Buffalo Neuroimaging Analysis Center, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, NY, USA.
Novartis Pharma AG, Basel, Switzerland.
Neuroimage Clin. 2017 Jun 19;15:769-779. doi: 10.1016/j.nicl.2017.06.022. eCollection 2017.
There is a need for a brain volume measure applicable to the clinical routine scans. Nearly every multiple sclerosis (MS) protocol includes low-resolution 2D T2-FLAIR imaging.
To develop and validate cross-sectional and longitudinal brain atrophy measures on clinical-quality T2-FLAIR images in MS patients.
A real-world dataset from 109 MS patients from 62 MRI scanners was used to develop a lateral ventricular volume (LVV) algorithm with a longitudinal Jacobian-based extension, called NeuroSTREAM. Gold-standard LVV was calculated on high-resolution T1 1 mm, while NeuroSTREAM LVV was obtained on low-resolution T2-FLAIR 3 mm thick images. Scan-rescan reliability was assessed in 5 subjects. The variability of LVV measurement at different field strengths was tested in 76 healthy controls and 125 MS patients who obtained both 1.5T and 3T scans in 72 hours. Clinical validation of algorithm was performed in 176 MS patients who obtained serial yearly MRI 1.5T scans for 10 years.
Correlation between gold-standard high-resolution T1 LVV and low-resolution T2-FLAIR LVV was r = 0.99, p < 0.001 and the scan-rescan coefficient of variation was 0.84%. Correlation between low-resolution T2-FLAIR LVV on 1.5T and 3T was r = 0.99, p < 0.001 and the scan-rescan coefficient of variation was 2.69% cross-sectionally and 2.08% via Jacobian integration. NeuroSTREAM showed comparable effect size (d = 0.39-0.71) in separating MS patients with and without confirmed disability progression, compared to SIENA and VIENA.
Brain atrophy measurement on clinical quality T2-FLAIR scans is feasible, accurate, reliable, and relates to clinical outcomes.
需要一种适用于临床常规扫描的脑容量测量方法。几乎每个多发性硬化症 (MS) 方案都包括低分辨率 2D T2-FLAIR 成像。
在 MS 患者的临床质量 T2-FLAIR 图像上开发和验证横断面和纵向脑萎缩测量方法。
使用来自 62 台 MRI 扫描仪的 109 名 MS 患者的真实世界数据集来开发一种侧脑室容积 (LVV) 算法，该算法具有基于纵向雅可比的扩展，称为 NeuroSTREAM。高分辨率 T1 1mm 上计算了金标准 LVV，而低分辨率 T2-FLAIR 3mm 厚图像上获得了 NeuroSTREAM LVV。在 5 名受试者中评估了扫描-扫描的可靠性。在 76 名健康对照者和 125 名 MS 患者中测试了不同场强下 LVV 测量的变异性，这些患者在 72 小时内同时获得了 1.5T 和 3T 扫描。在 176 名连续 10 年每年进行 1.5T 序列 MRI 扫描的 MS 患者中进行了算法的临床验证。
金标准高分辨率 T1 LVV 与低分辨率 T2-FLAIR LVV 之间的相关性为 r=0.99，p<0.001，扫描-扫描变异系数为 0.84%。1.5T 和 3T 上低分辨率 T2-FLAIR LVV 之间的相关性为 r=0.99，p<0.001，扫描-扫描变异系数为 2.69%（横断面上）和 2.08%（通过雅可比积分）。与 SIENA 和 VIENA 相比，NeuroSTREAM 在分离有和无确认残疾进展的 MS 患者方面显示出相当的效应大小 (d=0.39-0.71)。
在临床质量 T2-FLAIR 扫描上进行脑萎缩测量是可行的、准确的、可靠的，并且与临床结果相关。
