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Updated: May 30, 2026
09:14
Experimental Strategies to Bridge Large Tissue Gaps in the Injured Spinal Cord after Acute and Chronic Lesion
Published on: April 5, 2016
Approaches to normalization of spinal cord volume: application to multiple sclerosis
Brian C Healy1, Ashish Arora, Douglas L Hayden
1Department of Neurology, Partners Multiple Sclerosis Center, Brigham and Women's Hospital, Harvard Medical School, Massachusetts, USA. bchealy@partners.org
Summary
Normalizing spinal cord volume using the number of slices is recommended for multiple sclerosis (MS) research. This method effectively detects differences and improves correlations without significantly impacting reliability.
Area of Science:
- Neuroimaging
- Radiology
- Biomedical Engineering
Background:
- Accurate measurement of spinal cord volume is crucial for understanding neurological conditions like multiple sclerosis (MS).
- Standardization of MRI-derived spinal cord volume measurements is needed for reliable clinical research and patient assessment.
Purpose of the Study:
- To evaluate and recommend the optimal normalization method for spinal cord volume measurements obtained via MRI.
- To assess the impact of different normalization factors on the reliability and sensitivity of spinal cord volume quantification in MS patients.
Main Methods:
- Acquisition of 3-mm thick T2-weighted axial fast spin-echo MRI scans of the whole spinal cord at 3T in 34 MS patients and 15 healthy controls.
- Measurement of four spinal cord volumes (C2-3, cervical, thoracic, whole cord) and normalization using slice count, intracranial volume (ICV), BMI, and body surface area.
- Statistical analysis to compare normalized volumes between patient groups and assess correlations with clinical scores and reliability.
Main Results:
- Progressive MS patients exhibited significantly lower raw and normalized spinal cord volumes (by slices or ICV) compared to relapsing MS patients and controls.
- Spinal cord volumes, particularly C2-3 and cervical, showed significant correlations with Expanded Disability Status Scale scores.
- Normalization by slice count enhanced inter-regional volume correlations, while whole cord volume demonstrated better reliability across normalization methods.
Conclusions:
- Normalization by the number of slices is the recommended method for spinal cord volume quantification in MS research.
- This normalization approach offers a balance between detecting significant differences and maintaining measurement reliability.
- The chosen normalization factor has a limited impact on the overall ability to differentiate patient groups and assess disease severity.
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