Ost Kalum, Jacobs W Bradley, Evaniew Nathan, Cohen-Adad Julien, Anderson David, Cadotte David W
Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, Calgary, AB T2N 1N4, Canada.
Department of Clinical Neurosciences, Section of Neurosurgery, Cumming School of Medicine, University of Calgary, Calgary, AB T2N 1N4, Canada.
J Clin Med. 2021 Feb 23;10(4):892. doi: 10.3390/jcm10040892.
Despite Degenerative Cervical Myelopathy (DCM) being the most common form of spinal cord injury, effective methods to evaluate patients for its presence and severity are only starting to appear. Evaluation of patient images, while fast, is often unreliable; the pathology of DCM is complex, and clinicians often have difficulty predicting patient prognosis. Automated tools, such as the Spinal Cord Toolbox (SCT), show promise, but remain in the early stages of development. To evaluate the current state of an SCT automated process, we applied it to MR imaging records from 328 DCM patients, using the modified Japanese Orthopedic Associate scale as a measure of DCM severity. We found that the metrics extracted from these automated methods are insufficient to reliably predict disease severity. Such automated processes showed potential, however, by highlighting trends and barriers which future analyses could, with time, overcome. This, paired with findings from other studies with similar processes, suggests that additional non-imaging metrics could be added to achieve diagnostically relevant predictions. Although modeling techniques such as these are still in their infancy, future models of DCM severity could greatly improve automated clinical diagnosis, communications with patients, and patient outcomes.
尽管退行性颈椎脊髓病(DCM)是脊髓损伤最常见的形式,但评估患者是否存在该病及其严重程度的有效方法才刚刚开始出现。对患者图像的评估虽然快速,但往往不可靠;DCM的病理情况复杂,临床医生常常难以预测患者的预后。诸如脊髓工具箱(SCT)等自动化工具显示出了前景,但仍处于开发的早期阶段。为了评估SCT自动化流程的当前状态,我们将其应用于328例DCM患者的磁共振成像记录,使用改良的日本骨科协会量表作为DCM严重程度的衡量标准。我们发现,从这些自动化方法中提取的指标不足以可靠地预测疾病严重程度。然而,通过突出未来分析随着时间推移可以克服的趋势和障碍,此类自动化流程显示出了潜力。这与其他采用类似流程的研究结果相结合,表明可以添加额外的非成像指标来实现与诊断相关的预测。尽管此类建模技术仍处于起步阶段,但未来的DCM严重程度模型可能会极大地改善临床自动化诊断、与患者的沟通以及患者的治疗效果。
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