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Brain volume estimation from post-mortem newborn and fetal MRI
Eliza Orasanu1, Andrew Melbourne1, M Jorge Cardoso1
1Translational Imaging Group, Centre for Medical Image Computing (CMIC), University College London, UK.
Objective:
Minimally invasive autopsy using post-mortem magnetic resonance imaging (MRI) is a valid alternative to conventional autopsy in fetuses and infants. Estimation of brain weight is an integral part of autopsy, but manual segmentation of organ volumes on MRI is labor intensive and prone to errors, therefore unsuitable for routine clinical practice. In this paper we aim to show that volumetric measurements of the post-mortem fetal and neonatal brain can be accurately estimated using semi-automatic techniques and a high correlation can be found with the weights measured from conventional autopsy results.
Methods:
The brains of 17 newborn subjects, part of Magnetic Resonance Imaging Autopsy Study (MaRIAS), were segmented from post-mortem MR images into cerebrum, cerebellum and brainstem using a publicly available neonate brain atlas and semi-automatic segmentation algorithm. The results of the segmentation were averaged to create a new atlas, which was then used for the automated atlas-based segmentation of 17 MaRIAS fetus subjects. As validation, we manually segmented the MR images from 8 subjects of each cohort and compared them with the automatic ones. The semi-automatic estimation of cerebrum weight was compared with the results of the conventional autopsy.
Results:
The Dice overlaps between the manual and automatic segmentations are 0.991 and 0.992 for cerebrum, 0.873 and 0.888 for cerebellum and 0.819 and 0.815 for brainstem, for newborns and fetuses, respectively. Excellent agreement was obtained between the estimated MR weights and autopsy gold standard ones: mean absolute difference of 5 g and 2% maximum error for the fetus cohort and mean absolute difference of 20 g and 11% maximum error for the newborn one.
Conclusions:
The high correlation between the obtained segmentation and autopsy weights strengthens the idea of using post-mortem MRI as an alternative for conventional autopsy of the brain.
Insights
Semi-automatic post-mortem MRI brain segmentation accurately estimates fetal and neonatal brain weight. This method shows high correlation with conventional autopsy, offering a viable alternative for minimally invasive autopsy.
Area of Science:
- Medical Imaging
- Forensic Pathology
- Pediatric Pathology
Background:
- Post-mortem magnetic resonance imaging (MRI) is a minimally invasive autopsy alternative for fetuses and infants.
- Manual brain segmentation on post-mortem MRI is time-consuming and error-prone, hindering routine clinical use.
- Accurate brain weight estimation is crucial for autopsy but manual methods are impractical.
Purpose of the Study:
- To validate semi-automatic segmentation techniques for accurate post-mortem fetal and neonatal brain volumetric measurements.
- To assess the correlation between MRI-derived brain weights and conventional autopsy results.
- To establish post-mortem MRI as a reliable tool for brain weight estimation in forensic and pediatric autopsies.
Main Methods:
- Post-mortem MR images of 17 newborns and 17 fetuses were segmented using a semi-automatic algorithm and a neonate brain atlas.
- A new atlas was created from averaged segmentations and used for automated atlas-based segmentation.
- Manual segmentation and conventional autopsy weights were used for validation and comparison.
Main Results:
- High Dice overlap coefficients (0.815–0.992) between manual and automatic segmentations across brain regions.
- Excellent agreement between MRI-estimated and conventional autopsy brain weights.
- Low mean absolute differences (5g for fetuses, 20g for newborns) and maximum errors (2% for fetuses, 11% for newborns).
Conclusions:
- Semi-automatic post-mortem MRI segmentation provides accurate brain weight estimations.
- The high correlation with autopsy weights supports post-mortem MRI as a viable alternative to conventional autopsy for brain examination.
- This technique enhances the utility of minimally invasive autopsy in pediatric and forensic cases.
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