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Goo HW, Park SH. Fast Quantitative Magnetic Resonance Imaging Evaluation of Hydrocephalus Using 3-Dimensional Fluid-Attenuated Inversion Recovery: Initial Experience. J Comput Assist Tomogr 2024; 48:292-297. [PMID: 37621082 DOI: 10.1097/rct.0000000000001539] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/26/2023]
Abstract
OBJECTIVE This study aimed to demonstrate the initial experience of using fast quantitative magnetic resonance imaging (MRI) to evaluate hydrocephalus. METHODS A total of 109 brain MRI volumetry examinations (acquisition time, 7 minutes 30 seconds) were performed in 72 patients with hydrocephalus. From the measured ventricular system and brain volumes, ventricle-brain volume percentage was calculated to standardize hydrocephalus severity (processing time, <5 minutes). The obtained values were categorized into no, mild, and severe based on the fronto-occipital horn ratio (FOHR) and the ventricle-brain volume percentages reported in the literature. The measured volumes and percentages were compared between patients with mild hydrocephalus and those with severe hydrocephalus. The diagnostic performance of brain hydrocephalus MRI volumetry was evaluated using receiver operating characteristic curve analysis. RESULTS Ventricular volumes and ventricle-brain volume percentages were significantly higher in in patients with severe hydrocephalus than in those with mild hydrocephalus (FOHR-based severity: 352.6 ± 165.6 cm 3 vs 149.1 ± 78.5 cm 3 , P < 0.001, and 26.8% [20.8%-33.1%] vs 12.1% ± 6.0%, P < 0.001; percentage-based severity: 359.5 ± 143.3 cm 3 vs 137.0 ± 62.9 cm 3 , P < 0.001, and 26.8% [21.8%-33.1%] vs 11.3% ± 4.2%, P < 0.001, respectively), whereas brain volumes were significantly lower in patients with severe hydrocephalus than in those with mild hydrocephalus (FOHR-based severity: 878.1 ± 363.5 cm 3 vs 1130.1 cm 3 [912.1-1244.2 cm 3 ], P = 0.006; percentage-based severity: 896.2 ± 324.6 cm 3 vs 1142.3 cm 3 [944.2-1246.6 cm 3 ], P = 0.005, respectively). The ventricle-brain volume percentage was a good diagnostic parameter for evaluating the degree of hydrocephalus (area under the curve, 0.855; 95% confidence interval, 0.719-0.990; P < 0.001). CONCLUSIONS Brain MRI volumetry can be used to evaluate hydrocephalus severity and may provide guide interpretation because of its rapid acquisition and postprocessing times.
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Affiliation(s)
- Hyun Woo Goo
- From the Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
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Ziegelitz D, Hellström P, Björkman-Burtscher IM, Agerskov S, Stevens-Jones O, Farahmand D, Tullberg M. Evaluation of a Fully Automated Method for Ventricular Volume Segmentation Before and After Shunt Surgery in Idiopathic Normal Pressure Hydrocephalus. World Neurosurg 2024; 181:e303-e311. [PMID: 37838163 DOI: 10.1016/j.wneu.2023.10.045] [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: 09/27/2023] [Accepted: 10/07/2023] [Indexed: 10/16/2023]
Abstract
BACKGROUND Determination of the ventricle size in idiopathic normal pressure hydrocephalus (iNPH) is essential for diagnosis and follow-up of shunt results. Fully automated segmentation methods are anticipated to optimize the accuracy and time efficiency of ventricular volume measurements. We evaluated the accuracy of preoperative and postoperative ventricular volume measurements in iNPH by a magnetic resonance imaging (MRI)-based licensed software for fully automated quantitative assessment. METHODS Forty-eight patients diagnosed with iNPH were retrospectively analyzed. All patients received a ventriculoperitoneal shunt and had symptom grading and routine MRI preoperatively and 3-6 months postoperatively. Ventricular volumes, generated by fully automated T1-weighted imaging volume sequence segmentation, were compared with semiautomatic measurements and routine radiologic reports. The relation of postoperative ventricular size change to clinical response was evaluated. RESULTS Fully automated segmentation was achieved in 95% of the MRIs, but showed various rates of 8 minor segmentation errors. The correlation between both segmentation methods was very strong (r >0.9) and the agreement very good using Bland-Altman analyses. The ventricular volumes differed significantly between semiautomated and fully automated segmentations and between preoperative and postoperative MRI. The fully automated method systematically overestimated the ventricles by a median 15 mL preoperatively and 14 mL postoperatively; hence, the magnitudes of volume changes were equivalent. Routine radiologic reports of ventricular size changes were inaccurate in 51% and lacked association with treatment response. Objectively measured ventricular volume changes correlated moderately with postoperative clinical improvement. CONCLUSIONS A fully automated volumetric method permits reliable evaluation of preoperative ventriculomegaly and postoperative ventricular volume change in idiopathic normal pressure hydrocephalus.
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Affiliation(s)
- Doerthe Ziegelitz
- Department of Radiology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Per Hellström
- Department of Clinical Neuroscience, Hydrocephalus Research Unit, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Isabella M Björkman-Burtscher
- Department of Radiology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Simon Agerskov
- Department of Radiology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Oskar Stevens-Jones
- Department of Clinical Neuroscience, Hydrocephalus Research Unit, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Dan Farahmand
- Department of Clinical Neuroscience, Hydrocephalus Research Unit, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Mats Tullberg
- Department of Clinical Neuroscience, Hydrocephalus Research Unit, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Sahlgrenska University Hospital, Gothenburg, Sweden.
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Zamani J, Sadr A, Javadi AH. Comparison of cortical and subcortical structural segmentation methods in Alzheimer's disease: A statistical approach. J Clin Neurosci 2022; 99:99-108. [PMID: 35278936 DOI: 10.1016/j.jocn.2022.03.004] [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: 08/01/2021] [Revised: 02/13/2022] [Accepted: 03/02/2022] [Indexed: 11/18/2022]
Abstract
BACKGROUND Automated segmentation methods are developed to help with the segmentation of different brain areas. However, their reliability has yet to be fully investigated. To have a more comprehensive understanding of the distribution of changes in Alzheimer's disease (AD), as well as investigating the reliability of different segmentation methods, in this study we compared volumes of cortical and subcortical brain segments, using HIPS, volBrain, CAT and BrainSuite automated segmentation methods between AD, mild cognitive impairment (MCI) and healthy controls (HC). METHODS A total of 182 MRI images were taken from the minimal interval resonance imaging in Alzheimer's disease (MIRIAD; 22 AD and 22 HC) and the Alzheimer's disease neuroimaging initiative database (ADNI; 43 AD, 50 MCI and 45 HC) datasets. Statistical methods were used to compare different groups as well as the correlation between different methods. RESULTS The two methods of volBrain and CAT showed a strong correlation (p's < 0.035 Bonferroni corrected for multiple comparisons). The two methods, however, showed no significant correlation with BrainSuite (p's > 0.820 Bonferroni corrected). Furthermore, BrainSuite did not follow the same trend as the other three methods and only HIPS, volBrain and CAT showed strong conformity with the past literature with strong correlation with mini mental state examination (MMSE) scores. CONCLUSION Our results showed that automated segmentation methods HIPS, volBrain and CAT can be used in the classification of HC, AD and MCI. This is an indication that such methods can be used to inform researchers and clinicians of underlying mechanisms and progression of AD.
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Affiliation(s)
- Jafar Zamani
- School of Electrical Engineering, Iran University of Science and Technology, Tehran, Iran
| | - Ali Sadr
- School of Electrical Engineering, Iran University of Science and Technology, Tehran, Iran.
| | - Amir-Homayoun Javadi
- School of Psychology, University of Kent, Canterbury, UK; School of Rehabilitation, Tehran University of Medical Sciences, Tehran, Iran.
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Zamani J, Sadr A, Javadi AH. Diagnosis of early mild cognitive impairment using a multiobjective optimization algorithm based on T1-MRI data. Sci Rep 2022; 12:1020. [PMID: 35046444 PMCID: PMC8770462 DOI: 10.1038/s41598-022-04943-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Accepted: 01/04/2022] [Indexed: 12/03/2022] Open
Abstract
Alzheimer's disease (AD) is the most prevalent form of dementia. The accurate diagnosis of AD, especially in the early phases is very important for timely intervention. It has been suggested that brain atrophy, as measured with structural magnetic resonance imaging (sMRI), can be an efficacy marker of neurodegeneration. While classification methods have been successful in diagnosis of AD, the performance of such methods have been very poor in diagnosis of those in early stages of mild cognitive impairment (EMCI). Therefore, in this study we investigated whether optimisation based on evolutionary algorithms (EA) can be an effective tool in diagnosis of EMCI as compared to cognitively normal participants (CNs). Structural MRI data for patients with EMCI (n = 54) and CN participants (n = 56) was extracted from Alzheimer's disease Neuroimaging Initiative (ADNI). Using three automatic brain segmentation methods, we extracted volumetric parameters as input to the optimisation algorithms. Our method achieved classification accuracy of greater than 93%. This accuracy level is higher than the previously suggested methods of classification of CN and EMCI using a single- or multiple modalities of imaging data. Our results show that with an effective optimisation method, a single modality of biomarkers can be enough to achieve a high classification accuracy.
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Affiliation(s)
- Jafar Zamani
- School of Electrical Engineering, Iran University of Science and Technology, Narmak, Tehran, Iran
| | - Ali Sadr
- School of Electrical Engineering, Iran University of Science and Technology, Narmak, Tehran, Iran.
| | - Amir-Homayoun Javadi
- School of Psychology, Keynes College, University of Kent, Canterbury, UK.
- School of Rehabilitation, Tehran University of Medical Sciences, Tehran, Iran.
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Serru M, Marechal B, Kober T, Ribier L, Sembely Taveau C, Sirinelli D, Cottier JP, Morel B. Improving diagnosis accuracy of brain volume abnormalities during childhood with an automated MP2RAGE-based MRI brain segmentation. J Neuroradiol 2021; 48:259-265. [DOI: 10.1016/j.neurad.2019.06.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2019] [Revised: 06/04/2019] [Accepted: 06/07/2019] [Indexed: 11/30/2022]
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Wright KL, Hopkins RO, Robertson FE, Bigler ED, Taylor HG, Rubin KH, Vannatta K, Stancin T, Yeates KO. Assessment of White Matter Integrity after Pediatric Traumatic Brain Injury. J Neurotrauma 2020; 37:2188-2197. [PMID: 32253971 PMCID: PMC7580640 DOI: 10.1089/neu.2019.6691] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
White matter (WM) abnormalities, such as atrophy and hyperintensities (WMH), can be accessed via magnetic resonance imaging (MRI) after pediatric traumatic brain injury (TBI). Several methods are available to classify WM abnormalities (i.e., total WM volumes and WMHs), but automated and manual volumes and clinical ratings have yet to be compared in pediatric TBI. In addition, WM integrity has been associated reliably with processing speed. Consequently, methods of assessing WM integrity should relate to processing speed to have clinical application. This study had two goals: (1) to compare Scheltens rating scale, manual tracing, FreeSurfer, and NeuroQuant® methods of assessing WM abnormalities, and (2) to relate WM methods to processing speed scores. We report findings from the Social Outcomes of Brain Injury in Kids (SOBIK) study, a multi-center study of 60 children with chronic TBI (65% male) from ages 8-13. Scheltens WMH ratings had good to excellent agreement with WMH volumes for both NeuroQuant (ICC = 0.62; r = 0.29, p = 0.005) and manual tracing (ICC = 0.82; r = 0.50, p = 0.000). NeuroQuant WMH volumes did not correlate with manually traced WMH volumes (r = 0.12, p = 0.21) and had poor agreement (ICC = 0.24). NeuroQuant and FreeSurfer total WM volumes correlated (r = 0.38, p = 0.004) and had fair agreement (ICC = 0.52). The WMH assessment methods, both ratings and volumes, were associated with processing speed scores. In contrast, total WM volume was not related to processing speed. Measures of WMH may hold clinical utility for predicting cognitive functioning after pediatric TBI.
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Affiliation(s)
- Kacie L. Wright
- Psychology Department, Brigham Young University, Provo, Utah, USA
| | - Ramona O. Hopkins
- Department of Psychology and Neuroscience Center, Brigham Young University, Provo, Utah, USA
| | | | - Erin D. Bigler
- Psychology Department and Neuroscience Center, Brigham Young University, Provo, Utah, USA
| | - H. Gerry Taylor
- Department of Pediatrics, Ohio State University and Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, Ohio, USA
| | - Kenneth H. Rubin
- Department of Human Development and Quantitative Methodology, University of Maryland, College Park, Maryland, USA
| | - Kathryn Vannatta
- Department of Pediatrics, Ohio State University and Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, Ohio, USA
| | - Terry Stancin
- Department of Pediatrics, Case Western Reserve University, and Rainbow Babies and Children's Hospital, Cleveland, Ohio, USA
| | - Keith Owen Yeates
- Department of Psychology, Alberta Children's Hospital Research Institute, and Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada
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Morel B, Piredda GF, Cottier JP, Tauber C, Destrieux C, Hilbert T, Sirinelli D, Thiran JP, Maréchal B, Kober T. Normal volumetric and T1 relaxation time values at 1.5 T in segmented pediatric brain MRI using a MP2RAGE acquisition. Eur Radiol 2020; 31:1505-1516. [PMID: 32885296 DOI: 10.1007/s00330-020-07194-w] [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: 02/25/2020] [Revised: 07/02/2020] [Accepted: 08/13/2020] [Indexed: 10/23/2022]
Abstract
OBJECTIVES This study introduced a tailored MP2RAGE-based brain acquisition for a comprehensive assessment of the normal maturing brain. METHODS Seventy normal patients (35 girls and 35 boys) from 1 to 16 years of age were recruited within a prospective monocentric study conducted from a single University Hospital. Brain MRI examinations were performed at 1.5 T using a 20-channel head coil and an optimized 3D MP2RAGE sequence with a total acquisition time of 6:36 min. Automated 38 region segmentation was performed using the MorphoBox (template registration, bias field correction, brain extraction, and tissue classification) which underwent a major adaptation of three age-group T1-weighted templates. Volumetry and T1 relaxometry reference ranges were established using a logarithmic model and a modified Gompertz growth respectively. RESULTS Detailed automated brain segmentation and T1 mapping were successful in all patients. Using these data, an age-dependent model of normal brain maturation with respect to changes in volume and T1 relaxometry was established. After an initial rapid increase until 24 months of life, the total intracranial volume was found to converge towards 1400 mL during adolescence. The expected volumes of white matter (WM) and cortical gray matter (GM) showed a similar trend with age. After an initial major decrease, T1 relaxation times were observed to decrease progressively in all brain structures. The T1 drop in the first year of life was more pronounced in WM (from 1000-1100 to 650-700 ms) than in GM structures. CONCLUSION The 3D MP2RAGE sequence allowed to establish brain volume and T1 relaxation time normative ranges in pediatrics. KEY POINTS • The 3D MP2RAGE sequence provided a reliable quantitative assessment of brain volumes and T1 relaxation times during childhood. • An age-dependent model of normal brain maturation was established. • The normative ranges enable an objective comparison to a normal cohort, which can be useful to further understand, describe, and identify neurodevelopmental disorders in children.
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Affiliation(s)
- Baptiste Morel
- Inserm UMR 1253, iBrain, Université de Tours, Tours, France. .,Pediatric Radiology Department, Clocheville Hospital, CHRU de Tours, 49 Boulevard Beranger, 37000, Tours, France.
| | - Gian Franco Piredda
- Advanced Clinical Imaging Technology, Siemens Healthcare AG, Lausanne, Switzerland.,Department of Radiology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland.,LTS5, École Polytechnique FÉdÉrale de Lausanne (EPFL), Lausanne, Switzerland
| | | | - Clovis Tauber
- Inserm UMR 1253, iBrain, Université de Tours, Tours, France
| | | | - Tom Hilbert
- Advanced Clinical Imaging Technology, Siemens Healthcare AG, Lausanne, Switzerland.,Department of Radiology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland.,LTS5, École Polytechnique FÉdÉrale de Lausanne (EPFL), Lausanne, Switzerland
| | | | - Jean-Philippe Thiran
- Department of Radiology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland.,LTS5, École Polytechnique FÉdÉrale de Lausanne (EPFL), Lausanne, Switzerland
| | - Bénédicte Maréchal
- Advanced Clinical Imaging Technology, Siemens Healthcare AG, Lausanne, Switzerland.,Department of Radiology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland.,LTS5, École Polytechnique FÉdÉrale de Lausanne (EPFL), Lausanne, Switzerland
| | - Tobias Kober
- Advanced Clinical Imaging Technology, Siemens Healthcare AG, Lausanne, Switzerland.,Department of Radiology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland.,LTS5, École Polytechnique FÉdÉrale de Lausanne (EPFL), Lausanne, Switzerland
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Bastos MAV, Bastos PRHDO, e Paez LEF, de Souza EO, Bogo D, Perdomo RT, Portella RB, Ozaki JGO, Iandoli D, Lucchetti G. "Seat of the soul"? The structure and function of the pineal gland in women with alleged spirit possession-Results of two experimental studies. Brain Behav 2020; 10:e01693. [PMID: 32506697 PMCID: PMC7375051 DOI: 10.1002/brb3.1693] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2020] [Revised: 05/04/2020] [Accepted: 05/12/2020] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND Cultural traditions attribute to pineal gland an important role for spiritual experiences. Mediumship and spirit possession are cultural phenomena found worldwide which have been described as having dissociative and psychotic-like characteristics, but with nonpathological aspects. A sympathetic activation pattern in response to spirit possession has been reported in some studies, but empirical data on pineal gland is scarce in this context. METHODS We aimed to investigate pineal gland and pituitary volumes, as well as urinary 6-sulfatoxymelatonin levels in 16 alleged mediums (Medium Group-MG) compared with 16 healthy nonmedium controls (Control Group) (Experiment 1). Furthermore, we aimed to evaluate urinary 6-sulfatoxymelatonin and stress reactivity in GM (n = 10) under different physiological conditions (Experiment 2). RESULTS In Experiment 1, MG presented higher scores of anomalous experiences, but there were no between-group differences regarding mental health or subjective sleep quality. Similar pineal gland and pituitary volumes were observed between groups. There were no between-group differences in urinary 6-sulfatoxymelatonin collected under equivalent baseline conditions. In Experiment 2, the rise of anxiety and heart rate in response to mediumistic experience was intermediate between a nonstressful control task (reading) and a stressful control task (Trier Social Stress Test-TSST). No significant differences were observed in 6-sulfatoxymelatonin urinary levels between the three conditions. The pattern of stress reactivity during the TSST was normal, but with an attenuated salivary cortisol response. CONCLUSION The normal neuroimaging and stress reactivity findings in MG contrast with the abnormal results usually observed in subjects with psychotic and dissociative disorders.
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Affiliation(s)
| | | | | | | | - Danielle Bogo
- School of Pharmaceutical SciencesFederal University of Mato Grosso do SulCampo GrandeBrazil
| | - Renata Trentin Perdomo
- School of Pharmaceutical SciencesFederal University of Mato Grosso do SulCampo GrandeBrazil
| | | | | | - Décio Iandoli
- School of MedicineAnhanguera‐Uniderp UniversityCampo GrandeBrazil
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Bahrani AA, Al-Janabi OM, Abner EL, Bardach SH, Kryscio RJ, Wilcock DM, Smith CD, Jicha GA. Post-acquisition processing confounds in brain volumetric quantification of white matter hyperintensities. J Neurosci Methods 2019; 327:108391. [PMID: 31408649 DOI: 10.1016/j.jneumeth.2019.108391] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2019] [Revised: 08/03/2019] [Accepted: 08/03/2019] [Indexed: 01/18/2023]
Abstract
BACKGROUND Disparate research sites using identical or near-identical magnetic resonance imaging (MRI) acquisition techniques often produce results that demonstrate significant variability regarding volumetric quantification of white matter hyperintensities (WMH) in the aging population. The sources of such variability have not previously been fully explored. NEW METHOD 3D FLAIR sequences from a group of randomly selected aged subjects were analyzed to identify sources-of-variability in post-acquisition processing that can be problematic when comparing WMH volumetric data across disparate sites. The methods developed focused on standardizing post-acquisition protocol processing methods to develop a protocol with less than 0.5% inter-rater variance. RESULTS A series of experiments using standard MRI acquisition sequences explored post-acquisition sources-of-variability in the quantification of WMH volumetric data. Sources-of-variability included: the choice of image center, software suite and version, thresholding selection, and manual editing procedures (when used). Controlling for the identified sources-of-variability led to a protocol with less than 0.5% variability between independent raters in post-acquisition WMH volumetric quantification. COMPARISON WITH EXISTING METHOD(S) Post-acquisition processing techniques can introduce an average variance approaching 15% in WMH volume quantification despite identical scan acquisitions. Understanding and controlling for such sources-of-variability can reduce post-acquisition quantitative image processing variance to less than 0.5%. DISCUSSION Considerations of potential sources-of-variability in MRI volume quantification techniques and reduction in such variability is imperative to allow for reliable cross-site and cross-study comparisons.
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Affiliation(s)
- Ahmed A Bahrani
- Department of Biomedical Engineering, College of Engineering, University of Kentucky, Lexington, KY, 40506, United States; Sanders-Brown Center on Aging, College of Medicine, University of Kentucky, Lexington, KY, 40506, United States; Biomedical Engineering Department, Al-Khwarizmi College of Engineering, University of Baghdad, Baghdad, Iraq
| | - Omar M Al-Janabi
- Department of Behavioral Science, College of Medicine, University of Kentucky, Lexington, KY, 40506, United States; Sanders-Brown Center on Aging, College of Medicine, University of Kentucky, Lexington, KY, 40506, United States
| | - Erin L Abner
- Department of Neurology, College of Medicine, University of Kentucky, Lexington, KY, 40506, United States; Department of Epidemiology, College of Public Health, University of Kentucky, Lexington, KY, 40506, United States; Sanders-Brown Center on Aging, College of Medicine, University of Kentucky, Lexington, KY, 40506, United States
| | - Shoshana H Bardach
- Department of Gerontology, College of Public Health, University of Kentucky, Lexington, KY, 40506, United States; Sanders-Brown Center on Aging, College of Medicine, University of Kentucky, Lexington, KY, 40506, United States
| | - Richard J Kryscio
- Department of Biostatistics, College of Public Health, University of Kentucky, Lexington, KY, 40506, United States; Department of Statistics, College of Arts and Science, University of Kentucky, Lexington, KY, 40506, United States; Sanders-Brown Center on Aging, College of Medicine, University of Kentucky, Lexington, KY, 40506, United States
| | - Donna M Wilcock
- Department of Physiology, College of Medicine, University of Kentucky, Lexington, KY, 40506, United States; Sanders-Brown Center on Aging, College of Medicine, University of Kentucky, Lexington, KY, 40506, United States
| | - Charles D Smith
- Department of Neurology, College of Medicine, University of Kentucky, Lexington, KY, 40506, United States; Sanders-Brown Center on Aging, College of Medicine, University of Kentucky, Lexington, KY, 40506, United States; Magnetic Resonance Imaging and Spectroscopy Center (MRISC), College of Medicine, University of Kentucky, Lexington, KY, 40506, United States
| | - Gregory A Jicha
- Department of Behavioral Science, College of Medicine, University of Kentucky, Lexington, KY, 40506, United States; Department of Neurology, College of Medicine, University of Kentucky, Lexington, KY, 40506, United States; Sanders-Brown Center on Aging, College of Medicine, University of Kentucky, Lexington, KY, 40506, United States.
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Abdullah JY, Rajion ZA, Martin AG, Jaafar A, Ghani ARI, Abdullah JM. Shape-based interpolation method in measuring intracranial volume for pre- and post-operative decompressive craniectomy using open source software. Neurocirugia (Astur) 2019; 30:115-123. [PMID: 30782505 DOI: 10.1016/j.neucir.2018.12.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2018] [Revised: 11/25/2018] [Accepted: 12/01/2018] [Indexed: 11/25/2022]
Abstract
INTRODUCTION Intracranial volume (ICV) is an important tool in the management of patients undergoing decompressive craniectomy (DC) surgery. The aim of this study was to validate ICV measurement applying the shape-based interpolation (SBI) method using open source software on computed tomography (CT) images. METHODS The pre- and post-operative CT images of 55 patients undergoing DC surgery were analyzed. The ICV was measured by segmenting every slice of the CT images, and compared with estimated ICV calculated using the 1-in-10 sampling strategy and processed using the SBI method. An independent t test was conducted to compare the ICV measurements between the two different methods. The calculation using this method was repeated three times for reliability analysis using the intraclass correlations coefficient (ICC). The Bland-Altman plot was used to measure agreement between the methods for both pre- and post-operative ICV measurements. RESULTS The mean ICV (±SD) were 1341.1±122.1ml (manual) and 1344.11±122.6ml (SBI) for the preoperative CT data. The mean ICV (±SD) were 1396.4±132.4ml (manual) and 1400.53±132.1ml (SBI) for the post-operative CT data. No significant difference was found in ICV measurements using the manual and the SBI methods (p=.983 for pre-op, and p=.960 for post-op). The intrarater ICC showed a significant correlation; ICC=1.00. The Bland-Altman plot showed good agreement between the manual and the SBI method. CONCLUSION The shape-based interpolation method with 1-in-10 sampling strategy gave comparable results in estimating ICV compared to manual segmentation. Thus, this method could be used in clinical settings for rapid, reliable and repeatable ICV estimations.
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Affiliation(s)
- Johari Yap Abdullah
- Craniofacial Medical Imaging Research Group, School of Dental Sciences, Universiti Sains Malaysia, Kelantan, Malaysia
| | - Zainul Ahmad Rajion
- Craniofacial Medical Imaging Research Group, School of Dental Sciences, Universiti Sains Malaysia, Kelantan, Malaysia.
| | - Arvind Gerard Martin
- Department of Neurosurgery, Hospital Tengku Ampuan Afzan, Jalan Air Putih, Kuantan, Pahang, Malaysia
| | - Azlan Jaafar
- Faculty of Dentistry, Universiti Sains Islam Malaysia, Kuala Lumpur, Malaysia
| | - Abdul Rahman Izaini Ghani
- Department of Neurosciences, School of Medical Sciences, Universiti Sains Malaysia, Kelantan, Malaysia
| | - Jafri Malin Abdullah
- Centre for Neuroscience Services & Research, Universiti Sains Malaysia, Kelantan, Malaysia
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Clinical equivalence assessment of T2 synthesized pediatric brain magnetic resonance imaging. J Neuroradiol 2018; 46:130-135. [PMID: 29733917 DOI: 10.1016/j.neurad.2018.04.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2018] [Accepted: 04/21/2018] [Indexed: 11/23/2022]
Abstract
BACKGROUND AND PURPOSE Automated synthetic magnetic resonance imaging (MRI) provides qualitative, weighted image contrasts as well as quantitative information from one scan and is well-suited for various applications such as analysis of white matter disorders. However, the synthesized contrasts have been poorly evaluated in pediatric applications. The purpose of this study was to compare the image quality of synthetic T2 to conventional turbo spin-echo (TSE) T2 in pediatric brain MRI. MATERIALS AND METHODS This was a mono-center prospective study. Synthetic and conventional MRI acquisitions at 1.5 Tesla were performed for each patient during the same session using a prototype accelerated T2 mapping sequence package (TAsynthetic=3:07min, TAconventional=2:33min). Image sets were blindly and randomly analyzed by pediatric neuroradiologists. Global image quality, morphologic legibility of standard structures and artifacts were assessed using a 4-point Likert scale. Inter-observer kappa agreements were calculated. The capability of the synthesized contrasts and conventional TSE T2 to discern normal and pathologic cases was evaluated. RESULTS Sixty patients were included. The overall diagnostic quality of the synthesized contrasts was non-inferior to conventional imaging scale (P=0.06). There was no significant difference in the legibility of normal and pathological anatomic structures of synthetized and conventional TSE T2 (all P>0.05) as well as for artifacts except for phase encoding (P=0.008). Inter-observer agreement was good to almost perfect (kappa between 0.66 and 1). CONCLUSIONS T2 synthesized contrasts, which also provides quantitative T2 information that could be useful, could be suggested as an equivalent technique in pediatric neuro-imaging, compared to conventional TSE T2.
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Tabei KI, Kida H, Hosoya T, Satoh M, Tomimoto H. Prediction of Cognitive Decline from White Matter Hyperintensity and Single-Photon Emission Computed Tomography in Alzheimer's Disease. Front Neurol 2017; 8:408. [PMID: 28928704 PMCID: PMC5591322 DOI: 10.3389/fneur.2017.00408] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2017] [Accepted: 07/28/2017] [Indexed: 01/18/2023] Open
Abstract
BACKGROUND While several studies support an association of white matter hyperintensity (WMH) volume and regional cerebral blood flow (rCBF) with cognitive decline in Alzheimer's disease (AD), no reports have simultaneously considered the effects of both factors on cognitive decline. OBJECTIVE The purpose of the present study was to compare WMH volume and rCBF in relation to cognitive function by developing a new software program to fuse magnetic resonance imaging (MRI) and single-photon emission computed tomography (SPECT) data. METHOD We used MRI, SPECT, and neuropsychological data from 182 serial outpatients treated at the memory clinic of our hospital. RESULTS Twenty-nine AD patients fulfilled the inclusion criteria (18 females, mean age: 73.1 ± 7.9 years, mean Mini-Mental State Examination: 23.1 ± 3.0). Analysis of variance revealed that posterior deep WMH (DWMH) volume was significantly larger than both anterior periventricular hyperintensity (PVH) and DWMH, and posterior PVH volumes. Multivariate regression analysis showed that increased volumes of the anterior PVH and the posterior DWMH and decreased rCBF of the parietal cortex negatively affected cognitive function. The other areas had no significant negative effects on cognitive function. CONCLUSION Our findings show that the volume of the posterior WMH was significantly larger than that of other areas, and the increased posterior WMH volume and decreased rCBF of the parietal cortex negatively affected cognitive function. Therefore, the posterior WMH volume and the parietal rCBF are key parameters of cognitive decline in AD patients.
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Affiliation(s)
- Ken-Ichi Tabei
- Department of Dementia Prevention and Therapeutics, Graduate School of Medicine, Mie University, Mie, Japan.,Department of Neurology, Graduate School of Medicine, Mie University, Mie, Japan
| | - Hirotaka Kida
- Department of Dementia Prevention and Therapeutics, Graduate School of Medicine, Mie University, Mie, Japan
| | | | - Masayuki Satoh
- Department of Dementia Prevention and Therapeutics, Graduate School of Medicine, Mie University, Mie, Japan
| | - Hidekazu Tomimoto
- Department of Dementia Prevention and Therapeutics, Graduate School of Medicine, Mie University, Mie, Japan.,Department of Neurology, Graduate School of Medicine, Mie University, Mie, Japan
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West H, Leach JL, Jones BV, Care M, Radhakrishnan R, Merrow AC, Alvarado E, Serai SD. Clinical validation of synthetic brain MRI in children: initial experience. Neuroradiology 2016; 59:43-50. [PMID: 27889836 DOI: 10.1007/s00234-016-1765-z] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2016] [Accepted: 11/02/2016] [Indexed: 12/13/2022]
Abstract
INTRODUCTION The purpose of this study was to determine the diagnostic accuracy of synthetic MR sequences generated through post-acquisition processing of a single sequence measuring inherent R1, R2, and PD tissue properties compared with sequences acquired conventionally as part of a routine clinical pediatric brain MR exam. METHODS Thirty-two patients underwent routine clinical brain MRI with conventional and synthetic sequences acquired (22 abnormal). Synthetic axial T1, T2, and T2 fluid attenuation inversion recovery or proton density-weighted sequences were made to match the comparable clinical sequences. Two exams for each patient were de-identified. Four blinded reviewers reviewed eight patients and were asked to generate clinical reports on each exam (synthetic or conventional) at two different time points separated by a mean of 33 days. Exams were rated for overall and specific finding agreement (synthetic/conventional and compared to gold standard consensus review by two senior reviewers with knowledge of clinical report), quality, and diagnostic confidence. RESULTS Overall agreement between conventional and synthetic exams was 97%. Agreement with consensus readings was 84% (conventional) and 81% (synthetic), p = 0.61. There were no significant differences in sensitivity, specificity, or accuracy for specific imaging findings involving the ventricles, CSF, brain parenchyma, or vasculature between synthetic or conventional exams (p > 0.05). No significant difference in exam quality, diagnostic confidence, or noise/artifacts was noted comparing studies with synthetic or conventional sequences. CONCLUSIONS Diagnostic accuracy and quality of synthetically generated sequences are comparable to conventionally acquired sequences as part of a standard pediatric brain exam. Further confirmation in a larger study is warranted.
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Affiliation(s)
- Hollie West
- Department of Radiology, Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue, Cincinnati, OH, 45229, USA.
| | - James L Leach
- Department of Radiology, Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue, Cincinnati, OH, 45229, USA
| | - Blaise V Jones
- Department of Radiology, Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue, Cincinnati, OH, 45229, USA
| | - Marguerite Care
- Department of Radiology, Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue, Cincinnati, OH, 45229, USA
| | - Rupa Radhakrishnan
- Department of Radiology, Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue, Cincinnati, OH, 45229, USA
| | - Arnold C Merrow
- Department of Radiology, Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue, Cincinnati, OH, 45229, USA
| | - Enrique Alvarado
- Department of Radiology, Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue, Cincinnati, OH, 45229, USA
| | - Suraj D Serai
- Department of Radiology, Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue, Cincinnati, OH, 45229, USA
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Granberg T, Uppman M, Hashim F, Cananau C, Nordin LE, Shams S, Berglund J, Forslin Y, Aspelin P, Fredrikson S, Kristoffersen-Wiberg M. Clinical Feasibility of Synthetic MRI in Multiple Sclerosis: A Diagnostic and Volumetric Validation Study. AJNR Am J Neuroradiol 2016; 37:1023-9. [PMID: 26797137 DOI: 10.3174/ajnr.a4665] [Citation(s) in RCA: 100] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2015] [Accepted: 11/24/2015] [Indexed: 12/15/2022]
Abstract
BACKGROUND AND PURPOSE Quantitative MR imaging techniques are gaining interest as methods of reducing acquisition times while additionally providing robust measurements. This study aimed to implement a synthetic MR imaging method on a new scanner type and to compare its diagnostic accuracy and volumetry with conventional MR imaging in patients with MS and controls. MATERIALS AND METHODS Twenty patients with MS and 20 healthy controls were enrolled after ethics approval and written informed consent. Synthetic MR imaging was implemented on a Siemens 3T scanner. Comparable conventional and synthetic proton-density-, T1-, and T2-weighted, and FLAIR images were acquired. Diagnostic accuracy, lesion detection, and artifacts were assessed by blinded neuroradiologic evaluation, and contrast-to-noise ratios, by manual tracing. Volumetry was performed with synthetic MR imaging, FreeSurfer, FMRIB Software Library, and Statistical Parametric Mapping. Repeatability was quantified by using the coefficient of variance. RESULTS Synthetic proton-density-, T1-, and T2-weighted images were of sufficient or good quality and were acquired in 7% less time than with conventional MR imaging. Synthetic FLAIR images were degraded by artifacts. Lesion counts and volumes were higher in synthetic MR imaging due to differences in the contrast of dirty-appearing WM but did not affect the radiologic diagnostic classification or lesion topography (P = .50-.77). Synthetic MR imaging provided segmentations with the shortest processing time (16 seconds) and the lowest repeatability error for brain volume (0.14%), intracranial volume (0.12%), brain parenchymal fraction (0.14%), and GM fraction (0.56%). CONCLUSIONS Synthetic MR imaging can be an alternative to conventional MR imaging for generating diagnostic proton-density-, T1-, and T2-weighted images in patients with MS and controls while additionally delivering fast and robust volumetric measurements suitable for MS studies.
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Affiliation(s)
- T Granberg
- From the Departments of Clinical Science, Intervention and Technology (T.G., M.U., F.H., L.E.N., S.S., J.B., Y.F., P.A., M.K.-W.) Departments of Radiology (T.G., F.H., C.C., S.S., Y.F., P.A., M.K.-W)
| | - M Uppman
- From the Departments of Clinical Science, Intervention and Technology (T.G., M.U., F.H., L.E.N., S.S., J.B., Y.F., P.A., M.K.-W.) Diagnostic Medical Physics (M.U., L.E.N., J.B.)
| | - F Hashim
- From the Departments of Clinical Science, Intervention and Technology (T.G., M.U., F.H., L.E.N., S.S., J.B., Y.F., P.A., M.K.-W.) Departments of Radiology (T.G., F.H., C.C., S.S., Y.F., P.A., M.K.-W)
| | - C Cananau
- Departments of Radiology (T.G., F.H., C.C., S.S., Y.F., P.A., M.K.-W)
| | - L E Nordin
- From the Departments of Clinical Science, Intervention and Technology (T.G., M.U., F.H., L.E.N., S.S., J.B., Y.F., P.A., M.K.-W.) Diagnostic Medical Physics (M.U., L.E.N., J.B.)
| | - S Shams
- From the Departments of Clinical Science, Intervention and Technology (T.G., M.U., F.H., L.E.N., S.S., J.B., Y.F., P.A., M.K.-W.) Departments of Radiology (T.G., F.H., C.C., S.S., Y.F., P.A., M.K.-W)
| | - J Berglund
- From the Departments of Clinical Science, Intervention and Technology (T.G., M.U., F.H., L.E.N., S.S., J.B., Y.F., P.A., M.K.-W.) Diagnostic Medical Physics (M.U., L.E.N., J.B.)
| | - Y Forslin
- From the Departments of Clinical Science, Intervention and Technology (T.G., M.U., F.H., L.E.N., S.S., J.B., Y.F., P.A., M.K.-W.) Departments of Radiology (T.G., F.H., C.C., S.S., Y.F., P.A., M.K.-W)
| | - P Aspelin
- From the Departments of Clinical Science, Intervention and Technology (T.G., M.U., F.H., L.E.N., S.S., J.B., Y.F., P.A., M.K.-W.) Departments of Radiology (T.G., F.H., C.C., S.S., Y.F., P.A., M.K.-W)
| | - S Fredrikson
- Clinical Neuroscience (S.F.), Karolinska Institutet, Stockholm, Sweden Neurology (S.F.), Karolinska University Hospital, Stockholm, Sweden
| | - M Kristoffersen-Wiberg
- From the Departments of Clinical Science, Intervention and Technology (T.G., M.U., F.H., L.E.N., S.S., J.B., Y.F., P.A., M.K.-W.) Departments of Radiology (T.G., F.H., C.C., S.S., Y.F., P.A., M.K.-W)
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Szczepek E, Czerwosz L, Nowiński K, Jurkiewicz J, Czernicki Z. Evaluation of volumetric changes in differential diagnosis of brain atrophy and active hydrocephalus. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2015; 840:59-67. [PMID: 25310958 DOI: 10.1007/5584_2014_85] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/10/2023]
Abstract
Despite a variety of diagnostic methods, differentiation of symptoms of normal pressure hydrocephalus from those of atrophic processes of the brain is still a difficult task. In the present study an attempt of non-invasive differential diagnosis of normal pressure hydrocephalus (NPH) and brain atrophy (BA) was presented using volumetric analysis of CT images of the head by means of VisNow proprietary software. The analysis was based on the number of voxels converted to the amount of cerebrospinal fluid (CSF) in the subarachnoid space, skull base casters, and the ventricular system. The results demonstrate that the mean volumes of CSF in these compartments in patients with NPH differed significantly from those in BA. Similarly, the mean volumes of CSF in the subarachnoid space and skull base casters in patients with BA differed significantly from those in NPH. Volumetric assessment presented in the paper by application of VisNow software seems useful in the evaluation of NPH and brain BA.
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Affiliation(s)
- E Szczepek
- Department of Neurosurgery, Second Faculty of Medicine, Medical University of Warsaw, Warsaw, Poland
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Ishii K, Soma T, Shimada K, Oda H, Terashima A, Kawasaki R. Automatic volumetry of the cerebrospinal fluid space in idiopathic normal pressure hydrocephalus. Dement Geriatr Cogn Dis Extra 2013; 3:489-96. [PMID: 24516417 PMCID: PMC3919424 DOI: 10.1159/000357329] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Objectives To measure the cerebrospinal fluid (CSF) space volume in idiopathic normal pressure hydrocephalus (INPH), we developed a software that allows us to automatically measure the regional CSF space and compared the volumes of the ventricle systems (VS), Sylvian fissures (SF) and sulci at high convexity and midline (SHM) among INPH patients, Alzheimer's disease (AD) patients and healthy volunteers (HVs). Methods Fifteen INPH patients, 15 AD patients and 15 HVs were retrospectively selected for this study. 3D-T1 MR images were obtained. We improved upon an automatic gray matter volume system to measure CSF spaces, adopting new regions for the template of INPH-characteristic CSF spaces and measured them. The VS, SF and SHM volumes were calculated relative to the intracranial volume. Results The relative SHM volume of the INPH group (0.0237 ± 0.0064) was the smallest among the 3 groups (AD: 0.0477 ± 0.0109, HV: 0.0542 ± 0.0045). The VS (0.0499 ± 0.0135) and SF (0.0187 ± 0.0037) volumes of the INPH group were significantly larger than those of the AD (VS: 0.0311 ± 0.0075, SF: 0.0146 ± 0.0026) and HV groups (VS: 0.0167 ± 0.0065, SF: 0.0111 ± 0.017). Conclusion Automatic volume measurement can be used to delineate the characteristic changes in CSF space in patients with INPH and is useful in the diagnosis of INPH.
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Affiliation(s)
- Kazunari Ishii
- Department of Radiology, Kinki University Faculty of Medicine, Osakasayama, Tokyo, Japan ; Department of Radiology, Hyogo Brain and Heart Center, Himeji, Tokyo, Japan
| | - Tsutomu Soma
- Department of Radiology, The University of Tokyo, Tokyo, Japan ; Software Development Group, FUJIFILM RI Pharma Co. Ltd., Tokyo, Japan
| | - Kenichi Shimada
- Institute for Aging Brain and Cognitive Disorders, Hyogo Brain and Heart Center, Himeji, Tokyo, Japan
| | - Haruhiko Oda
- Institute for Aging Brain and Cognitive Disorders, Hyogo Brain and Heart Center, Himeji, Tokyo, Japan
| | - Akira Terashima
- Institute for Aging Brain and Cognitive Disorders, Hyogo Brain and Heart Center, Himeji, Tokyo, Japan
| | - Ryota Kawasaki
- Department of Radiology, Hyogo Brain and Heart Center, Himeji, Tokyo, Japan
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Wåhlin A, Ambarki K, Birgander R, Malm J, Eklund A. Intracranial pulsatility is associated with regional brain volume in elderly individuals. Neurobiol Aging 2013; 35:365-72. [PMID: 24080175 DOI: 10.1016/j.neurobiolaging.2013.08.026] [Citation(s) in RCA: 54] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2013] [Revised: 08/16/2013] [Accepted: 08/23/2013] [Indexed: 10/26/2022]
Abstract
Excessive intracranial pulsatility is thought to damage the cerebral microcirculation, causing cognitive decline in elderly individuals. We investigated relationships between brain structure and measures related to intracranial pulsatility among healthy elderly. Thirty-seven stroke-free, non-demented individuals (62-82 years of age) were included. We assessed brain structure, invasively measured cerebrospinal fluid (CSF) pulse pressure, and magnetic resonance-quantified arterial and CSF flow pulsatility, as well as arterial pulse pressure. Using both multivariate partial least squares and ordinary regression analyses, we identified a significant pattern of negative relationships between the volume of several brain regions and measures of intracranial pulsatility. The strongest relationships concerned the temporal lobe cortex and hippocampus. These findings were also coherent with observations of positive relationships between intracranial pulsatility and ventricular volume. In conclusion, elderly subjects with high intracranial pulsatility display smaller brain volume and larger ventricles, supporting the notion that excessive cerebral arterial pulsatility harms the brain. This calls for research investigating altered intracranial cardiac-related pulsatile stress as a potential risk factor that may cause or worsen the prognosis in subjects developing cognitive impairment and dementia.
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Affiliation(s)
- Anders Wåhlin
- Department of Radiation Sciences, Umeå University, Umeå, Sweden.
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Towards automated detection of depression from brain structural magnetic resonance images. Neuroradiology 2013; 55:567-84. [PMID: 23338839 DOI: 10.1007/s00234-013-1139-8] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2012] [Accepted: 01/07/2013] [Indexed: 01/06/2023]
Abstract
INTRODUCTION Depression is a major issue worldwide and is seen as a significant health problem. Stigma and patient denial, clinical experience, time limitations, and reliability of psychometrics are barriers to the clinical diagnoses of depression. Thus, the establishment of an automated system that could detect such abnormalities would assist medical experts in their decision-making process. This paper reviews existing methods for the automated detection of depression from brain structural magnetic resonance images (sMRI). METHODS Relevant sources were identified from various databases and online sites using a combination of keywords and terms including depression, major depressive disorder, detection, classification, and MRI databases. Reference lists of chosen articles were further reviewed for associated publications. RESULTS The paper introduces a generic structure for representing and describing the methods developed for the detection of depression from sMRI of the brain. It consists of a number of components including acquisition and preprocessing, feature extraction, feature selection, and classification. CONCLUSION Automated sMRI-based detection methods have the potential to provide an objective measure of depression, hence improving the confidence level in the diagnosis and prognosis of depression.
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Ambarki K, Lindqvist T, Wåhlin A, Petterson E, Warntjes MJB, Birgander R, Malm J, Eklund A. Evaluation of automatic measurement of the intracranial volume based on quantitative MR imaging. AJNR Am J Neuroradiol 2012; 33:1951-6. [PMID: 22555574 DOI: 10.3174/ajnr.a3067] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE Brain size is commonly described in relation to ICV, whereby accurate assessment of this quantity is fundamental. Recently, an optimized MR sequence (QRAPMASTER) was developed for simultaneous quantification of T1, T2, and proton density. ICV can be measured automatically within minutes from QRAPMASTER outputs and a dedicated software, SyMRI. Automatic estimations of ICV were evaluated against the manual segmentation. MATERIALS AND METHODS In 19 healthy subjects, manual segmentation of ICV was performed by 2 neuroradiologists (Obs1, Obs2) by using QBrain software and conventional T2-weighted images. The automatic segmentation from the QRAPMASTER output was performed by using SyMRI. Manual corrections of the automatic segmentation were performed (corrected-automatic) by Obs1 and Obs2, who were blinded from each other. Finally, the repeatability of the automatic method was evaluated in 6 additional healthy subjects, each having 6 repeated QRAPMASTER scans. The time required to measure ICV was recorded. RESULTS No significant difference was found between reference and automatic (and corrected-automatic) ICV (P > .25). The mean difference between the reference and automatic measurement was -4.84 ± 19.57 mL (or 0.31 ± 1.35%). Mean differences between the reference and the corrected-automatic measurements were -0.47 ± 17.95 mL (-0.01 ± 1.24%) and -1.26 ± 17.68 mL (-0.06 ± 1.22%) for Obs1 and Obs2, respectively. The repeatability errors of the automatic and the corrected-automatic method were <1%. The automatic method required 1 minute 11 seconds (SD = 12 seconds) of processing. Adding manual corrections required another 1 minute 32 seconds (SD = 38 seconds). CONCLUSIONS Automatic and corrected-automatic quantification of ICV showed good agreement with the reference method. SyMRI software provided a fast and reproducible measure of ICV.
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Affiliation(s)
- K Ambarki
- Department of Radiation Science, Umeå University, Umeå, Sweden.
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Vågberg M, Lindqvist T, Ambarki K, Warntjes JBM, Sundström P, Birgander R, Svenningsson A. Automated determination of brain parenchymal fraction in multiple sclerosis. AJNR Am J Neuroradiol 2012; 34:498-504. [PMID: 22976234 DOI: 10.3174/ajnr.a3262] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
BACKGROUND AND PURPOSE Brain atrophy is a manifestation of tissue damage in MS. Reduction in brain parenchymal fraction is an accepted marker of brain atrophy. In this study, the approach of synthetic tissue mapping was applied, in which brain parenchymal fraction was automatically calculated based on absolute quantification of the tissue relaxation rates R1 and R2 and the proton attenuation. MATERIALS AND METHODS The BPF values of 99 patients with MS and 35 control subjects were determined by using SyMap and tested in relationship to clinical variables. A subset of 5 patients with MS and 5 control subjects were also analyzed with a manual segmentation technique as a reference. Reproducibility of SyMap was assessed in a separate group of 6 healthy subjects, each scanned 6 consecutive times. RESULTS Patients with MS had significantly lower BPF (0.852 ± 0.0041, mean ± SE) compared with control subjects (0.890 ± 0.0040). Significant linear relationships between BPF and age, disease duration, and Expanded Disability Status Scale scores were observed (P < .001). A strong correlation existed between SyMap and the reference method (r = 0.96; P < .001) with no significant difference in mean BPF. Coefficient of variation of repeated SyMap BPF measurements was 0.45%. Scan time was <6 minutes, and postprocessing time was <2 minutes. CONCLUSIONS SyMap is a valid and reproducible method for determining BPF in MS within a clinically acceptable scan time and postprocessing time. Results are highly congruent with those described using other methods and show high agreement with the manual reference method.
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Affiliation(s)
- M Vågberg
- Department of Pharmacology and Clinical Neuroscience, Section of Neuroscience, Umeå University, Umeå, Sweden.
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Churilov L, Liu D, Ma H, Christensen S, Nagakane Y, Campbell B, Parsons MW, Levi CR, Davis SM, Donnan GA. Multiattribute selection of acute stroke imaging software platform for Extending the Time for Thrombolysis in Emergency Neurological Deficits (EXTEND) clinical trial. Int J Stroke 2012; 8:204-10. [PMID: 22812698 DOI: 10.1111/j.1747-4949.2012.00787.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND The appropriateness of a software platform for rapid MRI assessment of the amount of salvageable brain tissue after stroke is critical for both the validity of the Extending the Time for Thrombolysis in Emergency Neurological Deficits (EXTEND) Clinical Trial of stroke thrombolysis beyond 4.5 hours and for stroke patient care outcomes. AIMS The objective of this research is to develop and implement a methodology for selecting the acute stroke imaging software platform most appropriate for the setting of a multi-centre clinical trial. METHODS A multi-disciplinary decision making panel formulated the set of preferentially independent evaluation attributes. Alternative Multi-Attribute Value Measurement methods were used to identify the best imaging software platform followed by sensitivity analysis to ensure the validity and robustness of the proposed solution. RESULTS Four alternative imaging software platforms were identified. RApid processing of PerfusIon and Diffusion (RAPID) software was selected as the most appropriate for the needs of the EXTEND trial. A theoretically grounded generic multi-attribute selection methodology for imaging software was developed and implemented. CONCLUSIONS The developed methodology assured both a high quality decision outcome and a rational and transparent decision process. This development contributes to stroke literature in the area of comprehensive evaluation of MRI clinical software. At the time of evaluation, RAPID software presented the most appropriate imaging software platform for use in the EXTEND clinical trial. The proposed multi-attribute imaging software evaluation methodology is based on sound theoretical foundations of multiple criteria decision analysis and can be successfully used for choosing the most appropriate imaging software while ensuring both robust decision process and outcomes.
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Affiliation(s)
- Leonid Churilov
- National Stroke Research Institute, Florey Neuroscience Institutes, Melbourne, Australia.
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