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Published on: November 9, 2018
Utility of simultaneous brain, CSF and hyperintensity quantification in dementia
Richard H Swartz1, Sandra E Black, Anthony Feinstein
1Institute of Medical Science (SEB and RHS), Division of Neurology, Department of Medicine, University of Toronto and Sunnybrook and Women's College Health Sciences Centre, Ontario, Canada.
Abstract:
Improved methods of quantifying MRI are needed to study brain-behavior relationships in dementia. Rating scales are variable; lesion-tracing approaches can be subjective and ignore atrophy; segmentation of MRI hyperintensities is complicated by partial volume effects; and hyperintense lesions in different anatomical areas may have different effects. The goal of this study was to extend existing segmentation approaches to include hyperintensities and to demonstrate the utility of simultaneously assessing atrophy and lesion compartments in dementia. A semi-automated method was applied to quantify brain and cerebrospinal fluid (CSF) compartments and to subclassify hyperintensities into periventricular, deep white matter, thalamic and basal ganglia compartments. Twenty MR scans from participants in an ongoing dementia study were used to generate intra- and inter-rater reliability estimates. High intra- and inter-class correlation coefficients (0.83-0.99) were obtained for all measures and the semi-automated measurements were highly correlated with traced volumes. Brain, CSF and specific lesion volumes were significantly correlated with neuropsychological functions. In models using only total hyperintensity volumes, the effects of lesion compartments (such as thalamic) were masked. Simultaneous quantification of atrophy and anatomically distinct hyperintensities is important for understanding cognitive impairments in dementia.
Insights
Quantifying brain atrophy and lesions using magnetic resonance imaging (MRI) is crucial for understanding dementia. This study developed a semi-automated method to simultaneously assess these factors, improving diagnostic accuracy.
Area of Science:
- Neuroimaging
- Neurology
- Medical image analysis
Background:
- Current magnetic resonance imaging (MRI) quantification methods for dementia research have limitations, including variability in rating scales, subjectivity in lesion tracing, and challenges in segmenting hyperintensities due to partial volume effects.
- Different anatomical locations of hyperintense lesions may have distinct impacts on cognitive function, necessitating more precise quantification methods.
Purpose of the Study:
- To extend existing segmentation approaches for MRI to incorporate hyperintensities.
- To demonstrate the utility of simultaneously assessing brain atrophy and distinct lesion compartments in dementia.
- To improve the understanding of brain-behavior relationships in dementia through advanced MRI quantification.
Main Methods:
- A semi-automated method was developed and applied to quantify brain and cerebrospinal fluid (CSF) compartments.
- Hyperintensities were subclassified into specific anatomical compartments: periventricular, deep white matter, thalamic, and basal ganglia.
- Twenty MRI scans from dementia study participants were used to assess intra- and inter-rater reliability.
Main Results:
- High intra- and inter-class correlation coefficients (0.83-0.99) were achieved for all quantified measures, indicating excellent reliability.
- Semi-automated measurements showed high correlation with manual lesion tracing volumes.
- Quantified brain, CSF, and specific lesion volumes were significantly correlated with neuropsychological function measures.
Conclusions:
- Simultaneous quantification of brain atrophy and anatomically distinct hyperintensities provides crucial insights into cognitive impairments in dementia.
- The developed semi-automated method offers a reliable and accurate approach for MRI quantification in dementia research.
- Considering specific lesion compartments, rather than total lesion volume, is essential for understanding the impact of lesions on cognitive function.
