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Published on: May 19, 2015
Clinical feasibility of longitudinal lateral ventricular volume measurements on T2-FLAIR across MRI scanner changes
Dejan Jakimovski1, Robert Zivadinov2, Niels Bergsland3
1Buffalo Neuroimaging Analysis Center, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, NY, USA.
Background:
Greater brain atrophy is associated with disability progression (DP) in patients with multiple sclerosis (PwMS). However, methodological challenges limit its routine clinical use.
Objective:
To determine the feasibility of atrophy measures as markers of DP in PwMS scanned across different MRI field strengths.
Methods:
A total of 980 PwMS were scanned on either 1.5 T or 3.0 T MRI scanners. Demographic and clinical data were retrospectively collected, and the presence of DP was determined according to standard clinical trial criteria. Lateral ventricular volume (LVV) change was measured with the NeuroSTREAM technique on clinical routine T2-FLAIR images. Percent brain volume change (PBVC) was measured using SIENA and ventricular cerebrospinal fluid (vCSF) % change was measured using VIENA and SIENAX algorithms on 3D T1-weighted images (WI). Stable vs. DP PwMS were compared using analysis of covariance (ANCOVA). Mixed modeling determined the effect of MRI scanner change on MRI-derived atrophy measures.
Results:
Longitudinal LVV analysis was successful in all PwMS. SIENA-based PBVC and VIENA-based changes failed in 37.6% of cases, while SIENAX-based vCSF failed in 12.9% of cases. PwMS with DP (n = 241) had significantly greater absolute (20.9% vs. 8.7%, d = 0.66, p < 0.001) and annualized LVV % change (4.1% vs. 2.3%, d = 0.27, p < 0.001) when compared to stable PwMS (n = 739). In subjects with both analyses available, both 3D-T1 and T2-FLAIR-based analyses differentiated PwMS with DP (n = 149). However, only NeuroSTREAM and VIENA-based LVV/vCSF were able to show greater atrophy in PwMS that were scanned on different scanners. PBVC and SIENAX-based vCSF % changes were significantly affected by scanner change (Beta = -0.16, t-statistics = -2.133, p = 0.033 and Beta = -2.08, t-statistics = -4.084, p < 0.001), whereas no MRI scanner change effects on NeuroSTREAM-based PLVVC and VIENA-based vCSF % change were noted.
Conclusions:
LVV-based atrophy on T2-FLAIR is a clinically relevant measure in spite of MRI scanner changes and mild disability levels.
Insights
Brain atrophy measurement using lateral ventricular volume (LVV) on T2-FLAIR images is a feasible marker for disability progression in patients with multiple sclerosis (PwMS). This method remains reliable despite variations in MRI scanner field strengths.
Area of Science:
- Neuroimaging
- Neurology
- Medical Imaging Analysis
Background:
- Greater brain atrophy correlates with disability progression (DP) in patients with multiple sclerosis (PwMS).
- Methodological challenges have historically limited the routine clinical application of atrophy measures.
- Standardized and reliable atrophy quantification is crucial for monitoring disease course in PwMS.
Purpose of the Study:
- To assess the feasibility of using brain atrophy measures as reliable markers of DP in PwMS.
- To evaluate atrophy measures across different MRI field strengths (1.5 T and 3.0 T).
- To determine the impact of MRI scanner variability on atrophy quantification.
Main Methods:
- Retrospective analysis of 980 PwMS scanned on 1.5 T or 3.0 T MRI scanners.
- Measurement of lateral ventricular volume (LVV) change using the NeuroSTREAM technique on T2-FLAIR images.
- Measurement of percent brain volume change (PBVC) using SIENA and ventricular cerebrospinal fluid (vCSF) % change using VIENA and SIENAX on 3D T1-weighted images.
- Comparison of atrophy measures between stable PwMS and those with DP using ANCOVA and mixed modeling.
Main Results:
- Longitudinal LVV analysis was successful in all PwMS, demonstrating high feasibility.
- PwMS with DP exhibited significantly greater absolute and annualized LVV % change compared to stable PwMS.
- NeuroSTREAM (LVV) and VIENA (vCSF) methods showed greater atrophy in PwMS scanned on different scanners, indicating robustness.
- SIENA-based PBVC and SIENAX-based vCSF % changes were significantly affected by scanner changes, highlighting limitations.
Conclusions:
- Lateral ventricular volume (LVV)-based atrophy measurement on T2-FLAIR images is a clinically relevant and feasible marker for disability progression in PwMS.
- This method demonstrates reliability despite variations in MRI scanner field strengths and mild disability levels.
- NeuroSTREAM technique offers a robust approach for atrophy assessment in PwMS, unaffected by scanner changes.
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