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Within-patient fluctuation of brain volume estimates from short-term repeated MRI measurements using SIENA/FSL

Roland Opfer1,2, Ann-Christin Ostwaldt3, Christine Walker-Egger4

  • 1Neuroimmunology and Multiple Sclerosis Research, Department of Neurology, University Hospital Zurich and University of Zurich, Zurich, Switzerland. roland.opfer@jung-diagnostics.de.

Journal of Neurology
|March 18, 2018
PubMed
Abstract

Insights

Brain volume loss (BVL) measurement noise can be accounted for using within-patient fluctuation (WPF). This approach helps detect pathological BVL in multiple sclerosis (MS) patients, with 18% showing significant loss after one year.

Area of Science:

  • Neuroimaging
  • Quantitative MRI
  • Brain Volume Analysis

Background:

  • Brain volume loss (BVL) measurements in individual patients are controversial due to concerns about short-term biological noise, such as hydration status.
  • Accurate assessment of BVL is crucial for understanding disease progression, particularly in neurodegenerative conditions.

Purpose of the Study:

  • To quantify within-patient fluctuation (WPF) in brain volume measurements.
  • To establish an approach for interpreting individual BVL measurements in the context of WPF.
  • To determine if pathological BVL is detectable in early relapsing multiple sclerosis (MS) patients after one year.

Main Methods:

  • Analysis of three public reliability MRI datasets with short scan intervals (days to weeks).
  • Assessment of 60 early relapsing MS patients with 1-year MRI follow-ups.
  • Brain volume loss (BVL) calculated using SIENA/FSL; WPF defined as measurement error plus short-term biological fluctuations.

Main Results:

  • The standard deviation of BVL measurements across reliability datasets was estimated at 0.28%.
  • A threshold of 0.94% BVL per year was required to detect significant loss after one year with 5% error probability.
  • Median BVL per year in MS patients was 0.44%, with 18% (11 out of 60) exhibiting BVL greater than or equal to 0.94%.

Conclusions:

  • The quantified within-patient fluctuation (WPF) provides a reliable method for interpreting individual brain volume loss (BVL) results.
  • This approach aids in identifying pathological BVL in diseases like multiple sclerosis (MS) at the individual patient level.
Keywords:
Brain atrophyMRIMultiple sclerosisReliabilitySIENA

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