A rapid, reliable, and valid method for measuring infarct and brain compartment volumes from computed tomographic...

Area of Science:

• Neurology
• Radiology
• Medical Imaging

Background:

• Clinical stroke trials need objective and reproducible endpoint variables.
• Cerebral morphometry, including infarct volume, quantifies brain damage but can be time-consuming and difficult to standardize across centers.
• A rapid, reliable, and unbiased brain morphometry method based on stereological techniques was developed.

Purpose of the Study:

• To extend a previously developed brain morphometry method for analysis of routine computed tomographic (CT) scans.
• To assess the reliability and rapidity of this stereological method for cerebral morphometry in stroke patients.

Main Methods:

• CT scans from 18 stroke patients and 14 asymptomatic controls were analyzed.
• Three independent observers measured volumes of various cranial structures, including the cerebrum, cortex, white matter, and visible infarction.
• The method utilizes well-accepted stereological techniques and is applicable to routine CT scans.

Main Results:

• The stereological method demonstrated good inter-observer agreement, with intraclass correlation coefficients ranging from 0.87 to 0.93 for most structures.
• Cerebral volume was significantly smaller in stroke patients compared to controls (P < .001).
• Infarct volume averaged 55 ± 16 mL in patients, and scan analysis took 70–90 minutes per patient.

Conclusions:

• A stereological method for cerebral morphometry from CT scans is reliable, rapid, and simple.
• The measurements are unbiased and independent of machine variables, yielding results comparable to more labor-intensive methods.
• This method is suitable for large-scale, multicenter stroke therapy trials.