommended for use in future MS brain imaging studies requiring spatial normalization.
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17
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Stereological Investigation of Regional Brain Volumes after Acute and Chronic Cuprizone-Induced Demyelination. Cells 2019; 8:cells8091024. [PMID: 31484353 PMCID: PMC6770802 DOI: 10.3390/cells8091024] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2019] [Revised: 08/19/2019] [Accepted: 08/30/2019] [Indexed: 02/03/2023] Open
Abstract
Brain volume measurement is one of the most frequently used biomarkers to establish neuroprotective effects during pre-clinical multiple sclerosis (MS) studies. Furthermore, whole-brain atrophy estimates in MS correlate more robustly with clinical disability than traditional, lesion-based metrics. However, the underlying mechanisms leading to brain atrophy are poorly understood, partly due to the lack of appropriate animal models to study this aspect of the disease. The purpose of this study was to assess brain volumes and neuro-axonal degeneration after acute and chronic cuprizone-induced demyelination. C57BL/6 male mice were intoxicated with cuprizone for up to 12 weeks. Brain volume, as well as total numbers and densities of neurons, were determined using design-based stereology. After five weeks of cuprizone intoxication, despite severe demyelination, brain volumes were not altered at this time point. After 12 weeks of cuprizone intoxication, a significant volume reduction was found in the corpus callosum and diverse subcortical areas, particularly the internal capsule and the thalamus. Thalamic volume loss was accompanied by glucose hypermetabolism, analyzed by [18F]-fluoro-2-deoxy-d-glucose (18F-FDG) positron-emission tomography. This study demonstrates region-specific brain atrophy of different subcortical brain regions after chronic cuprizone-induced demyelination. The chronic cuprizone demyelination model in male mice is, thus, a useful tool to study the underlying mechanisms of subcortical brain atrophy and to investigate the effectiveness of therapeutic interventions.
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18
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Li C, Liu W, Guo F, Wang X, Kang X, Xu Y, Xi Y, Wang H, Zhu Y, Yin H. Voxel-based morphometry results in first-episode schizophrenia: a comparison of publicly available software packages. Brain Imaging Behav 2019; 14:2224-2231. [PMID: 31377989 DOI: 10.1007/s11682-019-00172-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Investigations of brain structure in schizophrenia using magnetic resonance imaging (MRI) have identified variations in regional grey matter (GM) volume throughout the brain but the results are mixed. This study aims to investigate whether the inconsistent voxel-based morphometry (VBM) findings in schizophrenia are due to the use of different software packages. T1 MRI images were obtained from 86 first-episode schizophrenia (FESZ) patients and 86 age- and gender-matched Healthy controls (HCs). VBM analysis was carried out using FMRIB software library (FSL) 5.0 and statistical parametric mapping 8 (SPM8). All images were processed using the default parameter settings as provided by these software packages. FSL-VBM revealed widespread GM volume reductions in FESZ patients compared with HCs, however, for SPM-VBM, only increased and circumscribed GM volume changes were found, both software revealed increased GM volume within cerebellum. Significant correlations between Positive and Negative Syndrome Scale (PANSS) and GM volume were mainly found in frontal regions. Algorithms of GM tissue segmentation, image registration and statistical strategies might contribute to these disparate results.
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Affiliation(s)
- Chen Li
- Department of Radiology, Xijing Hospital, Fourth Military Medical University, No. 127 West Changle Road, Xi'an, 710032, China
| | - Wenming Liu
- Department of Psychiatry, Xijing Hospital, The Fourth Military Medical University, Xi'an, Shaanxi, China
| | - Fan Guo
- Department of Radiology, Xijing Hospital, Fourth Military Medical University, No. 127 West Changle Road, Xi'an, 710032, China
| | - Xingrui Wang
- Department of Radiology, Xijing Hospital, Fourth Military Medical University, No. 127 West Changle Road, Xi'an, 710032, China
| | - Xiaowei Kang
- Department of Radiology, Xijing Hospital, Fourth Military Medical University, No. 127 West Changle Road, Xi'an, 710032, China
| | - Yongqiang Xu
- Department of Radiology, Xijing Hospital, Fourth Military Medical University, No. 127 West Changle Road, Xi'an, 710032, China
| | - Yibin Xi
- Department of Radiology, Xijing Hospital, Fourth Military Medical University, No. 127 West Changle Road, Xi'an, 710032, China
| | - Huaning Wang
- Department of Psychiatry, Xijing Hospital, The Fourth Military Medical University, Xi'an, Shaanxi, China
| | - Yuanqiang Zhu
- Department of Radiology, Xijing Hospital, Fourth Military Medical University, No. 127 West Changle Road, Xi'an, 710032, China.
| | - Hong Yin
- Department of Radiology, Xijing Hospital, Fourth Military Medical University, No. 127 West Changle Road, Xi'an, 710032, China.
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Five year iron changes in relapsing-remitting multiple sclerosis deep gray matter compared to healthy controls. Mult Scler Relat Disord 2019; 33:107-115. [DOI: 10.1016/j.msard.2019.05.028] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2018] [Revised: 05/22/2019] [Accepted: 05/29/2019] [Indexed: 12/11/2022]
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Guevara C, Garrido C, Martinez M, Farias GA, Orellana P, Soruco W, Alarcón P, Diaz V, Silva C, Kempton MJ, Barker G, de Grazia J. Prospective Assessment of No Evidence of Disease Activity-4 Status in Early Disease Stages of Multiple Sclerosis in Routine Clinical Practice. Front Neurol 2019; 10:788. [PMID: 31396148 PMCID: PMC6668013 DOI: 10.3389/fneur.2019.00788] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2019] [Accepted: 07/08/2019] [Indexed: 12/20/2022] Open
Abstract
Background: In relapsing-remitting multiple sclerosis, no evidence of disease activity-3 (NEDA-3) is defined as no relapses, no disability progression and no MRI activity. NEDA-4 status is defined as meeting all NEDA-3 criteria plus having an annualized brain volume loss (a-BVL) of ≤0.4%. Prospective real-world studies presenting data on NEDA-4 are scarce. Objective: To determine the proportion of patients failing to meet one or more NEDA-4 criteria and the contribution of each component to this failure. Methods: Forty-eight patients were followed for 12 months. Structural image evaluation, using normalization, of atrophy was used to assess a-BVL. Results: The patients had a mean age of 33.0 years (range 18-57), disease duration of 1.7 years (0.4-4) and Expanded Disability Status Scale score of 1.3 (0-4); 71% were women. All patients were on disease-modifying therapies. During follow-up, 21% of the patients had at least one relapse, 21% had disability progression, 8% had new T2 lesions, and 10% had gadolinium-enhanced lesions. Fifty-eight percent (28/48) achieved NEDA-3 status. a-BVL of >0.4% was observed in 52% (25/48). Only 29% (14/48) achieved NEDA-4 status. Conclusion: a-BVL is a good marker to detect subclinical disease activity. a-BVL is parameter to continue investigating for guiding clinical practice in relapsing-remitting multiple sclerosis.
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Affiliation(s)
- Carlos Guevara
- Faculty of Medicine, Hospital Clínico José Joaquín Aguirre, Santos Dummont, Universidad de Chile, Santiago, Chile
| | - Cristian Garrido
- Faculty of Medicine, Hospital Clínico José Joaquín Aguirre, Santos Dummont, Universidad de Chile, Santiago, Chile
| | - Melissa Martinez
- Faculty of Medicine, Hospital Clínico José Joaquín Aguirre, Santos Dummont, Universidad de Chile, Santiago, Chile
| | - Gonzalo A Farias
- Faculty of Medicine, Hospital Clínico José Joaquín Aguirre, Santos Dummont, Universidad de Chile, Santiago, Chile
| | - Patricia Orellana
- Faculty of Medicine, Hospital Clínico José Joaquín Aguirre, Santos Dummont, Universidad de Chile, Santiago, Chile
| | - Wendy Soruco
- Faculty of Medicine, Hospital Clínico José Joaquín Aguirre, Santos Dummont, Universidad de Chile, Santiago, Chile
| | - Pablo Alarcón
- Faculty of Medicine, Hospital Clínico José Joaquín Aguirre, Santos Dummont, Universidad de Chile, Santiago, Chile
| | - Violeta Diaz
- Faculty of Medicine, Hospital Clínico José Joaquín Aguirre, Santos Dummont, Universidad de Chile, Santiago, Chile
| | - Carlos Silva
- Faculty of Medicine, Hospital Clínico José Joaquín Aguirre, Santos Dummont, Universidad de Chile, Santiago, Chile
| | - Matthew J Kempton
- Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom
| | - Gareth Barker
- Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom
| | - José de Grazia
- Faculty of Medicine, Hospital Clínico José Joaquín Aguirre, Santos Dummont, Universidad de Chile, Santiago, Chile
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Pagnozzi AM, Fripp J, Rose SE. Quantifying deep grey matter atrophy using automated segmentation approaches: A systematic review of structural MRI studies. Neuroimage 2019; 201:116018. [PMID: 31319182 DOI: 10.1016/j.neuroimage.2019.116018] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2019] [Revised: 07/01/2019] [Accepted: 07/12/2019] [Indexed: 12/13/2022] Open
Abstract
The deep grey matter (DGM) nuclei of the brain play a crucial role in learning, behaviour, cognition, movement and memory. Although automated segmentation strategies can provide insight into the impact of multiple neurological conditions affecting these structures, such as Multiple Sclerosis (MS), Huntington's disease (HD), Alzheimer's disease (AD), Parkinson's disease (PD) and Cerebral Palsy (CP), there are a number of technical challenges limiting an accurate automated segmentation of the DGM. Namely, the insufficient contrast of T1 sequences to completely identify the boundaries of these structures, as well as the presence of iso-intense white matter lesions or extensive tissue loss caused by brain injury. Therefore in this systematic review, 269 eligible studies were analysed and compared to determine the optimal approaches for addressing these technical challenges. The automated approaches used among the reviewed studies fall into three broad categories, atlas-based approaches focusing on the accurate alignment of atlas priors, algorithmic approaches which utilise intensity information to a greater extent, and learning-based approaches that require an annotated training set. Studies that utilise freely available software packages such as FIRST, FreeSurfer and LesionTOADS were also eligible, and their performance compared. Overall, deep learning approaches achieved the best overall performance, however these strategies are currently hampered by the lack of large-scale annotated data. Improving model generalisability to new datasets could be achieved in future studies with data augmentation and transfer learning. Multi-atlas approaches provided the second-best performance overall, and may be utilised to construct a "silver standard" annotated training set for deep learning. To address the technical challenges, providing robustness to injury can be improved by using multiple channels, highly elastic diffeomorphic transformations such as LDDMM, and by following atlas-based approaches with an intensity driven refinement of the segmentation, which has been done with the Expectation Maximisation (EM) and level sets methods. Accounting for potential lesions should be achieved with a separate lesion segmentation approach, as in LesionTOADS. Finally, to address the issue of limited contrast, R2*, T2* and QSM sequences could be used to better highlight the DGM due to its higher iron content. Future studies could look to additionally acquire these sequences by retaining the phase information from standard structural scans, or alternatively acquiring these sequences for only a training set, allowing models to learn the "improved" segmentation from T1-sequences alone.
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Affiliation(s)
- Alex M Pagnozzi
- CSIRO Health and Biosecurity, The Australian e-Health Research Centre, Brisbane, Australia.
| | - Jurgen Fripp
- CSIRO Health and Biosecurity, The Australian e-Health Research Centre, Brisbane, Australia
| | - Stephen E Rose
- CSIRO Health and Biosecurity, The Australian e-Health Research Centre, Brisbane, Australia
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Hemond CC, Chu R, Tummala S, Tauhid S, Healy BC, Bakshi R. Whole-brain atrophy assessed by proportional- versus registration-based pipelines from 3T MRI in multiple sclerosis. Brain Behav 2018; 8:e01068. [PMID: 30019857 PMCID: PMC6085901 DOI: 10.1002/brb3.1068] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2018] [Revised: 06/11/2018] [Accepted: 06/20/2018] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND AND PURPOSE Whole-brain atrophy is a standard outcome measure in multiple sclerosis (MS) clinical trials as assessed by various software tools. The effect of processing method on the validity of such data obtained from high-resolution 3T MRI is not known. We compared two commonly used methods of quantifying whole-brain atrophy. METHODS Three-dimensional T1-weighted and FLAIR images were obtained at 3T in MS (n = 61) and normal control (NC, n = 30) groups. Whole-brain atrophy was assessed by two automated pipelines: (a) SPM8 to derive brain parenchymal fraction (BPF, proportional-based method); (b) SIENAX to derive normalized brain parenchymal volume (BPV, registration method). We assessed agreement between BPF and BPV, as well their relationship to Expanded Disability Status Scale (EDSS) score, timed 25-foot walk (T25FW), cognition, and cerebral T2 (FLAIR) lesion volume (T2LV). RESULTS Brain parenchymal fraction and BPV showed only partial agreement (r = 0.73) in the MS group, and r = 0.28 in NC. Both methods showed atrophy in MS versus NC (BPF p < 0.01, BPV p < 0.05). Within MS group comparisons, BPF (p < 0.05) but not BPV (p > 0.05) correlated with EDSS score. BPV (p = 0.03) but not BPF (p = 0.08) correlated with T25FW. Both metrics correlated with T2LV (p < 0.05) and cognitive subscales. BPF (p < 0.05) but not BPV (p > 0.05) showed lower brain volume in cognitively impaired (n = 23) versus cognitively preserved (n = 38) patients. However, direct comparisons of BPF and BPV sensitivities to atrophy and clinical correlations were not statistically significant. CONCLUSION Whole-brain atrophy metrics may not be interchangeable between proportional- and registration-based automated pipelines from 3T MRI in patients with MS.
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Affiliation(s)
- Christopher C Hemond
- Laboratory for Neuroimaging Research, Department of Neurology, Brigham & Women's Hospital, Partners MS Center, Ann Romney Center for Neurologic Diseases, Harvard Medical School, Boston, Massachusetts
| | - Renxin Chu
- Laboratory for Neuroimaging Research, Department of Neurology, Brigham & Women's Hospital, Partners MS Center, Ann Romney Center for Neurologic Diseases, Harvard Medical School, Boston, Massachusetts
| | - Subhash Tummala
- Laboratory for Neuroimaging Research, Department of Neurology, Brigham & Women's Hospital, Partners MS Center, Ann Romney Center for Neurologic Diseases, Harvard Medical School, Boston, Massachusetts
| | - Shahamat Tauhid
- Laboratory for Neuroimaging Research, Department of Neurology, Brigham & Women's Hospital, Partners MS Center, Ann Romney Center for Neurologic Diseases, Harvard Medical School, Boston, Massachusetts
| | - Brian C Healy
- Laboratory for Neuroimaging Research, Department of Neurology, Brigham & Women's Hospital, Partners MS Center, Ann Romney Center for Neurologic Diseases, Harvard Medical School, Boston, Massachusetts
| | - Rohit Bakshi
- Laboratory for Neuroimaging Research, Department of Neurology, Brigham & Women's Hospital, Partners MS Center, Ann Romney Center for Neurologic Diseases, Harvard Medical School, Boston, Massachusetts.,Laboratory for Neuroimaging Research, Department of Radiology, Brigham & Women's Hospital, Partners MS Center, Ann Romney Center for Neurologic Diseases, Harvard Medical School, Boston, Massachusetts
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Storelli L, Rocca MA, Pagani E, Van Hecke W, Horsfield MA, De Stefano N, Rovira A, Sastre-Garriga J, Palace J, Sima D, Smeets D, Filippi M. Measurement of Whole-Brain and Gray Matter Atrophy in Multiple Sclerosis: Assessment with MR Imaging. Radiology 2018; 288:554-564. [PMID: 29714673 DOI: 10.1148/radiol.2018172468] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Purpose To compare available methods for whole-brain and gray matter (GM) atrophy estimation in multiple sclerosis (MS) in terms of repeatability (same magnetic resonance [MR] imaging unit) and reproducibility (different system/field strength) for their potential clinical applications. Materials and Methods The softwares ANTs-v1.9, CIVET-v2.1, FSL-SIENAX/SIENA-5.0.1, Icometrix-MSmetrix-1.7, and SPM-v12 were compared. This retrospective study, performed between March 2015 and March 2017, collected data from (a) eight simulated MR images and longitudinal data (2 weeks) from 10 healthy control subjects to assess the cross-sectional and longitudinal accuracy of atrophy measures, (b) test-retest MR images in 29 patients with MS acquired within the same day at different imaging unit field strengths/manufacturers to evaluate precision, and (c) longitudinal data (1 year) in 24 patients with MS for the agreement between methods. Tissue segmentation, image registration, and white matter (WM) lesion filling were also evaluated. Multiple paired t tests were used for comparisons. Results High values of accuracy (0.87-0.97) for whole-brain and GM volumes were found, with the lowest values for MSmetrix. ANTs showed the lowest mean error (0.02%) for whole-brain atrophy in healthy control subjects, with a coefficient of variation of 0.5%. SPM showed the smallest mean error (0.07%) and coefficient of variation (0.08%) for GM atrophy. Globally, good repeatability (P > .05) but poor reproducibility (P < .05) were found for all methods. WM lesion filling technique mainly affected ANTs, MSmetrix, and SPM results (P < .05). Conclusion From this comparison, it would be possible to select a software for atrophy measurement, depending on the requirements of the application (research center, clinical trial) and its goal (accuracy and repeatability or reproducibility). An improved reproducibility is required for clinical application. © RSNA, 2018 Online supplemental material is available for this article.
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Affiliation(s)
- Loredana Storelli
- From the Neuroimaging Research Unit (L.S., M.A.R., E.P., M.F.) and Department of Neurology, Institute of Experimental Neurology, Division of Neuroscience (M.A.R., M.F.), San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Via Olgettina 60, 20132 Milan, Italy; Department of Research and Development, Icometrix, Leuven, Belgium (W.V.H., D. Sima, D. Smeets); Xinapse Systems, Colchester, England (M.A.H.); Department of Medicine, Surgery and Neuroscience, University of Siena, Siena, Italy (N.D.S.); Section of Neuroradiology, Department of Radiology, Hospital Universitari Vall d'Hebron, Barcelona, Spain (A.R.); Unit of Clinical Neuroimmunology, CEM-Cat, Hospital Universitari Vall d'Hebron, Barcelona, Spain (J.S.G.); and Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, England (J.P.)
| | - Maria A Rocca
- From the Neuroimaging Research Unit (L.S., M.A.R., E.P., M.F.) and Department of Neurology, Institute of Experimental Neurology, Division of Neuroscience (M.A.R., M.F.), San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Via Olgettina 60, 20132 Milan, Italy; Department of Research and Development, Icometrix, Leuven, Belgium (W.V.H., D. Sima, D. Smeets); Xinapse Systems, Colchester, England (M.A.H.); Department of Medicine, Surgery and Neuroscience, University of Siena, Siena, Italy (N.D.S.); Section of Neuroradiology, Department of Radiology, Hospital Universitari Vall d'Hebron, Barcelona, Spain (A.R.); Unit of Clinical Neuroimmunology, CEM-Cat, Hospital Universitari Vall d'Hebron, Barcelona, Spain (J.S.G.); and Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, England (J.P.)
| | - Elisabetta Pagani
- From the Neuroimaging Research Unit (L.S., M.A.R., E.P., M.F.) and Department of Neurology, Institute of Experimental Neurology, Division of Neuroscience (M.A.R., M.F.), San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Via Olgettina 60, 20132 Milan, Italy; Department of Research and Development, Icometrix, Leuven, Belgium (W.V.H., D. Sima, D. Smeets); Xinapse Systems, Colchester, England (M.A.H.); Department of Medicine, Surgery and Neuroscience, University of Siena, Siena, Italy (N.D.S.); Section of Neuroradiology, Department of Radiology, Hospital Universitari Vall d'Hebron, Barcelona, Spain (A.R.); Unit of Clinical Neuroimmunology, CEM-Cat, Hospital Universitari Vall d'Hebron, Barcelona, Spain (J.S.G.); and Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, England (J.P.)
| | - Wim Van Hecke
- From the Neuroimaging Research Unit (L.S., M.A.R., E.P., M.F.) and Department of Neurology, Institute of Experimental Neurology, Division of Neuroscience (M.A.R., M.F.), San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Via Olgettina 60, 20132 Milan, Italy; Department of Research and Development, Icometrix, Leuven, Belgium (W.V.H., D. Sima, D. Smeets); Xinapse Systems, Colchester, England (M.A.H.); Department of Medicine, Surgery and Neuroscience, University of Siena, Siena, Italy (N.D.S.); Section of Neuroradiology, Department of Radiology, Hospital Universitari Vall d'Hebron, Barcelona, Spain (A.R.); Unit of Clinical Neuroimmunology, CEM-Cat, Hospital Universitari Vall d'Hebron, Barcelona, Spain (J.S.G.); and Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, England (J.P.)
| | - Mark A Horsfield
- From the Neuroimaging Research Unit (L.S., M.A.R., E.P., M.F.) and Department of Neurology, Institute of Experimental Neurology, Division of Neuroscience (M.A.R., M.F.), San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Via Olgettina 60, 20132 Milan, Italy; Department of Research and Development, Icometrix, Leuven, Belgium (W.V.H., D. Sima, D. Smeets); Xinapse Systems, Colchester, England (M.A.H.); Department of Medicine, Surgery and Neuroscience, University of Siena, Siena, Italy (N.D.S.); Section of Neuroradiology, Department of Radiology, Hospital Universitari Vall d'Hebron, Barcelona, Spain (A.R.); Unit of Clinical Neuroimmunology, CEM-Cat, Hospital Universitari Vall d'Hebron, Barcelona, Spain (J.S.G.); and Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, England (J.P.)
| | - Nicola De Stefano
- From the Neuroimaging Research Unit (L.S., M.A.R., E.P., M.F.) and Department of Neurology, Institute of Experimental Neurology, Division of Neuroscience (M.A.R., M.F.), San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Via Olgettina 60, 20132 Milan, Italy; Department of Research and Development, Icometrix, Leuven, Belgium (W.V.H., D. Sima, D. Smeets); Xinapse Systems, Colchester, England (M.A.H.); Department of Medicine, Surgery and Neuroscience, University of Siena, Siena, Italy (N.D.S.); Section of Neuroradiology, Department of Radiology, Hospital Universitari Vall d'Hebron, Barcelona, Spain (A.R.); Unit of Clinical Neuroimmunology, CEM-Cat, Hospital Universitari Vall d'Hebron, Barcelona, Spain (J.S.G.); and Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, England (J.P.)
| | - Alex Rovira
- From the Neuroimaging Research Unit (L.S., M.A.R., E.P., M.F.) and Department of Neurology, Institute of Experimental Neurology, Division of Neuroscience (M.A.R., M.F.), San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Via Olgettina 60, 20132 Milan, Italy; Department of Research and Development, Icometrix, Leuven, Belgium (W.V.H., D. Sima, D. Smeets); Xinapse Systems, Colchester, England (M.A.H.); Department of Medicine, Surgery and Neuroscience, University of Siena, Siena, Italy (N.D.S.); Section of Neuroradiology, Department of Radiology, Hospital Universitari Vall d'Hebron, Barcelona, Spain (A.R.); Unit of Clinical Neuroimmunology, CEM-Cat, Hospital Universitari Vall d'Hebron, Barcelona, Spain (J.S.G.); and Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, England (J.P.)
| | - Jaume Sastre-Garriga
- From the Neuroimaging Research Unit (L.S., M.A.R., E.P., M.F.) and Department of Neurology, Institute of Experimental Neurology, Division of Neuroscience (M.A.R., M.F.), San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Via Olgettina 60, 20132 Milan, Italy; Department of Research and Development, Icometrix, Leuven, Belgium (W.V.H., D. Sima, D. Smeets); Xinapse Systems, Colchester, England (M.A.H.); Department of Medicine, Surgery and Neuroscience, University of Siena, Siena, Italy (N.D.S.); Section of Neuroradiology, Department of Radiology, Hospital Universitari Vall d'Hebron, Barcelona, Spain (A.R.); Unit of Clinical Neuroimmunology, CEM-Cat, Hospital Universitari Vall d'Hebron, Barcelona, Spain (J.S.G.); and Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, England (J.P.)
| | - Jacqueline Palace
- From the Neuroimaging Research Unit (L.S., M.A.R., E.P., M.F.) and Department of Neurology, Institute of Experimental Neurology, Division of Neuroscience (M.A.R., M.F.), San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Via Olgettina 60, 20132 Milan, Italy; Department of Research and Development, Icometrix, Leuven, Belgium (W.V.H., D. Sima, D. Smeets); Xinapse Systems, Colchester, England (M.A.H.); Department of Medicine, Surgery and Neuroscience, University of Siena, Siena, Italy (N.D.S.); Section of Neuroradiology, Department of Radiology, Hospital Universitari Vall d'Hebron, Barcelona, Spain (A.R.); Unit of Clinical Neuroimmunology, CEM-Cat, Hospital Universitari Vall d'Hebron, Barcelona, Spain (J.S.G.); and Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, England (J.P.)
| | - Diana Sima
- From the Neuroimaging Research Unit (L.S., M.A.R., E.P., M.F.) and Department of Neurology, Institute of Experimental Neurology, Division of Neuroscience (M.A.R., M.F.), San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Via Olgettina 60, 20132 Milan, Italy; Department of Research and Development, Icometrix, Leuven, Belgium (W.V.H., D. Sima, D. Smeets); Xinapse Systems, Colchester, England (M.A.H.); Department of Medicine, Surgery and Neuroscience, University of Siena, Siena, Italy (N.D.S.); Section of Neuroradiology, Department of Radiology, Hospital Universitari Vall d'Hebron, Barcelona, Spain (A.R.); Unit of Clinical Neuroimmunology, CEM-Cat, Hospital Universitari Vall d'Hebron, Barcelona, Spain (J.S.G.); and Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, England (J.P.)
| | - Dirk Smeets
- From the Neuroimaging Research Unit (L.S., M.A.R., E.P., M.F.) and Department of Neurology, Institute of Experimental Neurology, Division of Neuroscience (M.A.R., M.F.), San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Via Olgettina 60, 20132 Milan, Italy; Department of Research and Development, Icometrix, Leuven, Belgium (W.V.H., D. Sima, D. Smeets); Xinapse Systems, Colchester, England (M.A.H.); Department of Medicine, Surgery and Neuroscience, University of Siena, Siena, Italy (N.D.S.); Section of Neuroradiology, Department of Radiology, Hospital Universitari Vall d'Hebron, Barcelona, Spain (A.R.); Unit of Clinical Neuroimmunology, CEM-Cat, Hospital Universitari Vall d'Hebron, Barcelona, Spain (J.S.G.); and Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, England (J.P.)
| | - Massimo Filippi
- From the Neuroimaging Research Unit (L.S., M.A.R., E.P., M.F.) and Department of Neurology, Institute of Experimental Neurology, Division of Neuroscience (M.A.R., M.F.), San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Via Olgettina 60, 20132 Milan, Italy; Department of Research and Development, Icometrix, Leuven, Belgium (W.V.H., D. Sima, D. Smeets); Xinapse Systems, Colchester, England (M.A.H.); Department of Medicine, Surgery and Neuroscience, University of Siena, Siena, Italy (N.D.S.); Section of Neuroradiology, Department of Radiology, Hospital Universitari Vall d'Hebron, Barcelona, Spain (A.R.); Unit of Clinical Neuroimmunology, CEM-Cat, Hospital Universitari Vall d'Hebron, Barcelona, Spain (J.S.G.); and Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, England (J.P.)
| | -
- From the Neuroimaging Research Unit (L.S., M.A.R., E.P., M.F.) and Department of Neurology, Institute of Experimental Neurology, Division of Neuroscience (M.A.R., M.F.), San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Via Olgettina 60, 20132 Milan, Italy; Department of Research and Development, Icometrix, Leuven, Belgium (W.V.H., D. Sima, D. Smeets); Xinapse Systems, Colchester, England (M.A.H.); Department of Medicine, Surgery and Neuroscience, University of Siena, Siena, Italy (N.D.S.); Section of Neuroradiology, Department of Radiology, Hospital Universitari Vall d'Hebron, Barcelona, Spain (A.R.); Unit of Clinical Neuroimmunology, CEM-Cat, Hospital Universitari Vall d'Hebron, Barcelona, Spain (J.S.G.); and Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, England (J.P.)
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Sinnecker T, Granziera C, Wuerfel J, Schlaeger R. Future Brain and Spinal Cord Volumetric Imaging in the Clinic for Monitoring Treatment Response in MS. Curr Treat Options Neurol 2018; 20:17. [PMID: 29679165 DOI: 10.1007/s11940-018-0504-7] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
PURPOSE OF REVIEW Volumetric analysis of brain imaging has emerged as a standard approach used in clinical research, e.g., in the field of multiple sclerosis (MS), but its application in individual disease course monitoring is still hampered by biological and technical limitations. This review summarizes novel developments in volumetric imaging on the road towards clinical application to eventually monitor treatment response in patients with MS. RECENT FINDINGS In addition to the assessment of whole-brain volume changes, recent work was focused on the volumetry of specific compartments and substructures of the central nervous system (CNS) in MS. This included volumetric imaging of the deep brain structures and of the spinal cord white and gray matter. Volume changes of the latter indeed independently correlate with clinical outcome measures especially in progressive MS. Ultrahigh field MRI and quantitative MRI added to this trend by providing a better visualization of small compartments on highly resolving MR images as well as microstructural information. New developments in volumetric imaging have the potential to improve sensitivity as well as specificity in detecting and hence monitoring disease-related CNS volume changes in MS.
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Affiliation(s)
- Tim Sinnecker
- Neurologic Clinic and Policlinic, Departments of Medicine, Clinical Research and Biomedical Engineering, University Hospital Basel and University of Basel, Petersgraben 4, 4031, Basel, Switzerland
- Translational Imaging in Neurology (ThINK) Basel, Department of Medicine and Biomedical Engineering, University Hospital Basel and University of Basel, Basel, Switzerland
- Medical Image Analysis Center Basel AG, Basel, Switzerland
- NeuroCure Clinical Research Center, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Cristina Granziera
- Neurologic Clinic and Policlinic, Departments of Medicine, Clinical Research and Biomedical Engineering, University Hospital Basel and University of Basel, Petersgraben 4, 4031, Basel, Switzerland
- Translational Imaging in Neurology (ThINK) Basel, Department of Medicine and Biomedical Engineering, University Hospital Basel and University of Basel, Basel, Switzerland
| | - Jens Wuerfel
- Medical Image Analysis Center Basel AG, Basel, Switzerland
- NeuroCure Clinical Research Center, Charité Universitätsmedizin Berlin, Berlin, Germany
- Berlin Ultrahigh Field Facility, Max Delbrück Center for Molecular Medicine, Berlin, Germany
| | - Regina Schlaeger
- Neurologic Clinic and Policlinic, Departments of Medicine, Clinical Research and Biomedical Engineering, University Hospital Basel and University of Basel, Petersgraben 4, 4031, Basel, Switzerland.
- Translational Imaging in Neurology (ThINK) Basel, Department of Medicine and Biomedical Engineering, University Hospital Basel and University of Basel, Basel, Switzerland.
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Gaetano L, Häring DA, Radue EW, Mueller-Lenke N, Thakur A, Tomic D, Kappos L, Sprenger T. Fingolimod effect on gray matter, thalamus, and white matter in patients with multiple sclerosis. Neurology 2018. [DOI: 10.1212/wnl.0000000000005292] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
ObjectiveTo study the effect of fingolimod on deep gray matter (dGM), thalamus, cortical GM (cGM), white matter (WM), and ventricular volume (VV) in patients with relapsing-remitting multiple sclerosis (RRMS).MethodsData were pooled from 2 phase III studies. A total of 2,064 of 2,355 (88%) contributed to the analysis: fingolimod 0.5 mg n = 783, fingolimod 1.25 mg n = 799, or placebo n = 773. Percentage change from baseline in dGM and thalamic volumes was evaluated with FMRIB’s Integrated Registration & Segmentation Tool; WM, cGM, and VV were evaluated with structural image evaluation using normalization of atrophy cross-sectional version (SIENAX) at months 12 and 24.ResultsAt baseline, compound brain volume (brain volume in the z block [BVz] = cGM + dGM + WM) correlated with SIENAX-normalized brain volume (r = 0.938, p < 0.001); percentage change from baseline in BVz over 2 years correlated with structural image evaluation using normalization of atrophy percentage brain volume change (r = 0.713, p < 0.001). For placebo, volume reductions were most pronounced in cGM, and relative changes from baseline were strongest in dGM. Over 24 months, there were significant reductions with fingolimod vs placebo for dGM (0.5 mg −14.5%, p = 0.017; 1.25 mg −26.6%, p < 0.01) and thalamus (0.5 mg −26.1%, p = 0.006; 1.25 mg −49.7%, p < 0.001). Reduction of cGM volume loss was not significant. Significantly less WM loss and VV enlargement were seen with fingolimod vs placebo (all p < 0.001). A high T2 lesion volume at baseline predicted on-study cGM, dGM, and thalamic volume loss (p < 0.0001) but not WM loss. Patients taking placebo with high dGM (hazard ratio [HR] 0.54, p = 0.0323) or thalamic (HR 0.58, p = 0.0663) volume at baseline were less likely to show future disability worsening.ConclusionsFingolimod significantly reduced dGM volume loss (including thalamus) vs placebo in patients with RRMS. Reducing dGM and thalamic volume loss might improve long-term outcome.
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Battaglini M, Jenkinson M, De Stefano N. SIENA-XL for improving the assessment of gray and white matter volume changes on brain MRI. Hum Brain Mapp 2018; 39:1063-1077. [PMID: 29222814 PMCID: PMC6866496 DOI: 10.1002/hbm.23828] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2017] [Revised: 07/10/2017] [Accepted: 09/15/2017] [Indexed: 01/18/2023] Open
Abstract
In this article, SIENA-XL, a new segmentation-based longitudinal pipeline is introduced, for: (i) increasing the precision of longitudinal volume change estimation for white (WM) and gray (GM) matter separately, compared with cross-sectional segmentation methods such as SIENAX; and (ii) avoiding potential biases in registration-based methods when Jacobians are used, with a smoothing extent larger than spatial scale between tissue-interfaces, which is where atrophy usually occurs. SIENA-XL implements a new brain extraction procedure and a multi-time-point intensity equalization step before performing the final segmentation that also includes separate segmentation of deep GM structures by using FMRIB's Integrated Registration and Segmentation Tool. The detection of GM and WM volume changes with SIENA-XL was evaluated using different healthy control (HC) and multiple sclerosis (MS) MRI datasets and compared with the traditional SIENAX and two Jacobian-based approaches, SPM12 and SIENAX-JI (a version of SIENAX including Jacobian integration - JI). In scan-rescan data from HCs, SIENA-XL showed: (i) a significant decrease in error, of 50-70% when compared with SIENAX; (ii) no significant differences in error when compared with SIENAX-JI and SPM12 in a scan-rescan HC dataset that included repositioning. When tested in a HC dataset with scan-rescan both at baseline and after 1 year of follow-up, SIENA-XL showed: (i) significantly higher precision (P < 0.01) than SIENAX; (ii) no significant differences to SIENAX-JI and SPM12. Finally, in a dataset of 79 MS patients with a 2 years follow-up, SIENA-XL showed a substantial reduction of sample size, by comparison with SIENAX, SIENAX-JI, and SPM12, for detecting treatment effects of 25, 30, and 50%. Hum Brain Mapp 39:1063-1077, 2018. © 2017 Wiley Periodicals, Inc.
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Affiliation(s)
- Marco Battaglini
- Department of Medicine, Surgery and NeuroscienceUniversity of SienaItaly
| | - Mark Jenkinson
- Department of Medicine, Surgery and NeuroscienceUniversity of SienaItaly
- Department of Clinical Neurology, University of OxfordOxford University Centre for Functional MRI of the Brain (FMRIB)United Kingdom
| | - Nicola De Stefano
- Department of Medicine, Surgery and NeuroscienceUniversity of SienaItaly
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Yousuf F, Dupuy SL, Tauhid S, Chu R, Kim G, Tummala S, Khalid F, Weiner HL, Chitnis T, Healy BC, Bakshi R. A two-year study using cerebral gray matter volume to assess the response to fingolimod therapy in multiple sclerosis. J Neurol Sci 2017; 383:221-229. [DOI: 10.1016/j.jns.2017.10.019] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2017] [Revised: 09/14/2017] [Accepted: 10/09/2017] [Indexed: 02/04/2023]
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Velasco-Annis C, Akhondi-Asl A, Stamm A, Warfield SK. Reproducibility of Brain MRI Segmentation Algorithms: Empirical Comparison of Local MAP PSTAPLE, FreeSurfer, and FSL-FIRST. J Neuroimaging 2017; 28:162-172. [PMID: 29134725 DOI: 10.1111/jon.12483] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2017] [Revised: 10/06/2017] [Accepted: 10/16/2017] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND AND PURPOSE Segmentation of human brain structures is crucial for the volumetric quantification of brain disease. Advances in algorithmic approaches have led to automated techniques that save time compared to interactive methods. Recently, the utility and accuracy of template library fusion algorithms, such as Local MAP PSTAPLE (PSTAPLE), have been demonstrated but there is little guidance regarding its reproducibility compared to single template-based algorithms such as FreeSurfer and FSL-FIRST. METHODS Eight repeated magnetic resonance imagings of 20 subjects were segmented using FreeSurfer, FSL-FIRST, and PSTAPLE. We reported the reproducibility of segmentation-derived volume measurements for brain structures and calculated sample size estimates for detecting hypothetical rates of tissue atrophy given the observed variances. RESULTS PSTAPLE had the most reproducible volume measurements for hippocampus, putamen, thalamus, caudate, pallidum, amygdala, Accumbens area, and cortical regions. FreeSurfer was most reproducible for brainstem. PSTAPLE was the most accurate algorithm in terms of several metrics include Dice's coefficient. The sample size estimates showed that a study utilizing PSTAPLE would require tens to hundreds less subjects than the other algorithms for detecting atrophy rates typically observed in brain disease. CONCLUSIONS PSTAPLE is a useful tool for automatic human brain segmentation due to its precision and accuracy, which enable the detection of the size of the effect typically reported for neurological disorders with a substantially reduced sample size, in comparison to the other tools we assessed. This enables randomized controlled trials to be executed with reduced cost and duration, in turn, facilitating the assessment of new therapeutic interventions.
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Affiliation(s)
- Clemente Velasco-Annis
- Computational Radiology Laboratory, Department of Radiology, Boston Children's Hospital, and Harvard Medical School, Boston, MA
| | - Alireza Akhondi-Asl
- Computational Radiology Laboratory, Department of Radiology, Boston Children's Hospital, and Harvard Medical School, Boston, MA
| | - Aymeric Stamm
- Computational Radiology Laboratory, Department of Radiology, Boston Children's Hospital, and Harvard Medical School, Boston, MA
| | - Simon K Warfield
- Computational Radiology Laboratory, Department of Radiology, Boston Children's Hospital, and Harvard Medical School, Boston, MA
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Johnson EB, Gregory S, Johnson HJ, Durr A, Leavitt BR, Roos RA, Rees G, Tabrizi SJ, Scahill RI. Recommendations for the Use of Automated Gray Matter Segmentation Tools: Evidence from Huntington's Disease. Front Neurol 2017; 8:519. [PMID: 29066997 PMCID: PMC5641297 DOI: 10.3389/fneur.2017.00519] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2017] [Accepted: 09/19/2017] [Indexed: 01/15/2023] Open
Abstract
The selection of an appropriate segmentation tool is a challenge facing any researcher aiming to measure gray matter (GM) volume. Many tools have been compared, yet there is currently no method that can be recommended above all others; in particular, there is a lack of validation in disease cohorts. This work utilizes a clinical dataset to conduct an extensive comparison of segmentation tools. Our results confirm that all tools have advantages and disadvantages, and we present a series of considerations that may be of use when selecting a GM segmentation method, rather than a ranking of these tools. Seven segmentation tools were compared using 3 T MRI data from 20 controls, 40 premanifest Huntington's disease (HD), and 40 early HD participants. Segmented volumes underwent detailed visual quality control. Reliability and repeatability of total, cortical, and lobular GM were investigated in repeated baseline scans. The relationship between each tool was also examined. Longitudinal within-group change over 3 years was assessed via generalized least squares regression to determine sensitivity of each tool to disease effects. Visual quality control and raw volumes highlighted large variability between tools, especially in occipital and temporal regions. Most tools showed reliable performance and the volumes were generally correlated. Results for longitudinal within-group change varied between tools, especially within lobular regions. These differences highlight the need for careful selection of segmentation methods in clinical neuroimaging studies. This guide acts as a primer aimed at the novice or non-technical imaging scientist providing recommendations for the selection of cohort-appropriate GM segmentation software.
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Affiliation(s)
- Eileanoir B. Johnson
- Huntington’s Disease Centre, UCL Institute of Neurology, University College London, London, United Kingdom
| | - Sarah Gregory
- Huntington’s Disease Centre, UCL Institute of Neurology, University College London, London, United Kingdom
| | - Hans J. Johnson
- Department of Electrical and Computer Engineering, University of Iowa, Iowa City, IA, United States
| | - Alexandra Durr
- Department of Genetics and Cytogenetics, INSERMUMR S679, APHP, ICM Institute, Hôpital de la Salpêtrière, Paris, France
| | - Blair R. Leavitt
- Centre for Molecular Medicine and Therapeutics, Department of Medical Genetics, University of British Columbia, Vancouver, BC, Canada
| | - Raymund A. Roos
- Department of Neurology, Leiden University Medical Centre, Leiden, Netherlands
- George-Huntington-Institut, münster, Germany
| | - Geraint Rees
- Wellcome Trust Centre for Neuroimaging, University College London, London, United Kingdom
| | - Sarah J. Tabrizi
- Huntington’s Disease Centre, UCL Institute of Neurology, University College London, London, United Kingdom
| | - Rachael I. Scahill
- Huntington’s Disease Centre, UCL Institute of Neurology, University College London, London, United Kingdom
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Fragoso YD, Willie PR, Goncalves MVM, Brooks JBB. Critical analysis on the present methods for brain volume measurements in multiple sclerosis. ARQUIVOS DE NEURO-PSIQUIATRIA 2017; 75:464-469. [PMID: 28746434 DOI: 10.1590/0004-282x20170072] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/24/2016] [Accepted: 03/30/2017] [Indexed: 11/22/2022]
Abstract
Objective The treatment of multiple sclerosis (MS) has quickly evolved from a time when controlling clinical relapses would suffice, to the present day, when complete disease control is expected. Measurement of brain volume is still at an early stage to be indicative of therapeutic decisions in MS. Methods This paper provides a critical review of potential biases and artifacts in brain measurement in the follow-up of patients with MS. Results Clinical conditions (such as hydration or ovulation), time of the day, type of magnetic resonance machine (manufacturer and potency), brain volume artifacts and different platforms for volumetric assessment of the brain can induce variations that exceed the acceptable physiological rate of annual loss of brain volume. Conclusion Although potentially extremely valuable, brain volume measurement still has to be regarded with caution in MS.
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Affiliation(s)
- Yara Dadalti Fragoso
- Universidade Metropolitana de Santos, Centro de Referência de Esclerose Múltipla, Departamento de Neurologia, Santos SP, Brasil
| | - Paulo Roberto Willie
- Universidade da Região de Joinville, Departamento de Neuroradiologia, Joinville SC, Brasil
| | | | - Joseph Bruno Bidin Brooks
- Universidade Metropolitana de Santos, Centro de Referência de Esclerose Múltipla, Departamento de Neurologia, Santos SP, Brasil
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Steenwijk MD, Amiri H, Schoonheim MM, de Sitter A, Barkhof F, Pouwels PJW, Vrenken H. Agreement of MSmetrix with established methods for measuring cross-sectional and longitudinal brain atrophy. NEUROIMAGE-CLINICAL 2017; 15:843-853. [PMID: 28794970 PMCID: PMC5540882 DOI: 10.1016/j.nicl.2017.06.034] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/06/2017] [Revised: 06/14/2017] [Accepted: 06/29/2017] [Indexed: 11/02/2022]
Abstract
INTRODUCTION Despite the recognized importance of atrophy in multiple sclerosis (MS), methods for its quantification have been mostly restricted to the research domain. Recently, a CE labelled and FDA approved MS-specific atrophy quantification method, MSmetrix, has become commercially available. Here we perform a validation of MSmetrix against established methods in simulated and in vivo MRI data. METHODS Whole-brain and gray matter (GM) volume were measured with the cross-sectional pipeline of MSmetrix and compared to the outcomes of FreeSurfer (cross-sectional pipeline), SIENAX and SPM. For this comparison we investigated 20 simulated brain images, as well as in vivo data from 100 MS patients and 20 matched healthy controls. In fifty of the MS patients a second time point was available. In this subgroup, we additionally analyzed the whole-brain and GM volume change using the longitudinal pipeline of MSmetrix and compared the results with those of FreeSurfer (longitudinal pipeline) and SIENA. RESULTS In the simulated data, SIENAX displayed the smallest average deviation compared with the reference whole-brain volume (+ 19.56 ± 10.34 mL), followed by MSmetrix (- 38.15 ± 17.77 mL), SPM (- 42.99 ± 17.12 mL) and FreeSurfer (- 78.51 ± 12.68 mL). A similar pattern was seen in vivo. Among the cross-sectional methods, Deming regression analyses revealed proportional errors particularly in MSmetrix and SPM. The mean difference percentage brain volume change (PBVC) was lowest between longitudinal MSmetrix and SIENA (+ 0.16 ± 0.91%). A strong proportional error was present between longitudinal percentage gray matter volume change (PGVC) measures of MSmetrix and FreeSurfer (slope = 2.48). All longitudinal methods were sensitive to the MRI hardware upgrade that occurred during the time of the study. CONCLUSION MSmetrix, FreeSurfer, FSL and SPM show differences in atrophy measurements, even at the whole-brain level, that are large compared to typical atrophy rates observed in MS. Especially striking are the proportional errors between methods. Cross-sectional MSmetrix behaved similarly to SPM, both in terms of mean volume difference as well as proportional error. Longitudinal MSmetrix behaved most similar to SIENA. Our results indicate that brain volume measurement and normalization from T1-weighted images remains an unsolved problem that requires much more attention.
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Affiliation(s)
- Martijn D Steenwijk
- Department of Radiology and Nuclear Medicine, Neuroscience Campus Amsterdam, VU University Medical Center, The Netherlands; Department of Physics and Medical Technology, Neuroscience Campus Amsterdam, VU University Medical Center, The Netherlands.
| | - Houshang Amiri
- Department of Physics and Medical Technology, Neuroscience Campus Amsterdam, VU University Medical Center, The Netherlands.
| | - Menno M Schoonheim
- Department of Anatomy and Neurosciences, Neuroscience Campus Amsterdam, VU University Medical Center, The Netherlands.
| | - Alexandra de Sitter
- Department of Radiology and Nuclear Medicine, Neuroscience Campus Amsterdam, VU University Medical Center, The Netherlands
| | - Frederik Barkhof
- Department of Radiology and Nuclear Medicine, Neuroscience Campus Amsterdam, VU University Medical Center, The Netherlands; Institute of Neurology & Healthcare Engineering, UCL, London, UK.
| | - Petra J W Pouwels
- Department of Physics and Medical Technology, Neuroscience Campus Amsterdam, VU University Medical Center, The Netherlands.
| | - Hugo Vrenken
- Department of Radiology and Nuclear Medicine, Neuroscience Campus Amsterdam, VU University Medical Center, The Netherlands; Department of Physics and Medical Technology, Neuroscience Campus Amsterdam, VU University Medical Center, The Netherlands.
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Viviani R, Pracht ED, Brenner D, Beschoner P, Stingl JC, Stöcker T. Multimodal MEMPRAGE, FLAIR, and [Formula: see text] Segmentation to Resolve Dura and Vessels from Cortical Gray Matter. Front Neurosci 2017; 11:258. [PMID: 28536501 PMCID: PMC5423271 DOI: 10.3389/fnins.2017.00258] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2016] [Accepted: 04/21/2017] [Indexed: 02/03/2023] Open
Abstract
While widely in use in automated segmentation approaches for the detection of group differences or of changes associated with continuous predictors in gray matter volume, T1-weighted images are known to represent dura and cortical vessels with signal intensities similar to those of gray matter. By considering multiple signal sources at once, multimodal segmentation approaches may be able to resolve these different tissue classes and address this potential confound. We explored here the simultaneous use of FLAIR and apparent transverse relaxation rates (a signal related to T2* relaxation maps and having similar contrast) with T1-weighted images. Relative to T1-weighted images alone, multimodal segmentation had marked positive effects on 1. the separation of gray matter from dura, 2. the exclusion of vessels from the gray matter compartment, and 3. the contrast with extracerebral connective tissue. While obtainable together with the T1-weighted images without increasing scanning times, apparent transverse relaxation rates were less effective than added FLAIR images in providing the above mentioned advantages. FLAIR images also improved the detection of cortical matter in areas prone to susceptibility artifacts in standard MPRAGE T1-weighted images, while the addition of transverse relaxation maps exacerbated the effect of these artifacts on segmentation. Our results confirm that standard MPRAGE segmentation may overestimate gray matter volume by wrongly assigning vessels and dura to this compartment and show that multimodal approaches may greatly improve the specificity of cortical segmentation. Since multimodal segmentation is easily implemented, these benefits are immediately available to studies focusing on translational applications of structural imaging.
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Affiliation(s)
- Roberto Viviani
- Institute of Psychology, University of InnsbruckInnsbruck, Austria.,Psychiatry and Psychotherapy Clinic III, University of UlmUlm, Germany
| | | | - Daniel Brenner
- German Center for Neurodegenerative Diseases (DZNE)Bonn, Germany
| | - Petra Beschoner
- Clinic for Psychosomatic Medicine and Psychotherapy, University of UlmUlm, Germany
| | - Julia C Stingl
- Research Division, Federal Institute for Drugs and Medical DevicesBonn, Germany.,Center for Translational Medicine, University of Bonn Medical SchoolBonn, Germany
| | - Tony Stöcker
- German Center for Neurodegenerative Diseases (DZNE)Bonn, Germany.,Department of Physics and Astronomy, University of BonnBonn, Germany
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34
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Hanspach J, Dwyer MG, Bergsland NP, Feng X, Hagemeier J, Bertolino N, Polak P, Reichenbach JR, Zivadinov R, Schweser F. Methods for the computation of templates from quantitative magnetic susceptibility maps (QSM): Toward improved atlas- and voxel-based analyses (VBA). J Magn Reson Imaging 2017; 46:1474-1484. [PMID: 28263417 DOI: 10.1002/jmri.25671] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2016] [Accepted: 01/30/2017] [Indexed: 12/31/2022] Open
Abstract
PURPOSE To develop and assess a method for the creation of templates for voxel-based analysis (VBA) and atlas-based approaches using quantitative magnetic susceptibility mapping (QSM). MATERIALS AND METHODS We studied four strategies for the creation of magnetic susceptibility brain templates, derived as successive extensions of the conventional template generation (CONV) based on only T1 -weighted (T1 w) images. One method that used only T1 w images involved a minor improvement of CONV (U-CONV). One method used only magnetic susceptibility maps as input for template generation (DIRECT), and the other two used a linear combination of susceptibility and T1 w images (HYBRID) and an algorithm that directly used both image modalities (MULTI), respectively. The strategies were evaluated in a group of N = 10 healthy human subjects and semiquantitatively assessed by three experienced raters. Template quality was compared statistically via worth estimates (WEs) obtained with a log-linear Bradley-Terry model. RESULTS The overall quality of the templates was better for strategies including both susceptibility and T1 w contrast (MULTI: WE = 0.62; HYBRID: WE = 0.21), but the best method depended on the anatomical region of interest. While methods using only one modality resulted in lower WEs, lowest overall WEs were obtained when only T1 w images were used (DIRECT: WE = 0.12; U-CONV: WE = 0.05). CONCLUSION Template generation strategies that employ only magnetic susceptibility contrast or both magnetic susceptibility and T1 w contrast produce templates with the highest quality. The optimal approach depends on the anatomical structures of interest. The established approach of using only T1 w images (CONV) results in reduced image quality compared to all other approaches studied. LEVEL OF EVIDENCE 2 Technical Efficacy: Stage 1 J. Magn. Reson. Imaging 2017;46:1474-1484.
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Affiliation(s)
- Jannis Hanspach
- Buffalo Neuroimaging Analysis Center, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, New York, USA
| | - Michael G Dwyer
- Buffalo Neuroimaging Analysis Center, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, New York, USA
| | - Niels P Bergsland
- Buffalo Neuroimaging Analysis Center, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, New York, USA.,Magnetic Resonance Laboratory, IRCCS Don Gnocchi Foundation, Milan, Italy
| | - Xiang Feng
- Medical Physics Group, Institute of Diagnostic and Interventional Radiology, Jena University Hospital, Friedrich Schiller University Jena, Jena, TH, Germany
| | - Jesper Hagemeier
- Buffalo Neuroimaging Analysis Center, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, New York, USA
| | - Nicola Bertolino
- Buffalo Neuroimaging Analysis Center, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, New York, USA
| | - Paul Polak
- Buffalo Neuroimaging Analysis Center, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, New York, USA
| | - Jürgen R Reichenbach
- Medical Physics Group, Institute of Diagnostic and Interventional Radiology, Jena University Hospital, Friedrich Schiller University Jena, Jena, TH, Germany.,Michael Stifel Center for Data-driven and Simulation Science Jena, Friedrich Schiller University Jena, Jena, TH, Germany
| | - Robert Zivadinov
- Buffalo Neuroimaging Analysis Center, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, New York, USA.,MRI Clinical and Translational Research Center, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, New York, USA
| | - Ferdinand Schweser
- Buffalo Neuroimaging Analysis Center, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, New York, USA.,MRI Clinical and Translational Research Center, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, New York, USA
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Feng X, Deistung A, Dwyer MG, Hagemeier J, Polak P, Lebenberg J, Frouin F, Zivadinov R, Reichenbach JR, Schweser F. An improved FSL-FIRST pipeline for subcortical gray matter segmentation to study abnormal brain anatomy using quantitative susceptibility mapping (QSM). Magn Reson Imaging 2017; 39:110-122. [PMID: 28188873 DOI: 10.1016/j.mri.2017.02.002] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2016] [Revised: 02/05/2017] [Accepted: 02/05/2017] [Indexed: 12/13/2022]
Abstract
Accurate and robust segmentation of subcortical gray matter (SGM) nuclei is required in many neuroimaging applications. FMRIB's Integrated Registration and Segmentation Tool (FIRST) is one of the most popular software tools for automated subcortical segmentation based on T1-weighted (T1w) images. In this work, we demonstrate that FIRST tends to produce inaccurate SGM segmentation results in the case of abnormal brain anatomy, such as present in atrophied brains, due to a poor spatial match of the subcortical structures with the training data in the MNI space as well as due to insufficient contrast of SGM structures on T1w images. Consequently, such deviations from the average brain anatomy may introduce analysis bias in clinical studies, which may not always be obvious and potentially remain unidentified. To improve the segmentation of subcortical nuclei, we propose to use FIRST in combination with a special Hybrid image Contrast (HC) and Non-Linear (nl) registration module (HC-nlFIRST), where the hybrid image contrast is derived from T1w images and magnetic susceptibility maps to create subcortical contrast that is similar to that in the Montreal Neurological Institute (MNI) template. In our approach, a nonlinear registration replaces FIRST's default linear registration, yielding a more accurate alignment of the input data to the MNI template. We evaluated our method on 82 subjects with particularly abnormal brain anatomy, selected from a database of >2000 clinical cases. Qualitative and quantitative analyses revealed that HC-nlFIRST provides improved segmentation compared to the default FIRST method.
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Affiliation(s)
- Xiang Feng
- Medical Physics Group, Institute of Diagnostic and Interventional Radiology, Jena University Hospital - Friedrich Schiller University Jena, Jena, Germany.
| | - Andreas Deistung
- Medical Physics Group, Institute of Diagnostic and Interventional Radiology, Jena University Hospital - Friedrich Schiller University Jena, Jena, Germany; Section of Experimental Neurology, Department of Neurology, Essen University Hospital, Essen, Germany; Erwin L. Hahn Institute for Magnetic Resonance Imaging, University Duisburg-Essen, Essen, Germany
| | - Michael G Dwyer
- Buffalo Neuroimaging Analysis Center, Dept. of Neurology, Jacobs School of Medicine and Biomedical Sciences, State University of New York at Buffalo, Buffalo, NY, United States
| | - Jesper Hagemeier
- Buffalo Neuroimaging Analysis Center, Dept. of Neurology, Jacobs School of Medicine and Biomedical Sciences, State University of New York at Buffalo, Buffalo, NY, United States
| | - Paul Polak
- Buffalo Neuroimaging Analysis Center, Dept. of Neurology, Jacobs School of Medicine and Biomedical Sciences, State University of New York at Buffalo, Buffalo, NY, United States
| | - Jessica Lebenberg
- UNATI, CEA DRF/I2BM, INSERM, Université Paris-Sud, Université Paris-Saclay, NeuroSpin Center, Gif/Yvette, France
| | - Frédérique Frouin
- Inserm/CEA/Université Paris Sud/CNRS, CEA/I2BM/SHFJ, Laboratoire IMIV, Orsay, France
| | - Robert Zivadinov
- Buffalo Neuroimaging Analysis Center, Dept. of Neurology, Jacobs School of Medicine and Biomedical Sciences, State University of New York at Buffalo, Buffalo, NY, United States; MRI Molecular and Translational Imaging Center, Buffalo CTRC, State University of New York at Buffalo, Buffalo, NY, United States
| | - Jürgen R Reichenbach
- Medical Physics Group, Institute of Diagnostic and Interventional Radiology, Jena University Hospital - Friedrich Schiller University Jena, Jena, Germany; Center of Medical Optics and Photonics, Friedrich Schiller University Jena, Germany; Michael Stifel Center for Data-driven and Simulation Science Jena, Friedrich Schiller University Jena, Germany
| | - Ferdinand Schweser
- Buffalo Neuroimaging Analysis Center, Dept. of Neurology, Jacobs School of Medicine and Biomedical Sciences, State University of New York at Buffalo, Buffalo, NY, United States; MRI Molecular and Translational Imaging Center, Buffalo CTRC, State University of New York at Buffalo, Buffalo, NY, United States
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Besson P, Carrière N, Bandt SK, Tommasi M, Leclerc X, Derambure P, Lopes R, Tyvaert L. Whole-Brain High-Resolution Structural Connectome: Inter-Subject Validation and Application to the Anatomical Segmentation of the Striatum. Brain Topogr 2017; 30:291-302. [PMID: 28176164 DOI: 10.1007/s10548-017-0548-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2016] [Accepted: 01/18/2017] [Indexed: 01/30/2023]
Abstract
The present study describes extraction of high-resolution structural connectome (HRSC) in 99 healthy subjects, acquired and made available by the Human Connectome Project. Single subject connectomes were then registered to the common surface space to allow assessment of inter-individual reproducibility of this novel technique using a leave-one-out approach. The anatomic relevance of the surface-based connectome was examined via a clustering algorithm, which identified anatomic subdivisions within the striatum. The connectivity of these striatal subdivisions were then mapped on the cortical and other subcortical surfaces. Findings demonstrate that HRSC analysis is robust across individuals and accurately models the actual underlying brain networks related to the striatum. This suggests that this method has the potential to model and characterize the healthy whole-brain structural network at high anatomic resolution.
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Affiliation(s)
- Pierre Besson
- Aix Marseille Université, CNRS, CRMBM, 7339, Marseille, France. .,AP-HM, CHU Timone, Pôle d'Imagerie, CEMEREM, 264 rue Saint-Pierre, Marseille, 13385, France.
| | - Nicolas Carrière
- U1171, INSERM, Université de Lille, Lille, France.,Neurology and Movement disorders Department, Lille University Hospital, Lille, France
| | - S Kathleen Bandt
- Aix Marseille Université, CNRS, CRMBM, 7339, Marseille, France.,AP-HM, CHU Timone, Pôle d'Imagerie, CEMEREM, 264 rue Saint-Pierre, Marseille, 13385, France
| | - Marc Tommasi
- Université de Lille, CRIStAL UMR9189, INRIA, Magnet Team, Lille, France
| | - Xavier Leclerc
- Clinical Imaging Core Facility, INSERM U1171, Lille University Hospital, Lille, France
| | - Philippe Derambure
- U1171, INSERM, Université de Lille, Lille, France.,Department of Clinical Neurophysiology, Lille University Hospital, Lille, France
| | - Renaud Lopes
- Clinical Imaging Core Facility, INSERM U1171, Lille University Hospital, Lille, France
| | - Louise Tyvaert
- Department of Neurology, Nancy University Hospital, Nancy, France.,CRAN, UMR CNRS 7039, University of Lorraine, Nancy, France
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Vidal-Jordana A, Pareto D, Sastre-Garriga J, Auger C, Ciampi E, Montalban X, Rovira A. Measurement of Cortical Thickness and Volume of Subcortical Structures in Multiple Sclerosis: Agreement between 2D Spin-Echo and 3D MPRAGE T1-Weighted Images. AJNR Am J Neuroradiol 2017; 38:250-256. [PMID: 27884876 DOI: 10.3174/ajnr.a4999] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2016] [Accepted: 09/05/2016] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE Gray matter pathology is known to occur in multiple sclerosis and is related to disease outcomes. FreeSurfer and the FMRIB Integrated Registration and Segmentation Tool (FIRST) have been developed for measuring cortical and subcortical gray matter in 3D-gradient-echo T1-weighted images. Unfortunately, most historical MS cohorts do not have 3D-gradient-echo, but 2D-spin-echo images instead. We aimed to evaluate whether cortical thickness and the volume of subcortical structures measured with FreeSurfer and FIRST could be reliably measured in 2D-spin-echo images and to investigate the strength and direction of clinicoradiologic correlations. MATERIALS AND METHODS Thirty-eight patients with MS and 2D-spin-echo and 3D-gradient-echo T1-weighted images obtained at the same time were analyzed by using FreeSurfer and FIRST. The intraclass correlation coefficient between the estimates was obtained. Correlation coefficients were used to investigate clinicoradiologic associations. RESULTS Subcortical volumes obtained with both FreeSurfer and FIRST showed good agreement between 2D-spin-echo and 3D-gradient-echo images, with 68.8%-76.2% of the structures having either a substantial or almost perfect agreement. Nevertheless, with FIRST with 2D-spin-echo, 18% of patients had mis-segmentation. Cortical thickness had the lowest intraclass correlation coefficient values, with only 1 structure (1.4%) having substantial agreement. Disease duration and the Expanded Disability Status Scale showed a moderate correlation with most of the subcortical structures measured with 3D-gradient-echo images, but some correlations lost significance with 2D-spin-echo images, especially with FIRST. CONCLUSIONS Cortical thickness estimates with FreeSurfer on 2D-spin-echo images are inaccurate. Subcortical volume estimates obtained with FreeSurfer and FIRST on 2D-spin-echo images seem to be reliable, with acceptable clinicoradiologic correlations for FreeSurfer.
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Affiliation(s)
- A Vidal-Jordana
- From the Department of Neurology-Neuroimmunology and Multiple Sclerosis Centre of Catalonia (A.V.-J., J.S.-G., E.C., X.M.)
| | - D Pareto
- Magnetic Resonance Unit (D.P., C.A., A.R.), Radiology Department, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain.
| | - J Sastre-Garriga
- From the Department of Neurology-Neuroimmunology and Multiple Sclerosis Centre of Catalonia (A.V.-J., J.S.-G., E.C., X.M.)
| | - C Auger
- Magnetic Resonance Unit (D.P., C.A., A.R.), Radiology Department, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - E Ciampi
- From the Department of Neurology-Neuroimmunology and Multiple Sclerosis Centre of Catalonia (A.V.-J., J.S.-G., E.C., X.M.)
| | - X Montalban
- From the Department of Neurology-Neuroimmunology and Multiple Sclerosis Centre of Catalonia (A.V.-J., J.S.-G., E.C., X.M.)
| | - A Rovira
- Magnetic Resonance Unit (D.P., C.A., A.R.), Radiology Department, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
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38
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González Torre JA, Cruz-Gómez ÁJ, Belenguer A, Sanchis-Segura C, Ávila C, Forn C. Hippocampal dysfunction is associated with memory impairment in multiple sclerosis: A volumetric and functional connectivity study. Mult Scler 2017; 23:1854-1863. [PMID: 28086035 DOI: 10.1177/1352458516688349] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
BACKGROUND Previous studies have suggested a relationship between neuroanatomical and neurofunctional hippocampal alterations and episodic memory impairments in multiple sclerosis (MS) patients. OBJECTIVE We examined hippocampus volume and functional connectivity (FC) changes in MS patients with different episodic memory capabilities. METHODS Hippocampal subfield volume and FC changes were compared in two subgroups of MS patients with and without episodic memory impairment (multiple sclerosis impaired (MSi) and multiple sclerosis preserved (MSp), respectively) and healthy controls (HC). A discriminant function (DF) analysis was used to identify which of these neuroanatomical and neurofunctional parameters were the most relevant components of the mnemonic profiles of HC, MSp, and MSi. RESULTS MSi showed reduced volume in several hippocampal subfields compared to MSp and HC. Ordinal gradation (MSi > MSp > HC) was also observed for FC between the posterior hippocampus and several cortical areas. DF-based analyses revealed that reduced right fimbria volume and enhanced FC at the right posterior hippocampus were the main neural signatures of the episodic memory impairments observed in the MSi group. CONCLUSION Before any sign of episodic memory alterations (MSp), FC increased on several pathways that connect the hippocampus with cortical areas. These changes further increased when the several hippocampal volumes reduced and memory deficits appeared (MSi).
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Affiliation(s)
- Julio Alberto González Torre
- Departament de Psicología Bàsica, Clínica i Psicobiología, Facultat de Ciències de la Salut, Universitat Jaume I, Castelló de la Plana, Spain
| | - Álvaro Javier Cruz-Gómez
- Departament de Psicología Bàsica, Clínica i Psicobiología, Facultat de Ciències de la Salut, Universitat Jaume I, Castelló de la Plana, Spain
| | - Antonio Belenguer
- Servicio de Neurología, Hospital General de Castellón, Castelló de la Plana, Spain
| | - Carla Sanchis-Segura
- Departament de Psicología Bàsica, Clínica i Psicobiología, Facultat de Ciències de la Salut, Universitat Jaume I, Castelló de la Plana, Spain
| | - César Ávila
- Departament de Psicología Bàsica, Clínica i Psicobiología, Facultat de Ciències de la Salut, Universitat Jaume I, Castelló de la Plana, Spain
| | - Cristina Forn
- Departament de Psicología Bàsica, Clínica i Psicobiología, Facultat de Ciències de la Salut, Universitat Jaume I, Castelló de la Plana, Spain
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39
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Roura E, Schneider T, Modat M, Daga P, Muhlert N, Chard D, Ourselin S, Lladó X, Gandini Wheeler-Kingshott C. Multi-channel registration of fractional anisotropy and T1-weighted images in the presence of atrophy: application to multiple sclerosis. FUNCTIONAL NEUROLOGY 2016; 30:245-56. [PMID: 26727703 DOI: 10.11138/fneur/2015.30.4.245] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Co-registration of structural T1-weighted (T1w) scans and diffusion tensor imaging (DTI)-derived fractional anisotropy (FA) maps to a common space is of particular interest in neuroimaging, as T1w scans can be used for brain segmentation while DTI can provide microstructural tissue information. While the effect of lesions on registration has been tackled and solutions are available, the issue of atrophy is still open to discussion. Multi-channel (MC) registration algorithms have the advantage of maintaining anatomical correspondence between different contrast images after registration to any target space. In this work, we test the performance of an MC registration approach applied to T1w and FA data using simulated brain atrophy images. Experimental results are compared with a standard single-channel registration approach. Multi-channel registration of fractional anisotropy and T1-weighted images in the presence of atrophy: application to multiple sclerosis Both qualitative and quantitative evaluations are presented, showing that the MC approach provides better alignment with the target while maintaining better T1w and FA co-alignment.
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40
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Koini M, Filippi M, Rocca MA, Yousry T, Ciccarelli O, Tedeschi G, Gallo A, Ropele S, Valsasina P, Riccitelli G, Damjanovic D, Muhlert N, Mancini L, Fazekas F, Enzinger C. Correlates of Executive Functions in Multiple Sclerosis Based on Structural and Functional MR Imaging: Insights from a Multicenter Study. Radiology 2016; 280:869-79. [DOI: 10.1148/radiol.2016151809] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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41
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Biberacher V, Schmidt P, Keshavan A, Boucard CC, Righart R, Sämann P, Preibisch C, Fröbel D, Aly L, Hemmer B, Zimmer C, Henry RG, Mühlau M. Intra- and interscanner variability of magnetic resonance imaging based volumetry in multiple sclerosis. Neuroimage 2016; 142:188-197. [PMID: 27431758 DOI: 10.1016/j.neuroimage.2016.07.035] [Citation(s) in RCA: 59] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2016] [Revised: 07/05/2016] [Accepted: 07/14/2016] [Indexed: 11/26/2022] Open
Abstract
Brain volumetric measurements in multiple sclerosis (MS) reflect not only disease-specific processes but also other sources of variability. The latter has to be considered especially in multicenter and longitudinal studies. Here, we compare data generated by three different 3-Tesla magnetic resonance scanners (Philips Achieva; Siemens Verio; GE Signa MR750). We scanned two patients diagnosed with relapsing remitting MS six times per scanner within three weeks (T1w and FLAIR, 3D). We assessed T2-hyperintense lesions by an automated lesion segmentation tool and determined volumes of grey matter (GM), white matter (WM) and whole brain (GM+WM) from the lesion-filled T1-weighted images using voxel-based morphometry (SPM8/VBM8) and SIENAX (FSL). We measured cortical thickness using FreeSurfer from both, lesion-filled and original T1-weighted images. We quantified brain volume changes with SIENA. In both patients, we found significant differences in total lesion volume, global brain tissue volumes and cortical thickness measures between the scanners. Morphometric measures varied remarkably between repeated scans at each scanner, independent of the brain imaging software tool used. We conclude that for cross-sectional multicenter studies, the effect of different scanners has to be taken into account. For longitudinal monocentric studies, the expected effect size should exceed the size of false positive findings observed in this study. Assuming a physiological loss of brain volume of about 0.3% per year in healthy adult subjects (Good et al., 2001), which may double in MS (De Stefano et al., 2010; De Stefano et al., 2015), with current tools reliable estimation of brain atrophy in individual patients is only possible over periods of several years.
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Affiliation(s)
- Viola Biberacher
- Neurology, Technische Universität München, Ismaninger Str. 22, 81675 Munich, Germany; TUM-Neuroimaging Center, Technische Universität München, Munich, Germany.
| | - Paul Schmidt
- TUM-Neuroimaging Center, Technische Universität München, Munich, Germany; Statistics, Ludwig-Maximilians-Universität München, Ludwigstr. 33, 80539 Munich, Germany
| | - Anisha Keshavan
- Neurology, University of California San Francisco, 675 Nelson Rising Lane, San Francisco, CA 94158, United States
| | - Christine C Boucard
- Neurology, Technische Universität München, Ismaninger Str. 22, 81675 Munich, Germany; TUM-Neuroimaging Center, Technische Universität München, Munich, Germany
| | - Ruthger Righart
- Neurology, Technische Universität München, Ismaninger Str. 22, 81675 Munich, Germany; TUM-Neuroimaging Center, Technische Universität München, Munich, Germany
| | - Philipp Sämann
- Neuroimaging Core Unit, Max Planck Institute of Psychiatry, Kraepelinstr. 2-10, 80804 Munich, Germany
| | - Christine Preibisch
- Neuroradiology, Technische Universität München, Ismaninger Str. 22, 81675 Munich, Germany
| | - Daniel Fröbel
- Neuroradiology, Technische Universität München, Ismaninger Str. 22, 81675 Munich, Germany
| | - Lilian Aly
- Neurology, Technische Universität München, Ismaninger Str. 22, 81675 Munich, Germany
| | - Bernhard Hemmer
- Neurology, Technische Universität München, Ismaninger Str. 22, 81675 Munich, Germany; Munich Cluster for Systems Neurology (SyNergy), Feodor-Lynen-Str. 17, 81377 Munich, Germany
| | - Claus Zimmer
- Neuroradiology, Technische Universität München, Ismaninger Str. 22, 81675 Munich, Germany
| | - Roland G Henry
- Neurology, University of California San Francisco, 675 Nelson Rising Lane, San Francisco, CA 94158, United States
| | - Mark Mühlau
- Neurology, Technische Universität München, Ismaninger Str. 22, 81675 Munich, Germany; TUM-Neuroimaging Center, Technische Universität München, Munich, Germany
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42
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Nantes JC, Zhong J, Holmes SA, Narayanan S, Lapierre Y, Koski L. Cortical Damage and Disability in Multiple Sclerosis: Relation to Intracortical Inhibition and Facilitation. Brain Stimul 2016; 9:566-73. [DOI: 10.1016/j.brs.2016.01.003] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2015] [Revised: 12/11/2015] [Accepted: 01/05/2016] [Indexed: 10/22/2022] Open
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43
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Popescu V, Klaver R, Versteeg A, Voorn P, Twisk JWR, Barkhof F, Geurts JJG, Vrenken H. Postmortem validation of MRI cortical volume measurements in MS. Hum Brain Mapp 2016; 37:2223-33. [PMID: 26945922 DOI: 10.1002/hbm.23168] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2015] [Revised: 02/19/2016] [Accepted: 02/21/2016] [Indexed: 11/06/2022] Open
Abstract
Grey matter (GM) atrophy is a prominent aspect of multiple sclerosis pathology and an important outcome in studies. GM atrophy measurement requires accurate GM segmentation. Several methods are used in vivo for measuring GM volumes in MS, but assessing their validity in vivo remains challenging. In this postmortem study, we evaluated the correlation between postmortem MRI cortical volume or thickness and the cortical thickness measured on histological sections. Sixteen MS brains were scanned in situ using 3DT1-weighted MRI and these images were used to measure regional cortical volume using FSL-SIENAX, FreeSurfer, and SPM, and regional cortical thickness using FreeSurfer. Subsequently, cortical thickness was measured histologically in 5 systematically sampled cortical areas. Linear regression analyses were used to evaluate the relation between MRI regional cortical volume or thickness and histological cortical thickness to determine which postprocessing technique was most valid. After correction for multiple comparisons, we observed a significant correlation with the histological cortical thickness for FSL-SIENAX cortical volume with manual editing (std. β = 0.345, adjusted R(2) = 0.105, P = 0.005), and FreeSurfer cortical volume with manual editing (std. β = 0.379, adjusted R(2) = 0.129, P = 0.003). In addition, there was a significant correlation between FreeSurfer cortical thickness with manual editing and histological cortical thickness (std. β = 0.381, adjusted R(2) = 0.130, P = 0.003). The results support the use of FSL-SIENAX and FreeSurfer in cases of severe MS pathology. Interestingly none of the methods were significant in automated mode, which supports the use of manual editing to improve the automated segmentation. Hum Brain Mapp 37:2223-2233, 2016. © 2016 Wiley Periodicals, Inc.
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Affiliation(s)
- Veronica Popescu
- Department of Radiology and Nuclear Medicine, VU University Medical Center, Amsterdam, The Netherlands
| | - Roel Klaver
- Department of Anatomy and Neurosciences, VU University Medical Center, Amsterdam, The Netherlands
| | - Adriaan Versteeg
- Department of Radiology and Nuclear Medicine, VU University Medical Center, Amsterdam, The Netherlands
| | - Pieter Voorn
- Department of Anatomy and Neurosciences, VU University Medical Center, Amsterdam, The Netherlands
| | - Jos W R Twisk
- Department of Epidemiology and Biostatistics, VU University Medical Center, Amsterdam, The Netherlands
| | - Frederik Barkhof
- Department of Radiology and Nuclear Medicine, VU University Medical Center, Amsterdam, The Netherlands
| | - Jeroen J G Geurts
- Department of Anatomy and Neurosciences, VU University Medical Center, Amsterdam, The Netherlands
| | - Hugo Vrenken
- Department of Radiology and Nuclear Medicine, VU University Medical Center, Amsterdam, The Netherlands.,Department of Physics and Medical Technology, VU University Medical Center, Amsterdam, The Netherlands
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Pareto D, Sastre-Garriga J, Aymerich FX, Auger C, Tintoré M, Montalban X, Rovira A. Lesion filling effect in regional brain volume estimations: a study in multiple sclerosis patients with low lesion load. Neuroradiology 2016; 58:467-74. [DOI: 10.1007/s00234-016-1654-5] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2015] [Accepted: 01/26/2016] [Indexed: 11/30/2022]
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45
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Nantes JC, Zhong J, Holmes SA, Whatley B, Narayanan S, Lapierre Y, Arnold DL, Koski L. Intracortical inhibition abnormality during the remission phase of multiple sclerosis is related to upper limb dexterity and lesions. Clin Neurophysiol 2016; 127:1503-1511. [DOI: 10.1016/j.clinph.2015.08.011] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2015] [Revised: 07/24/2015] [Accepted: 08/24/2015] [Indexed: 11/24/2022]
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46
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Popescu V, Schoonheim MM, Versteeg A, Chaturvedi N, Jonker M, Xavier de Menezes R, Gallindo Garre F, Uitdehaag BMJ, Barkhof F, Vrenken H. Grey Matter Atrophy in Multiple Sclerosis: Clinical Interpretation Depends on Choice of Analysis Method. PLoS One 2016; 11:e0143942. [PMID: 26745873 PMCID: PMC4706325 DOI: 10.1371/journal.pone.0143942] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2015] [Accepted: 11/11/2015] [Indexed: 11/27/2022] Open
Abstract
Background Studies disagree on the location of grey matter (GM) atrophy in the multiple sclerosis (MS) brain. Aim To examine the consistency between FSL, FreeSurfer, SPM for GM atrophy measurement (for volumes, patient/control discrimination, and correlations with cognition). Materials and Methods 127 MS patients and 50 controls were included and cortical and deep grey matter (DGM) volumetrics were performed. Consistency of volumes was assessed with Intraclass Correlation Coefficient/ICC. Consistency of patients/controls discrimination was assessed with Cohen’s d, t-tests, MANOVA and a penalized double-loop logistic classifier. Consistency of association with cognition was assessed with Pearson correlation coefficient and ANOVA. Voxel-based morphometry (SPM-VBM and FSL-VBM) and vertex-wise FreeSurfer were used for group-level comparisons. Results The highest volumetry ICC were between SPM and FreeSurfer for cortical regions, and the lowest between SPM and FreeSurfer for DGM. The caudate nucleus and temporal lobes had high consistency between all software, while amygdala had lowest volumetric consistency. Consistency of patients/controls discrimination was largest in the DGM for all software, especially for thalamus and pallidum. The penalized double-loop logistic classifier most often selected the thalamus, pallidum and amygdala for all software. FSL yielded the largest number of significant correlations. DGM yielded stronger correlations with cognition than cortical volumes. Bilateral putamen and left insula volumes correlated with cognition using all methods. Conclusion GM volumes from FreeSurfer, FSL and SPM are different, especially for cortical regions. While group-level separation between MS and controls is comparable, correlations between regional GM volumes and clinical/cognitive variables in MS should be cautiously interpreted.
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Affiliation(s)
- Veronica Popescu
- Department of Radiology and Nuclear Medicine, Neuroscience Campus Amsterdam (NCA), VU University Medical Center, Amsterdam, The Netherlands
| | - Menno M. Schoonheim
- Department of Anatomy and Neurosciences, Neuroscience Campus Amsterdam (NCA), VU University Medical Center, Amsterdam, The Netherlands
| | - Adriaan Versteeg
- Department of Radiology and Nuclear Medicine, Neuroscience Campus Amsterdam (NCA), VU University Medical Center, Amsterdam, The Netherlands
| | - Nimisha Chaturvedi
- Department of Epidemiology and Biostatistics, VU University Medical Center, Amsterdam, The Netherlands
| | - Marianne Jonker
- Department of Epidemiology and Biostatistics, VU University Medical Center, Amsterdam, The Netherlands
| | - Renee Xavier de Menezes
- Department of Epidemiology and Biostatistics, VU University Medical Center, Amsterdam, The Netherlands
| | - Francisca Gallindo Garre
- Department of Epidemiology and Biostatistics, VU University Medical Center, Amsterdam, The Netherlands
| | - Bernard M. J. Uitdehaag
- Department of Neurology, Neuroscience Campus Amsterdam (NCA), VU University Medical Center, Amsterdam, The Netherlands
| | - Frederik Barkhof
- Department of Radiology and Nuclear Medicine, Neuroscience Campus Amsterdam (NCA), VU University Medical Center, Amsterdam, The Netherlands
| | - Hugo Vrenken
- Department of Radiology and Nuclear Medicine, Neuroscience Campus Amsterdam (NCA), VU University Medical Center, Amsterdam, The Netherlands
- Department of Physics and Medical Technology, Neuroscience Campus Amsterdam (NCA), VU University Medical Center, Amsterdam, The Netherlands
- * E-mail:
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47
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Guizard N, Nakamura K, Coupé P, Fonov VS, Arnold DL, Collins DL. Non-Local Means Inpainting of MS Lesions in Longitudinal Image Processing. Front Neurosci 2015; 9:456. [PMID: 26696815 PMCID: PMC4678220 DOI: 10.3389/fnins.2015.00456] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2015] [Accepted: 11/16/2015] [Indexed: 12/26/2022] Open
Abstract
In medical imaging, multiple sclerosis (MS) lesions can lead to confounding effects in automatic morphometric processing tools such as registration, segmentation and cortical extraction, and subsequently alter individual longitudinal measurements. Multiple magnetic resonance imaging (MRI) inpainting techniques have been proposed to decrease the impact of MS lesions in medical image processing, however, most of these methods make the assumption that lesions only affect white matter. Here, we propose a method to fill lesion regions using the patch-based non-local mean (NLM) strategy. The method consists of a hierarchical concentric filling strategy after identification of the lesion region. The lesion is filled iteratively, based on the surrounding tissue intensity, using an onion peel strategy. This concentric technique presents the advantage of preserving the local information and therefore the continuity of the anatomy and does not require identification of any a priori normal brain tissues. The method is first evaluated on 20 healthy subjects with simulated artificial MS lesions where we assessed our technique by measuring the peak signal-to-noise ratio (PSNR) of the images with inpainted lesion and the original healthy images. Second, in order to assess the impact of lesion filling on longitudinal image analyses, we performed a power analysis with sample size estimation to evaluate brain atrophy and ventricular growth in patients with MS. The method was compared to two different publicly available methods (FSL lesion fill and Lesion LEAP) and a more classic method, which fills the region with intensities similar to that of the surrounding healthy white matter tissue or mask the lesions. The proposed method was shown to exceed the other methods in reproducing the fidelity of healthy subject images where the lesions were inpainted. The method also improved the power to detect brain atrophy or ventricular growth by decreasing the sample size by 25% in the presence of MS lesions.
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Affiliation(s)
- Nicolas Guizard
- McConnell Brain Imaging Center, Montreal Neurological Institute, McGill University Montreal, QC Canada
| | - Kunio Nakamura
- McConnell Brain Imaging Center, Montreal Neurological Institute, McGill University Montreal, QC Canada ; Department of Biomedical Engineering, Lerner Research Institute, Cleveland Clinic Cleveland, OH, USA
| | - Pierrick Coupé
- Pictura Research Group, Unité Mixte de Recherche Centre National de la Recherche Scientifique, Laboratoire Bordelais de Recherche en Informatique Talence, France
| | - Vladimir S Fonov
- McConnell Brain Imaging Center, Montreal Neurological Institute, McGill University Montreal, QC Canada
| | - Douglas L Arnold
- McConnell Brain Imaging Center, Montreal Neurological Institute, McGill University Montreal, QC Canada
| | - D Louis Collins
- McConnell Brain Imaging Center, Montreal Neurological Institute, McGill University Montreal, QC Canada
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48
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Cobzas D, Sun H, Walsh AJ, Lebel RM, Blevins G, Wilman AH. Subcortical gray matter segmentation and voxel-based analysis using transverse relaxation and quantitative susceptibility mapping with application to multiple sclerosis. J Magn Reson Imaging 2015; 42:1601-10. [DOI: 10.1002/jmri.24951] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2015] [Accepted: 05/01/2015] [Indexed: 11/10/2022] Open
Affiliation(s)
- Dana Cobzas
- Biomedical Engineering; University of Alberta; Edmonton Canada
- Computing Science; University of Alberta; Edmonton Canada
| | - Hongfu Sun
- Biomedical Engineering; University of Alberta; Edmonton Canada
| | - Andrew J. Walsh
- Biomedical Engineering; University of Alberta; Edmonton Canada
| | - R. Marc Lebel
- Biomedical Engineering; University of Alberta; Edmonton Canada
| | - Gregg Blevins
- Division of Neurology; University of Alberta; Edmonton Canada
| | - Alan H. Wilman
- Biomedical Engineering; University of Alberta; Edmonton Canada
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49
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Kipp M, Wagenknecht N, Beyer C, Samer S, Wuerfel J, Nikoubashman O. Thalamus pathology in multiple sclerosis: from biology to clinical application. Cell Mol Life Sci 2015; 72:1127-47. [PMID: 25417212 PMCID: PMC11113280 DOI: 10.1007/s00018-014-1787-9] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2014] [Revised: 10/29/2014] [Accepted: 11/17/2014] [Indexed: 10/24/2022]
Abstract
There is a broad consensus that MS represents more than an inflammatory disease: it harbors several characteristic aspects of a classical neurodegenerative disorder, i.e. damage to axons, synapses and nerve cell bodies. While the clinician is equipped with appropriate tools to dampen peripheral cell recruitment and, thus, is able to prevent immune-cell driven relapses, effective therapeutic options to prevent the simultaneously progressing neurodegeneration are still missing. Furthermore, while several sophisticated paraclinical methods exist to monitor the inflammatory-driven aspects of the disease, techniques to monitor progression of early neurodegeneration are still in their infancy and have not been convincingly validated. In this review article, we aim to elaborate why the thalamus with its multiple reciprocal connections is sensitive to pathological processes occurring in different brain regions, thus acting as a "barometer" for diffuse brain parenchymal damage in MS. The thalamus might be, thus, an ideal region of interest to test the effectiveness of new neuroprotective MS drugs. Especially, we will address underlying pathological mechanisms operant during thalamus degeneration in MS, such as trans-neuronal or Wallerian degeneration. Furthermore, we aim at giving an overview about different paraclinical methods used to estimate the extent of thalamic pathology in MS patients, and we discuss their limitations. Finally, thalamus involvement in different MS animal models will be described, and their relevance for the design of preclinical trials elaborated.
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Affiliation(s)
- Markus Kipp
- Institute of Neuroanatomy, Faculty of Medicine, RWTH Aachen University, Wendlingweg 2, 52074, Aachen, Germany,
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Popescu V, Klaver R, Voorn P, Galis-de Graaf Y, Knol DL, Twisk JWR, Versteeg A, Schenk GJ, Van der Valk P, Barkhof F, De Vries HE, Vrenken H, Geurts JJG. What drives MRI-measured cortical atrophy in multiple sclerosis? Mult Scler 2015; 21:1280-90. [PMID: 25583833 DOI: 10.1177/1352458514562440] [Citation(s) in RCA: 80] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2014] [Accepted: 11/07/2014] [Indexed: 01/31/2023]
Abstract
BACKGROUND Cortical atrophy, assessed with magnetic resonance imaging (MRI), is an important outcome measure in multiple sclerosis (MS) studies. However, the underlying histopathology of cortical volume measures is unknown. OBJECTIVE We investigated the histopathological substrate of MRI-measured cortical volume in MS using combined post-mortem imaging and histopathology. METHODS MS brain donors underwent post-mortem whole-brain in-situ MRI imaging. After MRI, tissue blocks were systematically sampled from the superior and inferior frontal gyrus, anterior cingulate gyrus, inferior parietal lobule, and superior temporal gyrus. Histopathological markers included neuronal, axonal, synapse, astrocyte, dendrite, myelin, and oligodendrocyte densities. Matched cortical volumes from the aforementioned anatomical regions were measured on the MRI, and used as outcomes in a nested prediction model. RESULTS Forty-five tissue blocks were sampled from 11 MS brain donors. Mean age at death was 68±12 years, post-mortem interval 4±1 hours, and disease duration 35±15 years. MRI-measured regional cortical volumes varied depending on anatomical region. Neuronal density, neuronal size, and axonal density were significant predictors of GM volume. CONCLUSIONS In patients with long-standing disease, neuronal and axonal pathology are the predominant pathological substrates of MRI-measured cortical volume in chronic MS.
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Affiliation(s)
- V Popescu
- Department of Radiology and Nuclear Medicine, VU University Medical Center, Neuroscience Campus Amsterdam, The Netherlands
| | - R Klaver
- Department of Anatomy and Neurosciences, VU University Medical Center, Neuroscience Campus Amsterdam, The Netherlands
| | - P Voorn
- Department of Anatomy and Neurosciences, VU University Medical Center, Neuroscience Campus Amsterdam, The Netherlands
| | - Y Galis-de Graaf
- Department of Anatomy and Neurosciences, VU University Medical Center, Neuroscience Campus Amsterdam, The Netherlands
| | - D L Knol
- Department of Epidemiology and Biostatistics, VU University Medical Center, Neuroscience Campus Amsterdam, The Netherlands
| | - J W R Twisk
- Department of Epidemiology and Biostatistics, VU University Medical Center, Neuroscience Campus Amsterdam, The Netherlands
| | - A Versteeg
- Department of Radiology and Nuclear Medicine, VU University Medical Center, Neuroscience Campus Amsterdam, The Netherlands
| | - G J Schenk
- Department of Anatomy and Neurosciences, VU University Medical Center, Neuroscience Campus Amsterdam, The Netherlands
| | - P Van der Valk
- Department of Pathology, VU University Medical Center, Neuroscience Campus Amsterdam, The Netherlands
| | - F Barkhof
- Department of Radiology and Nuclear Medicine, VU University Medical Center, Neuroscience Campus Amsterdam, The Netherlands
| | - H E De Vries
- Department of Molecular Cell Biology and Immunology, VU University Medical Center, Neuroscience Campus Amsterdam, The Netherlands
| | - H Vrenken
- Department of Radiology and Nuclear Medicine, VU University Medical Center, Neuroscience Campus Amsterdam, The Netherlands/Department of Physics and Medical Technology, VU University Medical Center, Neuroscience Campus Amsterdam, The Netherlands
| | - J J G Geurts
- Department of Anatomy and Neurosciences, VU University Medical Center, Neuroscience Campus Amsterdam, The Netherlands
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