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Brain Infarct Segmentation and Registration on MRI or CT for Lesion-symptom Mapping
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Spatial Resolution and the Magnitude of Infarct Volume Measurement Error in DWI in Acute Ischemic Stroke
J M Ospel1,2, A Jaffray3, V Schulze-Zachau1
1From the Department of Radiology (J.M.O., V.S.-Z., C.F.), University Hospital Basel, University of Basel, Basel, Switzerland.
AJNR. American Journal of Neuroradiology
|April 25, 2020
Summary
Partial volume effects in acute stroke imaging cause significant errors in infarct volume measurement. Increasing spatial resolution of diffusion-weighted MRI substantially reduces these errors, improving prognostic accuracy and treatment decisions.
Area of Science:
- Radiology
- Neurology
- Medical Imaging
Background:
- Infarct volume is a critical prognostic marker in acute ischemic stroke.
- Accurate infarct volume measurement guides endovascular treatment decisions.
Purpose of the Study:
- To evaluate the error magnitude from partial volume effects in diffusion-weighted MRI infarct volume measurement.
- To assess the clinical impact of this error on treatment decisions.
- To explore how increased spatial resolution can mitigate this error.
Main Methods:
- Diffusion-weighted MRI data from 393 acute stroke patients were analyzed.
- 3D lesion-volume models were resampled to various spatial resolutions (4x4x8 mm to 1x1x2 mm).
- Partial volume error was calculated, and its impact on the 70 mL endovascular therapy threshold was assessed for cases with large-vessel occlusion.
Main Results:
- Mean partial volume error decreased from 14.7 ± 20.8 mL at 2x2x4 mm resolution to 7.4 ± 10.7 mL at 1x1x2 mm resolution.
- The proportion of large-vessel occlusion cases where the 70 mL threshold fell within the margin of error decreased from 12.5% to 5% with higher resolution.
- The range of potentially misclassified lesion volumes narrowed significantly with increased spatial resolution.
Conclusions:
- Partial volume effects represent a significant source of error in acute stroke infarct volume quantification.
- Enhancing spatial resolution in diffusion-weighted imaging markedly reduces measurement errors.
- Adopting high-resolution diffusion-weighted imaging is recommended to improve the reliability of infarct volume assessments.
