Beadnall H N, Wang C, Van Hecke W, Ribbens A, Billiet T, Barnett M H
Brain and Mind Centre, The University of Sydney, Sydney, Australia Royal Prince Alfred Hospital, Sydney, Australia.
Brain and Mind Centre, The University of Sydney, Sydney, Australia Sydney Neuroimaging Analysis Centre, Sydney, Australia.
Ther Adv Neurol Disord. 2019 Jan 25;12:1756286418823462. doi: 10.1177/1756286418823462. eCollection 2019.
Whole brain atrophy (WBA) estimates in multiple sclerosis (MS) correlate more robustly with clinical disability than traditional, lesion-based metrics. We compare Structural Image Evaluation using Normalisation of Atrophy (SIENA) with the icobrain longitudinal pipeline (icobrain long), for assessment of longitudinal WBA in MS patients.
Magnetic resonance imaging (MRI) scan pairs [1.05 (±0.15) year separation] from 102 MS patients were acquired on the same 3T scanner. Three-dimensional (3D) T1-weighted and two-dimensional (2D)/3D fluid-attenuated inversion-recovery sequences were analysed. Percentage brain volume change (PBVC) measurements were calculated using SIENA and icobrain long. Statistical correlation, agreement and consistency between methods was evaluated; MRI brain volumetric and clinical data were compared. The proportion of the cohort with annualized brain volume loss (aBVL) rates ⩾ 0.4%, ⩾0.8% and ⩾0.94% were calculated. No evidence of disease activity (NEDA) 3 and NEDA 4 were also determined.
Mean annualized PBVC was -0.59 (±0.65)% and -0.64 (±0.73)% as measured by icobrain long and SIENA. icobrain long and SIENA-measured annualized PBVC correlated strongly, = 0.805 ( < 0.001), and the agreement [intraclass correlation coefficient (ICC) 0.800] and consistency (ICC 0.801) were excellent. Weak correlations were found between MRI metrics and Expanded Disability Status Scale scores. Over half the cohort had aBVL ⩾ 0.4%, approximately a third ⩾0.8%, and aBVL was ⩾0.94% in 28.43% and 23.53% using SIENA and icobrain long, respectively. NEDA 3 was achieved in 35.29%, and NEDA 4 in 15.69% and 16.67% of the cohort, using SIENA and icobrain long to derive PBVC, respectively.
icobrain long quantified longitudinal WBA with a strong level of statistical agreement and consistency compared to SIENA in this real-world MS population. Utility of WBA measures in individuals remains challenging, but show promise as biomarkers of neurodegeneration in MS clinical practice. Optimization of MRI analysis algorithms/techniques are needed to allow reliable use in individuals. Increased levels of automation will enable more rapid clinical translation.
与传统的基于病灶的指标相比，多发性硬化症（MS）中的全脑萎缩（WBA）估计与临床残疾的相关性更强。我们比较了使用萎缩归一化的结构图像评估（SIENA）和icobrain纵向分析流程（icobrain long），以评估MS患者的纵向WBA。
在同一台3T扫描仪上获取了102例MS患者的磁共振成像（MRI）扫描对[间隔1.05（±0.15）年]。分析了三维（3D）T1加权和二维（2D）/3D液体衰减反转恢复序列。使用SIENA和icobrain long计算脑体积变化百分比（PBVC）测量值。评估了两种方法之间的统计相关性、一致性和一致性；比较了MRI脑容量和临床数据。计算了年化脑容量损失（aBVL）率≥0.4%、≥0.8%和≥0.94%的队列比例。还确定了无疾病活动证据（NEDA）3和NEDA 4。
icobrain long和SIENA测量的平均年化PBVC分别为-0.59（±0.65）%和-0.64（±0.73）%。icobrain long和SIENA测量的年化PBVC相关性很强，r = 0.805（P < 0.001），一致性[组内相关系数（ICC）0.800]和一致性（ICC 0.801）非常好。在MRI指标和扩展残疾状态量表评分之间发现了弱相关性。超过一半的队列aBVL≥0.4%，约三分之一≥0.8%，使用SIENA和icobrain long时，aBVL≥0.94%的比例分别为28.43%和23.53%。使用SIENA和icobrain long得出PBVC时，队列中分别有35.29%、15.69%和16.67%达到了NEDA 3和NEDA 4。
在这个真实世界的MS人群中，与SIENA相比，icobrain long在统计一致性和一致性水平上对纵向WBA进行了量化。WBA测量在个体中的实用性仍然具有挑战性，但在MS临床实践中作为神经退行性变的生物标志物显示出前景。需要优化MRI分析算法/技术，以便在个体中可靠使用。更高水平的自动化将实现更快速的临床转化。
