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Updated: Jun 16, 2026
08:51
Magnetic Resonance Imaging of Multiple Sclerosis at 7.0 Tesla
Published on: February 19, 2021
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Choroid plexus volume in multiple sclerosis can be estimated on structural MRI avoiding contrast injection.
Valentina Visani1, Francesca B Pizzini2, Valerio Natale3
1Department of Information Engineering, University of Padova, Padova, Italy.
European Radiology Experimental
|February 27, 2024
Summary
Non-contrast T1-weighted (T1w) MRI sequences can accurately estimate choroid plexus (ChP) volume, serving as a viable alternative to contrast-enhanced T1w sequences. Fluid-attenuated inversion-recovery (FLAIR) sequences overestimate ChP volume, making T1w sequences preferable for segmentation in multiple sclerosis research.
Area of Science:
- Neuroimaging
- Radiology
- Medical Image Analysis
Background:
- The choroid plexus (ChP) is a crucial structure within the brain ventricles.
- Accurate segmentation of the ChP is important for understanding its role in neurological diseases like multiple sclerosis (MS).
- Contrast-enhanced T1-weighted (CE-T1w) sequences are typically considered the reference standard for ChP segmentation.
Purpose of the Study:
- To compare the accuracy and reliability of manual choroid plexus segmentation using non-contrast-enhanced (non-CE) T1-weighted (T1w) and fluid-attenuated inversion-recovery (FLAIR) sequences against the reference standard CE-T1w sequences.
- To evaluate the suitability of non-CE T1w sequences as a surrogate for CE-T1w sequences in estimating ChP volume in patients with multiple sclerosis.
- To assess the overestimation of ChP volume by FLAIR sequences compared to CE-T1w sequences.
Main Methods:
- Manual segmentation of the choroid plexus (ChP) was performed on T1w, FLAIR, and CE-T1w MRI sequences in 61 multiple sclerosis patients.
- Inter-rater variability was assessed using the intraclass correlation coefficient (ICC).
- Signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR), and Dice similarity coefficient (DSC) were calculated. Spatial error distribution was analyzed after nonlinear coregistration to MNI152 space.
Main Results:
- High inter-rater reproducibility was observed across all sequences (ICC: T1w=0.93, FLAIR=0.93, CE-T1w=0.99).
- CE-T1w sequences demonstrated higher SNR and CNR compared to T1w and FLAIR sequences.
- FLAIR sequences significantly overestimated ChP volume (3.787 ± 0.679 mL) compared to CE-T1w (2.984 ± 0.506 mL) (p < 0.001), with a 28.02 ± 19.02% error.
- Non-CE T1w sequences provided an acceptable error (3.52 ± 12.61%) and showed good agreement with CE-T1w (DSC=0.67 ± 0.05), suggesting T1w as a surrogate for CE-T1w.
- Spatial error distribution was heterogeneous, particularly near the fornix and hippocampus.
Conclusions:
- Non-contrast T1w sequences can serve as a reliable surrogate for CE-T1w sequences for choroid plexus volume estimation in multiple sclerosis patients.
- FLAIR sequences tend to overestimate ChP volume and are less suitable for accurate volume assessment.
- These findings support the development of automated segmentation tools and facilitate longitudinal studies investigating the role of ChP volume in multiple sclerosis.
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