Department of Psychiatry, University of Oxford, United Kingdom; Oxford Health NHS Foundation Trust, Oxford, United Kingdom; Nuffield Department of Clinical Neurosciences, University of Oxford, United Kingdom; Wellcome Centre for Integrative Neuroimaging, University of Oxford, United Kingdom.
Department of Psychiatry, University of Oxford, United Kingdom; Oxford Health NHS Foundation Trust, Oxford, United Kingdom; Wellcome Centre for Integrative Neuroimaging, University of Oxford, United Kingdom.
Neuroimage Clin. 2022;36:103273. doi: 10.1016/j.nicl.2022.103273. Epub 2022 Nov 21.
The Oxford Brain Health Clinic (BHC) is a joint clinical-research service that provides memory clinic patients and clinicians access to high-quality assessments not routinely available, including brain MRI aligned with the UK Biobank imaging study (UKB). In this work we present how we 1) adapted the UKB MRI acquisition protocol to be suitable for memory clinic patients, 2) modified the imaging analysis pipeline to extract measures that are in line with radiology reports and 3) explored the alignment of measures from BHC patients to the largest brain MRI study in the world (ultimately 100,000 participants). Adaptations of the UKB acquisition protocol for BHC patients include dividing the scan into core and optional sequences (i.e., additional imaging modalities) to improve patients' tolerance for the MRI assessment. We adapted the UKB structural MRI analysis pipeline to take into account the characteristics of a memory clinic population (e.g., high amount of white matter hyperintensities and hippocampal atrophy). We then compared the imaging derived phenotypes (IDPs) extracted from the structural scans to visual ratings from radiology reports, non-imaging factors (age, cognition) and to reference distributions derived from UKB data. Of the first 108 BHC attendees (August 2020-November 2021), 92.5 % completed the clinical scans, 88.0 % consented to use of data for research, and 43.5 % completed the additional research sequences, demonstrating that the protocol is well tolerated. The high rates of consent to research makes this a valuable real-world quality research dataset routinely captured in a clinical service. Modified tissue-type segmentation with lesion masking greatly improved grey matter volume estimation. CSF-masking marginally improved hippocampal segmentation. The IDPs were in line with radiology reports and showed significant associations with age and cognitive performance, in line with the literature. Due to the age difference between memory clinic patients of the BHC (age range 65-101 years, average 78.3 years) and UKB participants (44-82 years, average 64 years), additional scans on elderly healthy controls are needed to improve reference distributions. Current and future work aims to integrate automated quantitative measures in the radiology reports and evaluate their clinical utility.
牛津大脑健康诊所（BHC）是一个临床研究服务联合机构，为记忆诊所患者和临床医生提供了高质量的评估，这些评估通常是不可用的，包括与英国生物银行成像研究（UKB）相匹配的大脑 MRI。在这项工作中，我们展示了如何 1）适应 UKB MRI 采集协议，使其适用于记忆诊所患者，2）修改成像分析管道，以提取与放射学报告一致的指标，3）探索 BHC 患者的指标与世界上最大的大脑 MRI 研究（最终为 100,000 名参与者）的一致性。为了适应 BHC 患者，我们对 UKB 采集协议进行了调整，包括将扫描分为核心和可选序列（即额外的成像方式），以提高患者对 MRI 评估的耐受性。我们对 UKB 结构 MRI 分析管道进行了调整，以考虑记忆诊所人群的特点（例如，大量的脑白质高信号和海马体萎缩）。然后，我们将从结构扫描中提取的成像衍生表型（IDP）与放射学报告中的视觉评分、非成像因素（年龄、认知）以及从 UKB 数据中得出的参考分布进行了比较。在 2020 年 8 月至 2021 年 11 月期间的前 108 名 BHC 参与者中，92.5%的人完成了临床扫描，88.0%的人同意将数据用于研究，43.5%的人完成了额外的研究序列，这表明该协议具有良好的耐受性。对研究的高同意率使这成为一个有价值的真实世界的质量研究数据集，通常在临床服务中捕获。带有病变掩模的改良组织类型分割极大地提高了灰质体积的估计。CSF 掩模略微改善了海马体分割。IDP 与放射学报告一致，并与文献一致，与年龄和认知表现有显著关联。由于 BHC 记忆诊所患者（年龄范围 65-101 岁，平均 78.3 岁）和 UKB 参与者（44-82 岁，平均 64 岁）之间的年龄差异，需要对老年健康对照者进行额外的扫描，以改善参考分布。当前和未来的工作旨在将自动定量指标集成到放射学报告中，并评估其临床效用。
