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Volumetric apparent diffusion coefficient (ADC) histogram analysis of the brain in paediatric patients with hypoxic
Mustafa Orhan Nalbant1, Irem Erdil1, Nihal Akcay2
1Department of Radiology, Bakirkoy Dr. Sadi Konuk Training and Research Hospital, University of Health Sciences, Bakırkoy, Istanbul, Turkey.
Insights
Apparent diffusion coefficient (ADC) histogram analysis reveals lower ADC values in the hippocampus, thalamus, and lentiform nucleus of paediatric patients with hypoxic-ischaemic encephalopathy (HIE). This volumetric analysis can serve as an imaging biomarker for HIE diagnosis.
Area of Science:
- Neuroimaging
- Pediatric Radiology
- Diffusion-Weighted Imaging
Background:
- Hypoxic-ischaemic encephalopathy (HIE) is a major cause of neonatal brain injury.
- Accurate and early diagnosis of HIE is crucial for timely intervention and improved outcomes.
- Apparent diffusion coefficient (ADC) histogram analysis offers a quantitative method to assess tissue microstructure.
Purpose of the Study:
- To evaluate the utility of volumetric apparent diffusion coefficient (ADC) histogram analysis in paediatric patients diagnosed with hypoxic-ischaemic encephalopathy (HIE).
- To assess ADC histogram parameters in the whole brain, hippocampus, thalamus, and lentiform nucleus.
- To determine if these parameters can serve as imaging markers for HIE.
Main Methods:
- Retrospective study including 25 HIE patients and 50 controls.
- Diffusion-weighted imaging acquired at b-values of 1000 mm²/s.
- Volumetric histogram analysis of ADC values (mean, min, max, percentiles, skewness, kurtosis, variance) in specified brain regions.
Main Results:
- Significantly lower ADCmin, ADCmean, and ADCmax, along with several percentiles, were observed in the hippocampus, thalamus, and lentiform nucleus of HIE patients compared to controls (p < 0.001).
- Whole-brain analysis showed lower ADC values in most parameters for the HIE group, with some exceptions.
- Hippocampal ADC histogram parameters demonstrated the highest diagnostic accuracy for HIE, with the 95th percentile yielding an AUC of 0.915.
Conclusions:
- Volumetric ADC histogram analysis of the whole brain, hippocampus, thalamus, and lentiform nucleus is a valuable imaging biomarker for HIE.
- ADC histogram parameters, particularly in the hippocampus, show high diagnostic accuracy for identifying HIE in paediatric patients.
- This quantitative imaging approach can aid in the diagnosis and assessment of HIE.
Purpose:
To evaluate the whole brain, hippocampus, thalamus, and lentiform nucleus by volumetric apparent diffusion coefficient (ADC) histogram analysis in paediatric patients with hypoxic-ischaemic encephalopathy (HIE).
Material And Methods:
This retrospective study included 25 patients with HIE and 50 patients as the control group. Diffusion-weighted imaging was obtained at b-values of 1000 mm2/s. The histogram parameters of ADC values, including the mean, minimum, maximum, 5th, 10th, 25th, 50th, 75th, 90th, and 95th percentiles, as well as skewness, kurtosis, and variance were determined. The interclass correlation coefficient (ICC) was used to assess the inter-observer agreement.
Results:
ADCmin, ADCmean, and ADCmax, as well as the 5th, 10th, 25th, 50th, 75th, 90th, and 95th percentiles of ADC values for the HIE group were all lower than those of the control group (p < 0.001) in the volumetric histogram analysis of the hippocampus, thalamus, and lentiform nucleus. In the whole-brain histogram analysis, ADC min, and the 50th and 75th percentiles of ADC values did not differ significantly, while other parameters were lower in the HIE group. The ROC curve revealed that the ADC histogram parameters of the hippocampus provided the most accurate results for the diagnosis of HIE. The area under the curve (AUC) of the 95th percentile of ADC values was the highest (AUC = 0.915; cut-off 1.262 × 10-3 mm2/s; sensitivity 88% and specificity 84%).
Conclusions:
Volumetric ADC histogram analysis of the whole brain, hippocampus, thalamus, and lentiform nucleus with b-values of 1000 mm2/s can serve as an imaging marker for determining HIE.
