Jasperse Bas, Valsasina Paola, Neacsu Veronica, Knol Dirk L, De Stefano Nicola, Enzinger Christian, Smith Stephen M, Ropele Stefan, Korteweg Tijmen, Giorgio Antonio, Anderson Valerie, Polman Chris H, Filippi Massimo, Miller David H, Rovaris Marco, Barkhof Frederik, Vrenken Hugo
Department of Neurology, VU University Medical Center, Amsterdam, The Netherlands.
J Magn Reson Imaging. 2007 Oct;26(4):881-5. doi: 10.1002/jmri.21101.
To investigate intercenter agreement of brain volume (change) measurement in multiple sclerosis (MS) using structural image evaluation using normalization of atrophy (SIENA) and the cross-sectional version of SIENA (SIENAX) with additional manual editing to correct for inadequate brain extraction.
Baseline and follow-up T1-weighted MR images of 20 MS patients were dispatched to five centers. Each center performed fully-automated and manually-edited analyses for SIENAX, yielding normalized brain volume (NBV), and SIENA, yielding percentage brain volume change (PBVC). Intercenter agreement was assessed with the concordance correlation coefficient (CCC).
Intercenter agreement was perfect for fully automated NBV and PBVC (both CCC = 1.0), and remained substantial upon manual editing (CCC = 0.94 for NBV, CCC = 0.95 for PBVC). Mean NBV values for each center decreased significantly after manual editing (overall mean NBV = 1605.3 cm(3) vs. 1651.1 cm(3) without manual editing; t = -4.58, P < 0.001). Total variance in PBVC decreased significantly by a factor of 1.8 after manual editing (sigma(2) = 2.82 before, and sigma(2) = 1.54 after manual editing, P < 0.05).
Substantial intercenter agreement was found for manually-edited SIENAX and SIENA, suggesting that measurements from multiple centers may be pooled. Manual editing reduces overestimation of NBV, and is likely to increase statistical power for PBVC.
使用基于萎缩归一化的结构图像评估（SIENA）和SIENA的横断面版本（SIENAX），并通过额外的手动编辑来校正脑提取不足的情况，研究多中心对多发性硬化症（MS）脑容量（变化）测量的一致性。
20例MS患者的基线和随访T1加权磁共振图像被分发给五个中心。每个中心对SIENAX进行全自动和手动编辑分析，得出归一化脑容量（NBV），对SIENA进行分析，得出脑容量变化百分比（PBVC）。用一致性相关系数（CCC）评估中心间的一致性。
全自动NBV和PBVC的中心间一致性完美（两者CCC = 1.0），手动编辑后仍保持高度一致（NBV的CCC = 0.94，PBVC的CCC = 0.95）。手动编辑后，每个中心的平均NBV值显著下降（总体平均NBV = 1605.3 cm³，未进行手动编辑时为1651.1 cm³；t = -4.58，P < 0.001）。手动编辑后，PBVC的总方差显著降低了1.8倍（手动编辑前σ² = 2.82，手动编辑后σ² = 1.54，P < 0.05）。
手动编辑的SIENAX和SIENA显示出高度的中心间一致性，这表明可以汇总来自多个中心的测量数据。手动编辑减少了NBV的高估，并且可能会提高PBVC的统计效能。
