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Luchetti L, Prados F, Cortese R, Gentile G, Calabrese M, Mortilla M, De Stefano N, Battaglini M. Evaluation of cervical spinal cord atrophy using a modified SIENA approach. Neuroimage 2024; 298:120775. [PMID: 39106936 DOI: 10.1016/j.neuroimage.2024.120775] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Revised: 07/12/2024] [Accepted: 08/02/2024] [Indexed: 08/09/2024] Open
Abstract
Spinal cord (SC) atrophy obtained from structural magnetic resonance imaging has gained relevance as an indicator of neurodegeneration in various neurological disorders. The common method to assess SC atrophy is by comparing numerical differences of the cross-sectional spinal cord area (CSA) between time points. However, this indirect approach leads to considerable variability in the obtained results. Studies showed that this limitation can be overcome by using a registration-based technique. The present study introduces the Structural Image Evaluation using Normalization of Atrophy on the Spinal Cord (SIENA-SC), which is an adapted version of the original SIENA method, designed to directly calculate the percentage of SC volume change over time from clinical brain MRI acquired with an extended field of view to cover the superior part of the cervical SC. In this work, we compared SIENA-SC with the Generalized Boundary Shift Integral (GBSI) and the CSA change. On a scan-rescan dataset, SIENA-SC was shown to have the lowest measurement error than the other two methods. When comparing a group of 190 Healthy Controls with a group of 65 Multiple Sclerosis patients, SIENA-SC provided significantly higher yearly rates of atrophy in patients than in controls and a lower sample size when measured for treatment effect sizes of 50%, 30% and 10%. Our findings indicate that SIENA-SC is a robust, reproducible, and sensitive approach for assessing longitudinal changes in spinal cord volume, providing neuroscientists with an accessible and automated tool able to reduce the need for manual intervention and minimize variability in measurements.
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Affiliation(s)
- Ludovico Luchetti
- Department of Medicine, Surgery and Neuroscience, University of Siena, Siena, Italy; Siena Imaging S.r.l., Siena, Italy
| | - Ferran Prados
- NMR Research Unit, Queen Square MS Centre, Department of Neuroinflammation, UCL Queen Square Institute of Neurology, Faculty of Brain Sciences, University College London, London, United Kingdom; Center for Medical Imaging Computing, Medical Physics and Biomedical Engineering Department, University College London, London, United Kingdom; e-Health Center, Universitat Oberta de Catalunya, Barcelona, Spain
| | - Rosa Cortese
- Department of Medicine, Surgery and Neuroscience, University of Siena, Siena, Italy
| | | | - Massimilano Calabrese
- Department of Neuroscience, Biomedicine and Movements, The Multiple Sclerosis Center of the University Hospital of Verona, Verona, Italy
| | - Marzia Mortilla
- Anna Meyer Children's University Hospital-IRCCS, Florence, Italy
| | - Nicola De Stefano
- Department of Medicine, Surgery and Neuroscience, University of Siena, Siena, Italy
| | - Marco Battaglini
- Department of Medicine, Surgery and Neuroscience, University of Siena, Siena, Italy; Siena Imaging S.r.l., Siena, Italy.
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Nitu NS, Sultana SZ, Haq A, Sumi SA, Bose SK, Sinha S, Kumar S, Haque M. Histological Study on the Thickness of Gray Matter at the Summit and Bottom of Folium in Different Age Groups of Bangladeshi People. Cureus 2023; 15:e42103. [PMID: 37476298 PMCID: PMC10354462 DOI: 10.7759/cureus.42103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/18/2023] [Indexed: 07/22/2023] Open
Abstract
Context The cerebellum is a part of the hindbrain and consists of cortical gray matter (GM) at the surface and a medullary core of white matter (WM). The GM contains a cell body of neurons that helps process and transmit any command type through nerve fibers found in the WM. The main functions of GM in the central nervous system empower persons to control motor activity, recollection, and passion. So, this research aims to assess the thickness of GM at the summit and bottom of folia by histologically studying the cerebellum cortex. Methods The collection of data was a descriptive type of cross-sectional study. The method was the purposive type. This study was conducted from August 2016 to March 2017, and the research was carried out at Mymensingh Medical College's Department of Anatomy, Bangladesh. Specimens containing cerebellum were preserved from Bangladeshi cadavers according to sexes and ages ranging in years. We chose fresh specimens from people who died within the last 12 hours and preserved them in 10% formol saline. The size of the tissue that was collected for the histological study was not more than 2 cm2 and not more than 4-5 mm thick. Then the tissue was placed in 10% formol saline. This fluid was used for quick fixation and partial dehydration of the tissue. After dehydration, each tissue segment is processed for infiltration and embedding separately. Every section was stained with hematoxylin and eosin stain (H&E) before being coated with dibutyl phthalate polystyrene xylene (DPX) coverslips on slides. Result The mean (±SD) thickness of GM at the summit of folium was 886.2±29.7µm in Group A, 925.2±25.9µm in Group B, 912.7±22.3µm in Group C, and 839.9±40.7µm in Group D. Mean (±SD) GM thickness at the bottom of the fissure was 395.6±12.2 µm, 403.9±26.0µm, 380.4±23.4 µm, and 375.8±28.8 µm in Groups A, B, C, and D respectively. Conclusion The thickness of the cortex is an essential factor in the normal development process, and it was similar in the current study. Normal aging, Alzheimer's disease, and other dementias cause reduced GM which makes the cortical sheet thin. Huntington's disease, corticobasal degeneration, amyotrophic lateral sclerosis, and schizophrenia are all examples of neurological disorders. Cortical thinning is typically locally localized, and the progression of atrophy can thus disclose much about a disease's history and causal variables. The present study correspondingly found that GM was reduced after the age of 50 years onward. Furthermore, longitudinal investigations of cortical atrophy have the potential to be extremely useful in measuring the efficacy of a wide range of treatments.
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Affiliation(s)
| | | | - Ahsanul Haq
- Statistics, Gonoshasthaya-RNA Molecular Diagnostic and Research Center, Dhanmondi, BGD
| | - Sharmin A Sumi
- Anatomy, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, BGD
| | | | - Susmita Sinha
- Physiology, Khulna City Medical College and Hospital, Khulna, BGD
| | - Santosh Kumar
- Periodontology and Implantology, Karnavati School of Dentistry, Karnavati University, Gandhinagar, IND
| | - Mainul Haque
- Karnavati Scientific Research Center (KSRC), School of Dentistry, Karnavati University, Gandhinagar, IND
- Pharmacology and Therapeutics, National Defence University of Malaysia, Kuala Lumpur, MYS
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Deep Learning-Based Auto-Segmentation of Spinal Cord Internal Structure of Diffusion Tensor Imaging in Cervical Spondylotic Myelopathy. Diagnostics (Basel) 2023; 13:diagnostics13050817. [PMID: 36899962 PMCID: PMC10000612 DOI: 10.3390/diagnostics13050817] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Revised: 02/14/2023] [Accepted: 02/19/2023] [Indexed: 02/24/2023] Open
Abstract
Cervical spondylotic myelopathy (CSM) is a chronic disorder of the spinal cord. ROI-based features on diffusion tensor imaging (DTI) provide additional information about spinal cord status, which would benefit the diagnosis and prognosis of CSM. However, the manual extraction of the DTI-related features on multiple ROIs is time-consuming and laborious. In total, 1159 slices at cervical levels from 89 CSM patients were analyzed, and corresponding fractional anisotropy (FA) maps were calculated. Eight ROIs were drawn, covering both sides of lateral, dorsal, ventral, and gray matter. The UNet model was trained with the proposed heatmap distance loss for auto-segmentation. Mean Dice coefficients on the test dataset for dorsal, lateral, and ventral column and gray matter were 0.69, 0.67, 0.57, 0.54 on the left side and 0.68, 0.67, 0.59, 0.55 on the right side. The ROI-based mean FA value based on segmentation model strongly correlated with the value based on manual drawing. The percentages of the mean absolute error between the two values of multiple ROIs were 0.07, 0.07, 0.11, and 0.08 on the left side and 0.07, 0.1, 0.1, 0.11, and 0.07 on the right side. The proposed segmentation model has the potential to offer a more detailed spinal cord segmentation and would be beneficial for quantifying a more detailed status of the cervical spinal cord.
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Tsagkas C, Horvath-Huck A, Haas T, Amann M, Todea A, Altermatt A, Müller J, Cagol A, Leimbacher M, Barakovic M, Weigel M, Pezold S, Sprenger T, Kappos L, Bieri O, Granziera C, Cattin P, Parmar K. Fully Automatic Method for Reliable Spinal Cord Compartment Segmentation in Multiple Sclerosis. AJNR Am J Neuroradiol 2023; 44:218-227. [PMID: 36702504 PMCID: PMC9891337 DOI: 10.3174/ajnr.a7756] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Accepted: 12/05/2022] [Indexed: 01/27/2023]
Abstract
BACKGROUND AND PURPOSE Fully automatic quantification methods of spinal cord compartments are needed to study pathologic changes of the spinal cord GM and WM in MS in vivo. We propose a novel method for automatic spinal cord compartment segmentation (SCORE) in patients with MS. MATERIALS AND METHODS The cervical spinal cords of 24 patients with MS and 24 sex- and age-matched healthy controls were scanned on a 3T MR imaging system, including an averaged magnetization inversion recovery acquisition sequence. Three experienced raters manually segmented the spinal cord GM and WM, anterior and posterior horns, gray commissure, and MS lesions. Subsequently, manual segmentations were used to train neural segmentation networks of spinal cord compartments with multidimensional gated recurrent units in a 3-fold cross-validation fashion. Total intracranial volumes were quantified using FreeSurfer. RESULTS The intra- and intersession reproducibility of SCORE was high in all spinal cord compartments (eg, mean relative SD of GM and WM: ≤ 3.50% and ≤1.47%, respectively) and was better than manual segmentations (all P < .001). The accuracy of SCORE compared with manual segmentations was excellent, both in healthy controls and in patients with MS (Dice similarity coefficients of GM and WM: ≥ 0.84 and ≥0.92, respectively). Patients with MS had lower total WM areas (P < .05), and total anterior horn areas (P < .01 respectively), as measured with SCORE. CONCLUSIONS We demonstrate a novel, reliable quantification method for spinal cord tissue segmentation in healthy controls and patients with MS and other neurologic disorders affecting the spinal cord. Patients with MS have reduced areas in specific spinal cord tissue compartments, which may be used as MS biomarkers.
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Affiliation(s)
- C Tsagkas
- From the Neurologic Clinic and Policlinic, Departments of Medicine (C.T., M.A., J.M., M.W., T.S., L.K., C.G., K.P.), Clinical Research and Biomedical Engineering
- Translational Imaging in Neurology Basel (C.T., A.T., J.M., A.C., M.B., M.W., C.G., K.P.)
| | - A Horvath-Huck
- Department of Biomedical Engineering (A.H.-H., M.A., A.C., M.B., M.W., S.P., O.B., C.G., P.C.), University of Basel, Allschwil, Switzerland
| | - T Haas
- Department of Medicine and Biomedical Engineering; Division of Radiological Physics (T.H., M.W., O.B.)
| | - M Amann
- From the Neurologic Clinic and Policlinic, Departments of Medicine (C.T., M.A., J.M., M.W., T.S., L.K., C.G., K.P.), Clinical Research and Biomedical Engineering
- Department of Biomedical Engineering (A.H.-H., M.A., A.C., M.B., M.W., S.P., O.B., C.G., P.C.), University of Basel, Allschwil, Switzerland
- Medical Image Analysis Center AG (M.A., A.A.), Basel, Switzerland
| | - A Todea
- Translational Imaging in Neurology Basel (C.T., A.T., J.M., A.C., M.B., M.W., C.G., K.P.)
- Department of Radiology; Department of Neuroradiology (A.T.), Clinic for Radiology & Nuclear Medicine; and Research Center for Clinical Neuroimmunology
| | - A Altermatt
- Medical Image Analysis Center AG (M.A., A.A.), Basel, Switzerland
| | - J Müller
- From the Neurologic Clinic and Policlinic, Departments of Medicine (C.T., M.A., J.M., M.W., T.S., L.K., C.G., K.P.), Clinical Research and Biomedical Engineering
- Translational Imaging in Neurology Basel (C.T., A.T., J.M., A.C., M.B., M.W., C.G., K.P.)
| | - A Cagol
- Translational Imaging in Neurology Basel (C.T., A.T., J.M., A.C., M.B., M.W., C.G., K.P.)
- Department of Biomedical Engineering (A.H.-H., M.A., A.C., M.B., M.W., S.P., O.B., C.G., P.C.), University of Basel, Allschwil, Switzerland
| | - M Leimbacher
- Medical Faculty (M.L., P.C.), University of Basel, Basel, Switzerland
| | - M Barakovic
- Translational Imaging in Neurology Basel (C.T., A.T., J.M., A.C., M.B., M.W., C.G., K.P.)
- Department of Biomedical Engineering (A.H.-H., M.A., A.C., M.B., M.W., S.P., O.B., C.G., P.C.), University of Basel, Allschwil, Switzerland
| | - M Weigel
- From the Neurologic Clinic and Policlinic, Departments of Medicine (C.T., M.A., J.M., M.W., T.S., L.K., C.G., K.P.), Clinical Research and Biomedical Engineering
- Translational Imaging in Neurology Basel (C.T., A.T., J.M., A.C., M.B., M.W., C.G., K.P.)
- Department of Medicine and Biomedical Engineering; Division of Radiological Physics (T.H., M.W., O.B.)
- Department of Biomedical Engineering (A.H.-H., M.A., A.C., M.B., M.W., S.P., O.B., C.G., P.C.), University of Basel, Allschwil, Switzerland
| | - S Pezold
- Department of Biomedical Engineering (A.H.-H., M.A., A.C., M.B., M.W., S.P., O.B., C.G., P.C.), University of Basel, Allschwil, Switzerland
| | - T Sprenger
- From the Neurologic Clinic and Policlinic, Departments of Medicine (C.T., M.A., J.M., M.W., T.S., L.K., C.G., K.P.), Clinical Research and Biomedical Engineering
- Department of Neurology (T.S.), DKD Helios Klinik Wiesbaden, Wiesbaden, Germany
| | - L Kappos
- From the Neurologic Clinic and Policlinic, Departments of Medicine (C.T., M.A., J.M., M.W., T.S., L.K., C.G., K.P.), Clinical Research and Biomedical Engineering
- Neuroscience Basel (RC2NB) (L.K.), Departments of Medicine, Clinical Research, and Biomedical Imaging, University Hospital Basel and University of Basel, Basel, Switzerland
| | - O Bieri
- Department of Medicine and Biomedical Engineering; Division of Radiological Physics (T.H., M.W., O.B.)
- Department of Biomedical Engineering (A.H.-H., M.A., A.C., M.B., M.W., S.P., O.B., C.G., P.C.), University of Basel, Allschwil, Switzerland
| | - C Granziera
- From the Neurologic Clinic and Policlinic, Departments of Medicine (C.T., M.A., J.M., M.W., T.S., L.K., C.G., K.P.), Clinical Research and Biomedical Engineering
- Translational Imaging in Neurology Basel (C.T., A.T., J.M., A.C., M.B., M.W., C.G., K.P.)
- Department of Biomedical Engineering (A.H.-H., M.A., A.C., M.B., M.W., S.P., O.B., C.G., P.C.), University of Basel, Allschwil, Switzerland
| | - P Cattin
- Department of Biomedical Engineering (A.H.-H., M.A., A.C., M.B., M.W., S.P., O.B., C.G., P.C.), University of Basel, Allschwil, Switzerland
- Medical Faculty (M.L., P.C.), University of Basel, Basel, Switzerland
| | - K Parmar
- From the Neurologic Clinic and Policlinic, Departments of Medicine (C.T., M.A., J.M., M.W., T.S., L.K., C.G., K.P.), Clinical Research and Biomedical Engineering
- Translational Imaging in Neurology Basel (C.T., A.T., J.M., A.C., M.B., M.W., C.G., K.P.)
- Reha Rheinfelden (K.P.), Rheinfelden, Switzerland
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MobileUNetV3—A Combined UNet and MobileNetV3 Architecture for Spinal Cord Gray Matter Segmentation. ELECTRONICS 2022. [DOI: 10.3390/electronics11152388] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
The inspection of gray matter (GM) tissue of the human spinal cord is a valuable tool for the diagnosis of a wide range of neurological disorders. Thus, the detection and segmentation of GM regions in magnetic resonance images (MRIs) is an important task when studying the spinal cord and its related medical conditions. This work proposes a new method for the segmentation of GM tissue in spinal cord MRIs based on deep convolutional neural network (CNNs) techniques. Our proposed method, called MobileUNetV3, has a UNet-like architecture, with the MobileNetV3 model being used as a pre-trained encoder. MobileNetV3 is light-weight and yields high accuracy compared with many other CNN architectures of similar size. It is composed of a series of blocks, which produce feature maps optimized using residual connections and squeeze-and-excitation modules. We carefully added a set of upsampling layers and skip connections to MobileNetV3 in order to build an effective UNet-like model for image segmentation. To illustrate the capabilities of the proposed method, we tested it on the spinal cord gray matter segmentation challenge dataset and compared it to a number of recent state-of-the-art methods. We obtained results that outperformed seven methods with respect to five evaluation metrics comprising the dice similarity coefficient (0.87), Jaccard index (0.78), sensitivity (87.20%), specificity (99.90%), and precision (87.96%). Based on these highly competitive results, MobileUNetV3 is an effective deep-learning model for the segmentation of GM MRIs in the spinal cord.
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Bischof A, Papinutto N, Keshavan A, Rajesh A, Kirkish G, Zhang X, Mallott JM, Asteggiano C, Sacco S, Gundel TJ, Zhao C, Stern WA, Caverzasi E, Zhou Y, Gomez R, Ragan NR, Santaniello A, Zhu AH, Juwono J, Bevan CJ, Bove RM, Crabtree E, Gelfand JM, Goodin DS, Graves JS, Green AJ, Oksenberg JR, Waubant E, Wilson MR, Zamvil SS, Cree BA, Hauser SL, Henry RG. Spinal cord atrophy predicts progressive disease in relapsing multiple sclerosis. Ann Neurol 2021; 91:268-281. [PMID: 34878197 PMCID: PMC8916838 DOI: 10.1002/ana.26281] [Citation(s) in RCA: 44] [Impact Index Per Article: 14.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Revised: 12/04/2021] [Accepted: 12/06/2021] [Indexed: 11/06/2022]
Abstract
Objective A major challenge in multiple sclerosis (MS) research is the understanding of silent progression and Progressive MS. Using a novel method to accurately capture upper cervical cord area from legacy brain MRI scans we aimed to study the role of spinal cord and brain atrophy for silent progression and conversion to secondary progressive disease (SPMS). Methods From a single‐center observational study, all RRMS (n = 360) and SPMS (n = 47) patients and 80 matched controls were evaluated. RRMS patient subsets who converted to SPMS (n = 54) or silently progressed (n = 159), respectively, during the 12‐year observation period were compared to clinically matched RRMS patients remaining RRMS (n = 54) or stable (n = 147), respectively. From brain MRI, we assessed the value of brain and spinal cord measures to predict silent progression and SPMS conversion. Results Patients who developed SPMS showed faster cord atrophy rates (−2.19%/yr) at least 4 years before conversion compared to their RRMS matches (−0.88%/yr, p < 0.001). Spinal cord atrophy rates decelerated after conversion (−1.63%/yr, p = 0.010) towards those of SPMS patients from study entry (−1.04%). Each 1% faster spinal cord atrophy rate was associated with 69% (p < 0.0001) and 53% (p < 0.0001) shorter time to silent progression and SPMS conversion, respectively. Interpretation Silent progression and conversion to secondary progressive disease are predominantly related to cervical cord atrophy. This atrophy is often present from the earliest disease stages and predicts the speed of silent progression and conversion to Progressive MS. Diagnosis of SPMS is rather a late recognition of this neurodegenerative process than a distinct disease phase. ANN NEUROL 2022;91:268–281
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Affiliation(s)
- Antje Bischof
- Weill Institute for Neurosciences, Department of Neurology, University of California, San Francisco, 675, Nelson Rising Lane, 94158, San Francisco, California, USA
| | - Nico Papinutto
- Weill Institute for Neurosciences, Department of Neurology, University of California, San Francisco, 675, Nelson Rising Lane, 94158, San Francisco, California, USA
| | - Anisha Keshavan
- Weill Institute for Neurosciences, Department of Neurology, University of California, San Francisco, 675, Nelson Rising Lane, 94158, San Francisco, California, USA
| | - Anand Rajesh
- Weill Institute for Neurosciences, Department of Neurology, University of California, San Francisco, 675, Nelson Rising Lane, 94158, San Francisco, California, USA
| | - Gina Kirkish
- Weill Institute for Neurosciences, Department of Neurology, University of California, San Francisco, 675, Nelson Rising Lane, 94158, San Francisco, California, USA
| | - Xinheng Zhang
- Weill Institute for Neurosciences, Department of Neurology, University of California, San Francisco, 675, Nelson Rising Lane, 94158, San Francisco, California, USA
| | - Jacob M Mallott
- Weill Institute for Neurosciences, Department of Neurology, University of California, San Francisco, 675, Nelson Rising Lane, 94158, San Francisco, California, USA
| | - Carlo Asteggiano
- Weill Institute for Neurosciences, Department of Neurology, University of California, San Francisco, 675, Nelson Rising Lane, 94158, San Francisco, California, USA
| | - Simone Sacco
- Weill Institute for Neurosciences, Department of Neurology, University of California, San Francisco, 675, Nelson Rising Lane, 94158, San Francisco, California, USA
| | - Tristan J Gundel
- Weill Institute for Neurosciences, Department of Neurology, University of California, San Francisco, 675, Nelson Rising Lane, 94158, San Francisco, California, USA
| | - Chao Zhao
- Weill Institute for Neurosciences, Department of Neurology, University of California, San Francisco, 675, Nelson Rising Lane, 94158, San Francisco, California, USA
| | - William A Stern
- Weill Institute for Neurosciences, Department of Neurology, University of California, San Francisco, 675, Nelson Rising Lane, 94158, San Francisco, California, USA
| | - Eduardo Caverzasi
- Weill Institute for Neurosciences, Department of Neurology, University of California, San Francisco, 675, Nelson Rising Lane, 94158, San Francisco, California, USA
| | - Yifan Zhou
- Weill Institute for Neurosciences, Department of Neurology, University of California, San Francisco, 675, Nelson Rising Lane, 94158, San Francisco, California, USA
| | - Refujia Gomez
- Weill Institute for Neurosciences, Department of Neurology, University of California, San Francisco, 675, Nelson Rising Lane, 94158, San Francisco, California, USA
| | - Nicholas R Ragan
- Weill Institute for Neurosciences, Department of Neurology, University of California, San Francisco, 675, Nelson Rising Lane, 94158, San Francisco, California, USA
| | - Adam Santaniello
- Weill Institute for Neurosciences, Department of Neurology, University of California, San Francisco, 675, Nelson Rising Lane, 94158, San Francisco, California, USA
| | - Alyssa H Zhu
- Weill Institute for Neurosciences, Department of Neurology, University of California, San Francisco, 675, Nelson Rising Lane, 94158, San Francisco, California, USA
| | - Jeremy Juwono
- Weill Institute for Neurosciences, Department of Neurology, University of California, San Francisco, 675, Nelson Rising Lane, 94158, San Francisco, California, USA
| | - Carolyn J Bevan
- Weill Institute for Neurosciences, Department of Neurology, University of California, San Francisco, 675, Nelson Rising Lane, 94158, San Francisco, California, USA
| | - Riley M Bove
- Weill Institute for Neurosciences, Department of Neurology, University of California, San Francisco, 675, Nelson Rising Lane, 94158, San Francisco, California, USA
| | - Elizabeth Crabtree
- Weill Institute for Neurosciences, Department of Neurology, University of California, San Francisco, 675, Nelson Rising Lane, 94158, San Francisco, California, USA
| | - Jeffrey M Gelfand
- Weill Institute for Neurosciences, Department of Neurology, University of California, San Francisco, 675, Nelson Rising Lane, 94158, San Francisco, California, USA
| | - Douglas S Goodin
- Weill Institute for Neurosciences, Department of Neurology, University of California, San Francisco, 675, Nelson Rising Lane, 94158, San Francisco, California, USA
| | - Jennifer S Graves
- Weill Institute for Neurosciences, Department of Neurology, University of California, San Francisco, 675, Nelson Rising Lane, 94158, San Francisco, California, USA
| | - Ari J Green
- Weill Institute for Neurosciences, Department of Neurology, University of California, San Francisco, 675, Nelson Rising Lane, 94158, San Francisco, California, USA
| | - Jorge R Oksenberg
- Weill Institute for Neurosciences, Department of Neurology, University of California, San Francisco, 675, Nelson Rising Lane, 94158, San Francisco, California, USA
| | - Emmanuelle Waubant
- Weill Institute for Neurosciences, Department of Neurology, University of California, San Francisco, 675, Nelson Rising Lane, 94158, San Francisco, California, USA
| | - Michael R Wilson
- Weill Institute for Neurosciences, Department of Neurology, University of California, San Francisco, 675, Nelson Rising Lane, 94158, San Francisco, California, USA
| | - Scott S Zamvil
- Weill Institute for Neurosciences, Department of Neurology, University of California, San Francisco, 675, Nelson Rising Lane, 94158, San Francisco, California, USA
| | -
- Weill Institute for Neurosciences, Department of Neurology, University of California, San Francisco, 675, Nelson Rising Lane, 94158, San Francisco, California, USA
| | - Bruce A Cree
- Weill Institute for Neurosciences, Department of Neurology, University of California, San Francisco, 675, Nelson Rising Lane, 94158, San Francisco, California, USA
| | - Stephen L Hauser
- Weill Institute for Neurosciences, Department of Neurology, University of California, San Francisco, 675, Nelson Rising Lane, 94158, San Francisco, California, USA
| | - Roland G Henry
- Weill Institute for Neurosciences, Department of Neurology, University of California, San Francisco, 675, Nelson Rising Lane, 94158, San Francisco, California, USA
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Fiederling F, Hammond LA, Ng D, Mason C, Dodd J. Tools for efficient analysis of neurons in a 3D reference atlas of whole mouse spinal cord. CELL REPORTS METHODS 2021; 1:100074. [PMID: 34661190 PMCID: PMC8516137 DOI: 10.1016/j.crmeth.2021.100074] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Revised: 07/23/2021] [Accepted: 08/16/2021] [Indexed: 12/20/2022]
Abstract
To fill the prevailing gap in methodology for whole spinal cord (SC) analysis, we have (1) designed scaffolds (SpineRacks) that facilitate efficient and ordered cryo-sectioning of the entire SC in a single block, (2) constructed a 3D reference atlas of adult mouse SC, and (3) developed software (SpinalJ) to register images of sections and for standardized analysis of cells and projections in atlas space. We have verified mapping accuracies for known neurons and demonstrated the usefulness of this platform to reveal unknown neuronal distributions. Together, these tools provide high-throughput analyses of whole mouse SC and enable direct comparison of 3D spatial information between animals and studies.
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Affiliation(s)
- Felix Fiederling
- Departments of Physiology & Cellular Biophysics, and Neuroscience, Zuckerman Institute, Columbia University, New York, NY 10027, USA
| | - Luke A. Hammond
- Zuckerman Institute, Columbia University, New York, NY 10027, USA
| | - David Ng
- Zuckerman Institute, Columbia University, New York, NY 10027, USA
| | - Carol Mason
- Department of Pathology and Cell Biology, Neuroscience, and Ophthalmology, Zuckerman Institute, Columbia University, New York, NY 10027, USA
| | - Jane Dodd
- Departments of Physiology & Cellular Biophysics, and Neuroscience, Zuckerman Institute, Columbia University, New York, NY 10027, USA
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Lukas C, Bellenberg B, Prados F, Valsasina P, Parmar K, Brouwer I, Pareto D, Rovira À, Sastre-Garriga J, Gandini Wheeler-Kingshott CAM, Kappos L, Rocca MA, Filippi M, Yiannakas M, Barkhof F, Vrenken H. Quantification of Cervical Cord Cross-Sectional Area: Which Acquisition, Vertebra Level, and Analysis Software? A Multicenter Repeatability Study on a Traveling Healthy Volunteer. Front Neurol 2021; 12:693333. [PMID: 34421797 PMCID: PMC8371197 DOI: 10.3389/fneur.2021.693333] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2021] [Accepted: 06/14/2021] [Indexed: 11/15/2022] Open
Abstract
Background: Considerable spinal cord (SC) atrophy occurs in multiple sclerosis (MS). While MRI-based techniques for SC cross-sectional area (CSA) quantification have improved over time, there is no common agreement on whether to measure at single vertebral levels or across larger regions and whether upper SC CSA can be reliably measured from brain images. Aim: To compare in a multicenter setting three CSA measurement methods in terms of repeatability at different anatomical levels. To analyze the agreement between measurements performed on the cervical cord and on brain MRI. Method: One healthy volunteer was scanned three times on the same day in six sites (three scanner vendors) using a 3T MRI protocol including sagittal 3D T1-weighted imaging of the brain (covering the upper cervical cord) and of the SC. Images were analyzed using two semiautomated methods [NeuroQLab (NQL) and the Active Surface Model (ASM)] and the fully automated Spinal Cord Toolbox (SCT) on different vertebral levels (C1-C2; C2/3) on SC and brain images and the entire cervical cord (C1-C7) on SC images only. Results: CSA estimates were significantly smaller using SCT compared to NQL and ASM (p < 0.001), regardless of the cord level. Inter-scanner repeatability was best in C1-C7: coefficients of variation for NQL, ASM, and SCT: 0.4, 0.6, and 1.0%, respectively. CSAs estimated in brain MRI were slightly lower than in SC MRI (all p ≤ 0.006 at the C1-C2 level). Despite protocol harmonization between the centers with regard to image resolution and use of high-contrast 3D T1-weighted sequences, the variability of CSA was partly scanner dependent probably due to differences in scanner geometry, coil design, and details of the MRI parameter settings. Conclusion: For CSA quantification, dedicated isotropic SC MRI should be acquired, which yielded best repeatability in the entire cervical cord. In the upper part of the cervical cord, use of brain MRI scans entailed only a minor loss of CSA repeatability compared to SC MRI. Due to systematic differences between scanners and the CSA quantification software, both should be kept constant within a study. The MRI dataset of this study is available publicly to test new analysis approaches.
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Affiliation(s)
- Carsten Lukas
- Institute of Neuroradiology, St. Josef Hospital, Ruhr-University Bochum, Bochum, Germany
| | - Barbara Bellenberg
- Institute of Neuroradiology, St. Josef Hospital, Ruhr-University Bochum, Bochum, Germany
| | - Ferran Prados
- Department of Medical Physics and Biomedical Engineering, Centre for Medical Image Computing (CMIC), University College London, London, United Kingdom
- Queen Square Multiple Sclerosis Centre, UCL Queen Square Institute of Neurology, University College London, London, United Kingdom
- e-Health Centre, Universitat Oberta de Catalunya, Barcelona, Spain
| | - Paola Valsasina
- Neuroimaging Research Unit, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Katrin Parmar
- Neurological Clinic and Policlinic, Department of Medicine, University Hospital Basel, Basel, Switzerland
| | - Iman Brouwer
- Department of Radiology and Nuclear Medicine, Multiple Sclerosis Center Amsterdam, Amsterdam Neuroscience Amsterdam University Medical Centers (UMC), Vrije Universiteit Medical Center (VUmc), Amsterdam, Netherlands
| | - Deborah Pareto
- Section of Neuroradiology, Department of Radiology, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - Àlex Rovira
- Section of Neuroradiology, Department of Radiology, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - Jaume Sastre-Garriga
- Department of Neurology–Neuroimmunology, Multiple Sclerosis Center of Catalonia (Cemcat), Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - Claudia A. M. Gandini Wheeler-Kingshott
- Queen Square Multiple Sclerosis Centre, UCL Queen Square Institute of Neurology, University College London, London, United Kingdom
- Department of Brain & Behavioral Sciences, University of Pavia, Pavia, Italy
- Brain Connectivity Center, IRCCS Mondino Foundation, Pavia, Italy
| | - Ludwig Kappos
- Neurological Clinic and Policlinic, Department of Medicine, University Hospital Basel, Basel, Switzerland
- Department of Biomedical Engineering, University of Basel, Allschwig, Switzerland
| | - Maria A. Rocca
- Neuroimaging Research Unit, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy
- Neurology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
- Vita-Salute San Raffaele University, Milan, Italy
| | - Massimo Filippi
- Neuroimaging Research Unit, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy
- Neurology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
- Vita-Salute San Raffaele University, Milan, Italy
- Neurorehabilitation Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
- Neurophysiology Service, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Marios Yiannakas
- Queen Square Multiple Sclerosis Centre, UCL Queen Square Institute of Neurology, University College London, London, United Kingdom
| | - Frederik Barkhof
- Department of Medical Physics and Biomedical Engineering, Centre for Medical Image Computing (CMIC), University College London, London, United Kingdom
- Queen Square Multiple Sclerosis Centre, UCL Queen Square Institute of Neurology, University College London, London, United Kingdom
- Department of Radiology and Nuclear Medicine, Multiple Sclerosis Center Amsterdam, Amsterdam Neuroscience Amsterdam University Medical Centers (UMC), Vrije Universiteit Medical Center (VUmc), Amsterdam, Netherlands
| | - Hugo Vrenken
- Department of Radiology and Nuclear Medicine, Multiple Sclerosis Center Amsterdam, Amsterdam Neuroscience Amsterdam University Medical Centers (UMC), Vrije Universiteit Medical Center (VUmc), Amsterdam, Netherlands
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9
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Shahrampour S, De Leener B, Alizadeh M, Middleton D, Krisa L, Flanders AE, Faro SH, Cohen-Adad J, Mohamed FB. Atlas-Based Quantification of DTI Measures in a Typically Developing Pediatric Spinal Cord. AJNR Am J Neuroradiol 2021; 42:1727-1734. [PMID: 34326104 DOI: 10.3174/ajnr.a7221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Accepted: 04/19/2021] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE Multi-parametric MRI, provides a variety of biomarkers sensitive to white matter integrity, However, spinal cord MRI data in pediatrics is rare compared to adults. The purpose of this work was 3-fold: 1) to develop a processing pipeline for atlas-based generation of the typically developing pediatric spinal cord WM tracts, 2) to derive atlas-based normative values of the DTI indices for various WM pathways, and 3) to investigate age-related changes in the obtained normative DTI indices along the extracted tracts. MATERIALS AND METHODS DTI scans of 30 typically developing subjects (age range, 6-16 years) were acquired on a 3T MR imaging scanner. The data were registered to the PAM50 template in the Spinal Cord Toolbox. Next, the DTI indices for various WM regions were extracted at a single section centered at the C3 vertebral body in all the 30 subjects. Finally, an ANOVA test was performed to examine the effects of the following: 1) laterality, 2) functionality, and 3) age, with DTI-derived indices in 34 extracted WM regions. RESULTS A postprocessing pipeline was developed and validated to delineate pediatric spinal cord WM tracts. The results of ANOVA on fractional anisotropy values showed no effect for laterality (P = .72) but an effect for functionality (P < .001) when comparing the 30 primary WM labels. There was a significant (P < .05) effect of age and maturity of the left spinothalamic tract on mean diffusivity, radial diffusivity, and axial diffusivity values. CONCLUSIONS The proposed automated pipeline in this study incorporates unique postprocessing steps followed by template registration and quantification of DTI metrics using atlas-based regions. This method eliminates the need for manual ROI analysis of WM tracts and, therefore, increases the accuracy and speed of the measurements.
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Affiliation(s)
- S Shahrampour
- From the Departments of Radiology (S.S., M.A., D.M., F.B.M.)
| | - B De Leener
- Department of Computer Engineering and Software Engineering (B.D.L.)
| | - M Alizadeh
- From the Departments of Radiology (S.S., M.A., D.M., F.B.M.)
| | - D Middleton
- From the Departments of Radiology (S.S., M.A., D.M., F.B.M.)
| | | | - A E Flanders
- Radiology (A.E.F., S.H.F.), Thomas Jefferson University, Philadelphia, Pennsylvania
| | - S H Faro
- Radiology (A.E.F., S.H.F.), Thomas Jefferson University, Philadelphia, Pennsylvania
| | - J Cohen-Adad
- NeuroPoly Lab (J.C.-A.), Institute of Biomedical Engineering, Polytechnique Montreal, Montreal, Quebec, Canada.,Functional Neuroimaging Unit (J.C.-A.), Centre de Recherche de l'Institut Universitaire de Gériatrie de Montréal, Université de Montréal, Montreal, Quebec, Canada
| | - F B Mohamed
- From the Departments of Radiology (S.S., M.A., D.M., F.B.M.)
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10
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Savini G, Asteggiano C, Paoletti M, Parravicini S, Pezzotti E, Solazzo F, Muzic SI, Santini F, Deligianni X, Gardani A, Germani G, Farina LM, Bergsland N, Gandini Wheeler-Kingshott CAM, Berardinelli A, Bastianello S, Pichiecchio A. Pilot Study on Quantitative Cervical Cord and Muscular MRI in Spinal Muscular Atrophy: Promising Biomarkers of Disease Evolution and Treatment? Front Neurol 2021; 12:613834. [PMID: 33854470 PMCID: PMC8039452 DOI: 10.3389/fneur.2021.613834] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2020] [Accepted: 02/15/2021] [Indexed: 12/11/2022] Open
Abstract
Introduction: Nusinersen is a recent promising therapy approved for the treatment of spinal muscular atrophy (SMA), a rare disease characterized by the degeneration of alpha motor neurons (αMN) in the spinal cord (SC) leading to progressive muscle atrophy and dysfunction. Muscle and cervical SC quantitative magnetic resonance imaging (qMRI) has never been used to monitor drug treatment in SMA. The aim of this pilot study is to investigate whether qMRI can provide useful biomarkers for monitoring treatment efficacy in SMA. Methods: Three adult SMA 3a patients under treatment with nusinersen underwent longitudinal clinical and qMRI examinations every 4 months from baseline to 21-month follow-up. The qMRI protocol aimed to quantify thigh muscle fat fraction (FF) and water-T2 (w-T2) and to characterize SC volumes and microstructure. Eleven healthy controls underwent the same SC protocol (single time point). We evaluated clinical and imaging outcomes of SMA patients longitudinally and compared SC data between groups transversally. Results: Patient motor function was stable, with only Patient 2 showing moderate improvements. Average muscle FF was already high at baseline (50%) and progressed over time (57%). w-T2 was also slightly higher than previously published data at baseline and slightly decreased over time. Cross-sectional area of the whole SC, gray matter (GM), and ventral horns (VHs) of Patients 1 and 3 were reduced compared to controls and remained stable over time, while GM and VHs areas of Patient 2 slightly increased. We found altered diffusion and magnetization transfer parameters in SC structures of SMA patients compared to controls, thus suggesting changes in tissue microstructure and myelin content. Conclusion: In this pilot study, we found a progression of FF in thigh muscles of SMA 3a patients during nusinersen therapy and a concurrent slight reduction of w-T2 over time. The SC qMRI analysis confirmed previous imaging and histopathological studies suggesting degeneration of αMN of the VHs, resulting in GM atrophy and demyelination. Our longitudinal data suggest that qMRI could represent a feasible technique for capturing microstructural changes induced by SMA in vivo and a candidate methodology for monitoring the effects of treatment, once replicated on a larger cohort.
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Affiliation(s)
- Giovanni Savini
- Advanced Imaging and Radiomics Center, Neuroradiology Department, IRCCS Mondino Foundation, Pavia, Italy
| | - Carlo Asteggiano
- Advanced Imaging and Radiomics Center, Neuroradiology Department, IRCCS Mondino Foundation, Pavia, Italy
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - Matteo Paoletti
- Advanced Imaging and Radiomics Center, Neuroradiology Department, IRCCS Mondino Foundation, Pavia, Italy
| | - Stefano Parravicini
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - Elena Pezzotti
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - Francesca Solazzo
- Advanced Imaging and Radiomics Center, Neuroradiology Department, IRCCS Mondino Foundation, Pavia, Italy
| | - Shaun I. Muzic
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - Francesco Santini
- Department of Radiology, Division of Radiological Physics, University Hospital Basel, Basel, Switzerland
- Department of Biomedical Engineering, University of Basel, Allschwil, Switzerland
| | - Xeni Deligianni
- Department of Radiology, Division of Radiological Physics, University Hospital Basel, Basel, Switzerland
- Department of Biomedical Engineering, University of Basel, Allschwil, Switzerland
| | - Alice Gardani
- Child Neuropsychiatry Unit, IRCCS Mondino Foundation, Pavia, Italy
| | - Giancarlo Germani
- Advanced Imaging and Radiomics Center, Neuroradiology Department, IRCCS Mondino Foundation, Pavia, Italy
| | - Lisa M. Farina
- Advanced Imaging and Radiomics Center, Neuroradiology Department, IRCCS Mondino Foundation, Pavia, Italy
| | - Niels Bergsland
- Buffalo Neuroimaging Analysis Center, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, The State University of New York, Buffalo, NY, United States
- IRCCS, Fondazione Don Carlo Gnocchi ONLUS, Milan, Italy
| | - Claudia A. M. Gandini Wheeler-Kingshott
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
- NMR Research Unit, Queen Square MS Centre, Department of Neuroinflammation, UCL Queen Square Institute of Neurology, University College London, Russell Square, London, United Kingdom
- Brain Connectivity Research Unit, IRCCS Mondino Foundation, Pavia, Italy
| | | | - Stefano Bastianello
- Advanced Imaging and Radiomics Center, Neuroradiology Department, IRCCS Mondino Foundation, Pavia, Italy
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - Anna Pichiecchio
- Advanced Imaging and Radiomics Center, Neuroradiology Department, IRCCS Mondino Foundation, Pavia, Italy
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
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11
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Kesenheimer EM, Wendebourg MJ, Weigel M, Weidensteiner C, Haas T, Richter L, Sander L, Horvath A, Barakovic M, Cattin P, Granziera C, Bieri O, Schlaeger R. Normalization of Spinal Cord Total Cross-Sectional and Gray Matter Areas as Quantified With Radially Sampled Averaged Magnetization Inversion Recovery Acquisitions. Front Neurol 2021; 12:637198. [PMID: 33841307 PMCID: PMC8027254 DOI: 10.3389/fneur.2021.637198] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Accepted: 02/05/2021] [Indexed: 11/19/2022] Open
Abstract
Background: MR imaging of the spinal cord (SC) gray matter (GM) at the cervical and lumbar enlargements' level may be particularly informative in lower motor neuron disorders, e. g., spinal muscular atrophy, but also in other neurodegenerative or autoimmune diseases affecting the SC. Radially sampled averaged magnetization inversion recovery acquisition (rAMIRA) is a novel approach to perform SC imaging in clinical settings with favorable contrast and is well-suited for SC GM quantitation. However, before applying rAMIRA in clinical studies, it is important to understand (i) the sources of inter-subject variability of total SC cross-sectional areas (TCA) and GM area (GMA) measurements in healthy subjects and (ii) their relation to age and sex to facilitate the detection of pathology-associated changes. In this study, we aimed to develop normalization strategies for rAMIRA-derived SC metrics using skull and spine-based metrics to reduce anatomical variability. Methods: Sixty-one healthy subjects (age range 11–93 years, 37.7% women) were investigated with axial two-dimensional rAMIRA imaging at 3T MRI. Cervical and thoracic levels including the level of the cervical (C4/C5) and lumbar enlargements (Tmax) were examined. SC T2-weighted sagittal images and high-resolution 3D whole-brain T1-weighted images were acquired. TCA and GMAs were quantified. Anatomical variables with associations of |r| > 0.30 in univariate association with SC areas, and age and sex were used to construct normalization models using backward selection with TCAC4/C5 as outcome. The effect of the normalization was assessed by % relative standard deviation (RSD) reductions. Results: Mean inter-individual variability and the SD of the SC area metrics were considerable: TCAC4/5: 8.1%/9.0; TCATmax: 8.9%/6.5; GMAC4/C5: 8.6%/2.2; GMATmax: 12.2%/3.8. Normalization based on sex, brain WM volume, and spinal canal area resulted in RSD reductions of 23.7% for TCAs and 12.0% for GM areas at C4/C5. Normalizations based on the area of spinal canal alone resulted in RSD reductions of 10.2% for TCAs and 9.6% for GM areas at C4/C5, respectively. Discussion: Anatomic inter-individual variability of SC areas is substantial. This study identified effective normalization models for inter-subject variability reduction in TCA and SC GMA in healthy subjects based on rAMIRA imaging.
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Affiliation(s)
- Eva M Kesenheimer
- Neurologic Clinic and Policlinic, University Hospital Basel, Basel, Switzerland.,Department of Clinical Research, University of Basel, Basel, Switzerland.,Translational Imaging in Neurology (ThINK) Basel, Department of Medicine and Biomedical Engineering, Research Center for Clinical Neuroimmunology and Neuroscience Basel (RC2NB), University Hospital Basel and University of Basel, Basel, Switzerland
| | - Maria Janina Wendebourg
- Neurologic Clinic and Policlinic, University Hospital Basel, Basel, Switzerland.,Department of Clinical Research, University of Basel, Basel, Switzerland.,Translational Imaging in Neurology (ThINK) Basel, Department of Medicine and Biomedical Engineering, Research Center for Clinical Neuroimmunology and Neuroscience Basel (RC2NB), University Hospital Basel and University of Basel, Basel, Switzerland
| | - Matthias Weigel
- Neurologic Clinic and Policlinic, University Hospital Basel, Basel, Switzerland.,Translational Imaging in Neurology (ThINK) Basel, Department of Medicine and Biomedical Engineering, Research Center for Clinical Neuroimmunology and Neuroscience Basel (RC2NB), University Hospital Basel and University of Basel, Basel, Switzerland.,Division of Radiological Physics, Department of Radiology, University Hospital Basel, Basel, Switzerland
| | - Claudia Weidensteiner
- Division of Radiological Physics, Department of Radiology, University Hospital Basel, Basel, Switzerland.,Department of Biomedical Engineering, University of Basel, Allschwil, Switzerland
| | - Tanja Haas
- Division of Radiological Physics, Department of Radiology, University Hospital Basel, Basel, Switzerland
| | - Laura Richter
- Neurologic Clinic and Policlinic, University Hospital Basel, Basel, Switzerland.,Department of Clinical Research, University of Basel, Basel, Switzerland.,Translational Imaging in Neurology (ThINK) Basel, Department of Medicine and Biomedical Engineering, Research Center for Clinical Neuroimmunology and Neuroscience Basel (RC2NB), University Hospital Basel and University of Basel, Basel, Switzerland
| | - Laura Sander
- Neurologic Clinic and Policlinic, University Hospital Basel, Basel, Switzerland.,Department of Clinical Research, University of Basel, Basel, Switzerland.,Translational Imaging in Neurology (ThINK) Basel, Department of Medicine and Biomedical Engineering, Research Center for Clinical Neuroimmunology and Neuroscience Basel (RC2NB), University Hospital Basel and University of Basel, Basel, Switzerland
| | - Antal Horvath
- Department of Biomedical Engineering, University of Basel, Allschwil, Switzerland
| | - Muhamed Barakovic
- Translational Imaging in Neurology (ThINK) Basel, Department of Medicine and Biomedical Engineering, Research Center for Clinical Neuroimmunology and Neuroscience Basel (RC2NB), University Hospital Basel and University of Basel, Basel, Switzerland.,Department of Biomedical Engineering, University of Basel, Allschwil, Switzerland
| | - Philippe Cattin
- Department of Biomedical Engineering, University of Basel, Allschwil, Switzerland
| | - Cristina Granziera
- Neurologic Clinic and Policlinic, University Hospital Basel, Basel, Switzerland.,Translational Imaging in Neurology (ThINK) Basel, Department of Medicine and Biomedical Engineering, Research Center for Clinical Neuroimmunology and Neuroscience Basel (RC2NB), University Hospital Basel and University of Basel, Basel, Switzerland.,Department of Biomedical Engineering, University of Basel, Allschwil, Switzerland
| | - Oliver Bieri
- Division of Radiological Physics, Department of Radiology, University Hospital Basel, Basel, Switzerland.,Department of Biomedical Engineering, University of Basel, Allschwil, Switzerland
| | - Regina Schlaeger
- Neurologic Clinic and Policlinic, University Hospital Basel, Basel, Switzerland.,Department of Clinical Research, University of Basel, Basel, Switzerland.,Translational Imaging in Neurology (ThINK) Basel, Department of Medicine and Biomedical Engineering, Research Center for Clinical Neuroimmunology and Neuroscience Basel (RC2NB), University Hospital Basel and University of Basel, Basel, Switzerland
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12
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Zhang X, Li Y, Liu Y, Tang SX, Liu X, Punithakumar K, Shi D. Automatic spinal cord segmentation from axial-view MRI slices using CNN with grayscale regularized active contour propagation. Comput Biol Med 2021; 132:104345. [PMID: 33780869 DOI: 10.1016/j.compbiomed.2021.104345] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2020] [Revised: 03/09/2021] [Accepted: 03/12/2021] [Indexed: 11/29/2022]
Abstract
Accurate positioning of the responsible segment for patients with cervical spondylotic myelopathy (CSM) is clinically important not only to the surgery but also to reduce the incidence of surgical trauma and complications. Spinal cord segmentation is a crucial step in the positioning procedure. This study proposed a fully automated approach for spinal cord segmentation from 2D axial-view MRI slices of patients with CSM. The proposed method was trained and tested using clinical data from 20 CSM patients (359 images) acquired by the Peking University Third Hospital, with ground truth labeled by professional radiologists. The accuracy of the proposed method was evaluated using quantitative measures, the reliability metric as well as visual assessment. The proposed method yielded a Dice coefficient of 87.0%, Hausdorff distance of 9.7 mm, root-mean-square error of 5.9 mm. Higher conformance with ground truth was observed for the proposed method in comparison to the state-of-the-art algorithms. The results are also statistically significant with p-values calculated between state-of-the-art methods and the proposed methods.
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Affiliation(s)
- Xiaoran Zhang
- School of Automation, Beijing Institute of Technology, Beijing, 100081, China; Department of Electrical and Computer Engineering, University of California, Los Angeles, Los Angeles, CA, 90095-1594, USA.
| | - Yan Li
- Department of Orthopaedics, Peking University Third Hospital and the Engineering Research Center of Bone and Joint Precision Medicine, Ministry of Education, Beijing, China.
| | - Yicun Liu
- School of Automation, Beijing Institute of Technology, Beijing, 100081, China.
| | - Shu-Xia Tang
- Department of Mechanical Engineering, Texas Tech University, Lubbock, TX, 79409, USA.
| | - Xiaoguang Liu
- Department of Orthopaedics, Peking University Third Hospital and the Engineering Research Center of Bone and Joint Precision Medicine, Ministry of Education, Beijing, China.
| | - Kumaradevan Punithakumar
- Department of Radiology and Diagnostic Imaging, University of Alberta, Edmonton, Alberta, 8440, Canada.
| | - Dawei Shi
- School of Automation, Beijing Institute of Technology, Beijing, 100081, China.
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13
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Rasoanandrianina H, Demortière S, Trabelsi A, Ranjeva JP, Girard O, Duhamel G, Guye M, Pelletier J, Audoin B, Callot V. Sensitivity of the Inhomogeneous Magnetization Transfer Imaging Technique to Spinal Cord Damage in Multiple Sclerosis. AJNR Am J Neuroradiol 2020; 41:929-937. [PMID: 32414903 DOI: 10.3174/ajnr.a6554] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2019] [Accepted: 03/12/2020] [Indexed: 12/11/2022]
Abstract
BACKGROUND AND PURPOSE The inhomogeneous magnetization transfer technique has demonstrated high specificity for myelin, and has shown sensitivity to multiple sclerosis-related impairment in brain tissue. Our aim was to investigate its sensitivity to spinal cord impairment in MS relative to more established MR imaging techniques (volumetry, magnetization transfer, DTI). MATERIALS AND METHODS Anatomic images covering the cervical spinal cord from the C1 to C6 levels and DTI, magnetization transfer/inhomogeneous magnetization transfer images at the C2/C5 levels were acquired in 19 patients with MS and 19 paired healthy controls. Anatomic images were segmented in spinal cord GM and WM, both manually and using the AMU40 atlases. MS lesions were manually delineated. MR metrics were analyzed within normal-appearing and lesion regions in anterolateral and posterolateral WM and compared using Wilcoxon rank tests and z scores. Correlations between MR metrics and clinical scores in patients with MS were evaluated using the Spearman rank correlation. RESULTS AMU40-based C1-to-C6 GM/WM automatic segmentations in patients with MS were evaluated relative to manual delineation. Mean Dice coefficients were 0.75/0.89, respectively. All MR metrics (WM/GM cross-sectional areas, normal-appearing and lesion diffusivities, and magnetization transfer/inhomogeneous magnetization transfer ratios) were observed altered in patients compared with controls (P < .05). Additionally, the absolute inhomogeneous magnetization transfer ratio z scores were significantly higher than those of the other MR metrics (P < .0001), suggesting a higher inhomogeneous magnetization transfer sensitivity toward spinal cord impairment in MS. Significant correlations with the Expanded Disability Status Scale (ρ = -0.73/P = .02, ρ = -0.81/P = .004) and the total Medical Research Council scale (ρ = 0.80/P = .009, ρ = -0.74/P = .02) were observed for inhomogeneous magnetization transfer and magnetization transfer ratio z scores, respectively, in normal-appearing WM regions, while weaker and nonsignificant correlations were obtained for DTI metrics. CONCLUSIONS With inhomogeneous magnetization transfer being highly sensitive to spinal cord damage in MS compared with conventional magnetization transfer and DTI, it could generate great clinical interest for longitudinal follow-up and potential remyelinating clinical trials. In line with other advanced myelin techniques with which it could be compared, it opens perspectives for multicentric investigations.
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Affiliation(s)
- H Rasoanandrianina
- From the Center for Magnetic Resonance in Biology and Medicine (H.R., S.D., A.T., J.P.R., O.G., G.D., M.G., J.P., B.A., V.C.), Centre National de la Recherche Scientifique, Aix-Marseille Université, Marseille, France.,Centre d'Exploration Métabolique par Résonance Magnétique (H.R., S.D., A.T., J.P.R., O.G., G.D., M.G., J.P., B.A., V.C.), Assistance Publique-Hopitaux de Marseille, Hôpital Universitaire Timone, Marseille, France.,Laboratoire de Biomécanique Appliquée, Institut Français des Sciences et Technologies des Transports, de l'Aménagement et des Reseaux, Aix-Marseille Université; iLab-Spine International Associated Laboratory (H.R., J.P.R., V.C.), Marseille-Montreal, France-Canada
| | - S Demortière
- From the Center for Magnetic Resonance in Biology and Medicine (H.R., S.D., A.T., J.P.R., O.G., G.D., M.G., J.P., B.A., V.C.), Centre National de la Recherche Scientifique, Aix-Marseille Université, Marseille, France.,Centre d'Exploration Métabolique par Résonance Magnétique (H.R., S.D., A.T., J.P.R., O.G., G.D., M.G., J.P., B.A., V.C.), Assistance Publique-Hopitaux de Marseille, Hôpital Universitaire Timone, Marseille, France.,Department of Neurology (S.D., J.P., B.A.), Centre Hospitalier Universitaire Timone, Assistance Publique-Hopitaux de Marseille, Marseille, France
| | - A Trabelsi
- From the Center for Magnetic Resonance in Biology and Medicine (H.R., S.D., A.T., J.P.R., O.G., G.D., M.G., J.P., B.A., V.C.), Centre National de la Recherche Scientifique, Aix-Marseille Université, Marseille, France.,Centre d'Exploration Métabolique par Résonance Magnétique (H.R., S.D., A.T., J.P.R., O.G., G.D., M.G., J.P., B.A., V.C.), Assistance Publique-Hopitaux de Marseille, Hôpital Universitaire Timone, Marseille, France
| | - J P Ranjeva
- From the Center for Magnetic Resonance in Biology and Medicine (H.R., S.D., A.T., J.P.R., O.G., G.D., M.G., J.P., B.A., V.C.), Centre National de la Recherche Scientifique, Aix-Marseille Université, Marseille, France.,Centre d'Exploration Métabolique par Résonance Magnétique (H.R., S.D., A.T., J.P.R., O.G., G.D., M.G., J.P., B.A., V.C.), Assistance Publique-Hopitaux de Marseille, Hôpital Universitaire Timone, Marseille, France.,Laboratoire de Biomécanique Appliquée, Institut Français des Sciences et Technologies des Transports, de l'Aménagement et des Reseaux, Aix-Marseille Université; iLab-Spine International Associated Laboratory (H.R., J.P.R., V.C.), Marseille-Montreal, France-Canada
| | - O Girard
- From the Center for Magnetic Resonance in Biology and Medicine (H.R., S.D., A.T., J.P.R., O.G., G.D., M.G., J.P., B.A., V.C.), Centre National de la Recherche Scientifique, Aix-Marseille Université, Marseille, France.,Centre d'Exploration Métabolique par Résonance Magnétique (H.R., S.D., A.T., J.P.R., O.G., G.D., M.G., J.P., B.A., V.C.), Assistance Publique-Hopitaux de Marseille, Hôpital Universitaire Timone, Marseille, France
| | - G Duhamel
- From the Center for Magnetic Resonance in Biology and Medicine (H.R., S.D., A.T., J.P.R., O.G., G.D., M.G., J.P., B.A., V.C.), Centre National de la Recherche Scientifique, Aix-Marseille Université, Marseille, France.,Centre d'Exploration Métabolique par Résonance Magnétique (H.R., S.D., A.T., J.P.R., O.G., G.D., M.G., J.P., B.A., V.C.), Assistance Publique-Hopitaux de Marseille, Hôpital Universitaire Timone, Marseille, France
| | - M Guye
- From the Center for Magnetic Resonance in Biology and Medicine (H.R., S.D., A.T., J.P.R., O.G., G.D., M.G., J.P., B.A., V.C.), Centre National de la Recherche Scientifique, Aix-Marseille Université, Marseille, France.,Centre d'Exploration Métabolique par Résonance Magnétique (H.R., S.D., A.T., J.P.R., O.G., G.D., M.G., J.P., B.A., V.C.), Assistance Publique-Hopitaux de Marseille, Hôpital Universitaire Timone, Marseille, France
| | - J Pelletier
- From the Center for Magnetic Resonance in Biology and Medicine (H.R., S.D., A.T., J.P.R., O.G., G.D., M.G., J.P., B.A., V.C.), Centre National de la Recherche Scientifique, Aix-Marseille Université, Marseille, France.,Centre d'Exploration Métabolique par Résonance Magnétique (H.R., S.D., A.T., J.P.R., O.G., G.D., M.G., J.P., B.A., V.C.), Assistance Publique-Hopitaux de Marseille, Hôpital Universitaire Timone, Marseille, France.,Department of Neurology (S.D., J.P., B.A.), Centre Hospitalier Universitaire Timone, Assistance Publique-Hopitaux de Marseille, Marseille, France
| | - B Audoin
- From the Center for Magnetic Resonance in Biology and Medicine (H.R., S.D., A.T., J.P.R., O.G., G.D., M.G., J.P., B.A., V.C.), Centre National de la Recherche Scientifique, Aix-Marseille Université, Marseille, France.,Centre d'Exploration Métabolique par Résonance Magnétique (H.R., S.D., A.T., J.P.R., O.G., G.D., M.G., J.P., B.A., V.C.), Assistance Publique-Hopitaux de Marseille, Hôpital Universitaire Timone, Marseille, France.,Department of Neurology (S.D., J.P., B.A.), Centre Hospitalier Universitaire Timone, Assistance Publique-Hopitaux de Marseille, Marseille, France
| | - V Callot
- From the Center for Magnetic Resonance in Biology and Medicine (H.R., S.D., A.T., J.P.R., O.G., G.D., M.G., J.P., B.A., V.C.), Centre National de la Recherche Scientifique, Aix-Marseille Université, Marseille, France .,Centre d'Exploration Métabolique par Résonance Magnétique (H.R., S.D., A.T., J.P.R., O.G., G.D., M.G., J.P., B.A., V.C.), Assistance Publique-Hopitaux de Marseille, Hôpital Universitaire Timone, Marseille, France.,Laboratoire de Biomécanique Appliquée, Institut Français des Sciences et Technologies des Transports, de l'Aménagement et des Reseaux, Aix-Marseille Université; iLab-Spine International Associated Laboratory (H.R., J.P.R., V.C.), Marseille-Montreal, France-Canada
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14
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Solanky BS, Prados F, Tur C, Yiannakas MC, Kanber B, Cawley N, Brownlee W, Ourselin S, Golay X, Ciccarelli O, Gandini Wheeler-Kingshott CAM. Sodium in the Relapsing-Remitting Multiple Sclerosis Spinal Cord: Increased Concentrations and Associations With Microstructural Tissue Anisotropy. J Magn Reson Imaging 2020; 52:1429-1438. [PMID: 32476227 DOI: 10.1002/jmri.27201] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2020] [Revised: 05/05/2020] [Accepted: 05/06/2020] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Associations between brain total sodium concentration, disability, and disease progression have recently been reported in multiple sclerosis. However, such measures in spinal cord have not been reported. PURPOSE To measure total sodium concentration (TSC) alterations in the cervical spinal cord of people with relapsing-remitting multiple sclerosis (RRMS) and a control cohort using sodium MR spectroscopy (MRS). STUDY TYPE Retrospective cohort. SUBJECTS Nineteen people with RRMS and 21 healthy controls. FIELD STRENGTH/SEQUENCE 3 T sodium MRS, diffusion tensor imaging, and 3D gradient echo. ASSESSMENT Quantification of total sodium concentration in the cervical cord using a reference phantom. Measures of spinal cord cross-sectional area, fractional anisotropy, mean diffusivity, radial diffusivity, and axial diffusivity from 1 H MRI. Clinical assessments of 9-Hole Peg Test, 25-Foot Timed walk test, Paced Auditory Serial Addition Test with 3-second intervals, grip strength, vibration sensitivity, and posturography were performed on the RRMS cohort as well as reporting lesions in the C2/3 area. STATISTICAL TESTS Multiple linear regression models were run between sodium and clinical scores, cross-sectional area, and diffusion metrics to establish any correlations. RESULTS A significant increase in spinal cord total sodium concentration was found in people with RRMS relative to healthy controls (57.6 ± 18 mmol and 38.0 ± 8.6 mmol, respectively, P < 0.001). Increased TSC correlated with reduced fractional anisotropy (P = 0.034) and clinically with decreased mediolateral stability assessed with posturography (P = 0.045). DATA CONCLUSION Total sodium concentration in the cervical spinal cord is elevated in RRMS. This alteration is associated with reduced fractional anisotropy, which may be due to changes in tissue microstructure and, hence, in the integrity of spinal cord tissue. LEVEL OF EVIDENCE 1 TECHNICAL EFFICACY STAGE: 2.
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Affiliation(s)
- Bhavana S Solanky
- NMR Research Unit, Queen Square MS Centre, UCL Queen Square Institute of Neurology, Faculty of Brain Sciences, University College London, London, UK
| | - Ferran Prados
- NMR Research Unit, Queen Square MS Centre, UCL Queen Square Institute of Neurology, Faculty of Brain Sciences, University College London, London, UK.,Translational Imaging Group, Centre for Medical Image Computing, Department of Medical Physics and Biomedical Engineering, University College London, London, UK
| | - Carmen Tur
- NMR Research Unit, Queen Square MS Centre, UCL Queen Square Institute of Neurology, Faculty of Brain Sciences, University College London, London, UK
| | - Marios C Yiannakas
- NMR Research Unit, Queen Square MS Centre, UCL Queen Square Institute of Neurology, Faculty of Brain Sciences, University College London, London, UK
| | - Baris Kanber
- NMR Research Unit, Queen Square MS Centre, UCL Queen Square Institute of Neurology, Faculty of Brain Sciences, University College London, London, UK.,Translational Imaging Group, Centre for Medical Image Computing, Department of Medical Physics and Biomedical Engineering, University College London, London, UK
| | - Niamh Cawley
- NMR Research Unit, Queen Square MS Centre, UCL Queen Square Institute of Neurology, Faculty of Brain Sciences, University College London, London, UK
| | - Wallace Brownlee
- NMR Research Unit, Queen Square MS Centre, UCL Queen Square Institute of Neurology, Faculty of Brain Sciences, University College London, London, UK
| | - Sebastien Ourselin
- Translational Imaging Group, Centre for Medical Image Computing, Department of Medical Physics and Biomedical Engineering, University College London, London, UK
| | - Xavier Golay
- Brain Repair and Rehabilitation, Queen Square Institute of Neurology, University College London, London, UK
| | - Olga Ciccarelli
- NMR Research Unit, Queen Square MS Centre, UCL Queen Square Institute of Neurology, Faculty of Brain Sciences, University College London, London, UK
| | - Claudia A M Gandini Wheeler-Kingshott
- NMR Research Unit, Queen Square MS Centre, UCL Queen Square Institute of Neurology, Faculty of Brain Sciences, University College London, London, UK.,Department of Brain and Behavioural Sciences, University of Pavia, Pavia, Italy.,Brain MRI 3T Research Centre, IRCCS Mondino Foundation, Pavia, Italy
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15
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Lorenzi RM, Palesi F, Castellazzi G, Vitali P, Anzalone N, Bernini S, Cotta Ramusino M, Sinforiani E, Micieli G, Costa A, D’Angelo E, Gandini Wheeler-Kingshott CAM. Unsuspected Involvement of Spinal Cord in Alzheimer Disease. Front Cell Neurosci 2020; 14:6. [PMID: 32082122 PMCID: PMC7002560 DOI: 10.3389/fncel.2020.00006] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2019] [Accepted: 01/10/2020] [Indexed: 11/13/2022] Open
Abstract
Objective: Brain atrophy is an established biomarker for dementia, yet spinal cord involvement has not been investigated to date. As the spinal cord is relaying sensorimotor control signals from the cortex to the peripheral nervous system and vice-versa, it is indeed a very interesting question to assess whether it is affected by atrophy due to a disease that is known for its involvement of cognitive domains first and foremost, with motor symptoms being clinically assessed too. We, therefore, hypothesize that in Alzheimer's disease (AD), severe atrophy can affect the spinal cord too and that spinal cord atrophy is indeed an important in vivo imaging biomarker contributing to understanding neurodegeneration associated with dementia. Methods: 3DT1 images of 31 AD and 35 healthy control (HC) subjects were processed to calculate volume of brain structures and cross-sectional area (CSA) and volume (CSV) of the cervical cord [per vertebra as well as the C2-C3 pair (CSA23 and CSV23)]. Correlated features (ρ > 0.7) were removed, and the best subset identified for patients' classification with the Random Forest algorithm. General linear model regression was used to find significant differences between groups (p ≤ 0.05). Linear regression was implemented to assess the explained variance of the Mini-Mental State Examination (MMSE) score as a dependent variable with the best features as predictors. Results: Spinal cord features were significantly reduced in AD, independently of brain volumes. Patients classification reached 76% accuracy when including CSA23 together with volumes of hippocampi, left amygdala, white and gray matter, with 74% sensitivity and 78% specificity. CSA23 alone explained 13% of MMSE variance. Discussion: Our findings reveal that C2-C3 spinal cord atrophy contributes to discriminate AD from HC, together with more established features. The results show that CSA23, calculated from the same 3DT1 scan as all other brain volumes (including right and left hippocampi), has a considerable weight in classification tasks warranting further investigations. Together with recent studies revealing that AD atrophy is spread beyond the temporal lobes, our result adds the spinal cord to a number of unsuspected regions involved in the disease. Interestingly, spinal cord atrophy explains also cognitive scores, which could significantly impact how we model sensorimotor control in degenerative diseases with a primary cognitive domain involvement. Prospective studies should be purposely designed to understand the mechanisms of atrophy and the role of the spinal cord in AD.
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Affiliation(s)
| | - Fulvia Palesi
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
- Neuroradiology Unit, Brain MRI 3T Research Center, IRCCS Mondino Foundation, Pavia, Italy
| | - Gloria Castellazzi
- Department of Electrical, Computer and Biomedical Engineering, University of Pavia, Pavia, Italy
- Queen Square MS Centre, Department of Neuroinflammation, UCL Queen Square Institute of Neurology, Faculty of Brain Sciences, University College London, London, United Kingdom
| | - Paolo Vitali
- Neuroradiology Unit, Brain MRI 3T Research Center, IRCCS Mondino Foundation, Pavia, Italy
| | | | - Sara Bernini
- Laboratory of Neuropsychology, IRCCS Mondino Foundation, Pavia, Italy
| | - Matteo Cotta Ramusino
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
- Unit of Behavioral Neurology, IRCCS Mondino Foundation, Pavia, Italy
| | - Elena Sinforiani
- Laboratory of Neuropsychology, IRCCS Mondino Foundation, Pavia, Italy
| | - Giuseppe Micieli
- Department of Emergency Neurology, IRCCS Mondino Foundation, Pavia, Italy
| | - Alfredo Costa
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
- Unit of Behavioral Neurology, IRCCS Mondino Foundation, Pavia, Italy
| | - Egidio D’Angelo
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
- Brain Connectivity Center (BCC), IRCCS Mondino Foundation, Pavia, Italy
| | - Claudia A. M. Gandini Wheeler-Kingshott
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
- Queen Square MS Centre, Department of Neuroinflammation, UCL Queen Square Institute of Neurology, Faculty of Brain Sciences, University College London, London, United Kingdom
- Brain MRI 3T Research Center, IRCCS Mondino Foundation, Pavia, Italy
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16
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Generalised boundary shift integral for longitudinal assessment of spinal cord atrophy. Neuroimage 2019; 209:116489. [PMID: 31877375 DOI: 10.1016/j.neuroimage.2019.116489] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2019] [Revised: 12/18/2019] [Accepted: 12/21/2019] [Indexed: 12/18/2022] Open
Abstract
Spinal cord atrophy measurements obtained from structural magnetic resonance imaging (MRI) are associated with disability in many neurological diseases and serve as in vivo biomarkers of neurodegeneration. Longitudinal spinal cord atrophy rate is commonly determined from the numerical difference between two volumes (based on 3D surface fitting) or two cross-sectional areas (CSA, based on 2D edge detection) obtained at different time-points. Being an indirect measure, atrophy rates are susceptible to variable segmentation errors at the edge of the spinal cord. To overcome those limitations, we developed a new registration-based pipeline that measures atrophy rates directly. We based our approach on the generalised boundary shift integral (GBSI) method, which registers 2 scans and uses a probabilistic XOR mask over the edge of the spinal cord, thereby measuring atrophy more accurately than segmentation-based techniques. Using a large cohort of longitudinal spinal cord images (610 subjects with multiple sclerosis from a multi-centre trial and 52 healthy controls), we demonstrated that GBSI is a sensitive, quantitative and objective measure of longitudinal spinal cord volume change. The GBSI pipeline is repeatable, reproducible, and provides more precise measurements of longitudinal spinal cord atrophy than segmentation-based methods in longitudinal spinal cord atrophy studies.
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17
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Lenchik L, Heacock L, Weaver AA, Boutin RD, Cook TS, Itri J, Filippi CG, Gullapalli RP, Lee J, Zagurovskaya M, Retson T, Godwin K, Nicholson J, Narayana PA. Automated Segmentation of Tissues Using CT and MRI: A Systematic Review. Acad Radiol 2019; 26:1695-1706. [PMID: 31405724 PMCID: PMC6878163 DOI: 10.1016/j.acra.2019.07.006] [Citation(s) in RCA: 62] [Impact Index Per Article: 12.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2019] [Revised: 07/17/2019] [Accepted: 07/17/2019] [Indexed: 01/10/2023]
Abstract
RATIONALE AND OBJECTIVES The automated segmentation of organs and tissues throughout the body using computed tomography and magnetic resonance imaging has been rapidly increasing. Research into many medical conditions has benefited greatly from these approaches by allowing the development of more rapid and reproducible quantitative imaging markers. These markers have been used to help diagnose disease, determine prognosis, select patients for therapy, and follow responses to therapy. Because some of these tools are now transitioning from research environments to clinical practice, it is important for radiologists to become familiar with various methods used for automated segmentation. MATERIALS AND METHODS The Radiology Research Alliance of the Association of University Radiologists convened an Automated Segmentation Task Force to conduct a systematic review of the peer-reviewed literature on this topic. RESULTS The systematic review presented here includes 408 studies and discusses various approaches to automated segmentation using computed tomography and magnetic resonance imaging for neurologic, thoracic, abdominal, musculoskeletal, and breast imaging applications. CONCLUSION These insights should help prepare radiologists to better evaluate automated segmentation tools and apply them not only to research, but eventually to clinical practice.
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Affiliation(s)
- Leon Lenchik
- Department of Radiology, Wake Forest School of Medicine, Medical Center Boulevard, Winston-Salem, NC 27157.
| | - Laura Heacock
- Department of Radiology, NYU Langone, New York, New York
| | - Ashley A Weaver
- Department of Biomedical Engineering, Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - Robert D Boutin
- Department of Radiology, University of California Davis School of Medicine, Sacramento, California
| | - Tessa S Cook
- Department of Radiology, University of Pennsylvania, Philadelphia Pennsylvania
| | - Jason Itri
- Department of Radiology, Wake Forest School of Medicine, Medical Center Boulevard, Winston-Salem, NC 27157
| | - Christopher G Filippi
- Department of Radiology, Donald and Barbara School of Medicine at Hofstra/Northwell, Lenox Hill Hospital, NY, New York
| | - Rao P Gullapalli
- Department of Radiology, University of Maryland School of Medicine, Baltimore, Maryland
| | - James Lee
- Department of Radiology, University of Kentucky, Lexington, Kentucky
| | | | - Tara Retson
- Department of Radiology, University of California San Diego, San Diego, California
| | - Kendra Godwin
- Medical Library, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Joey Nicholson
- NYU Health Sciences Library, NYU School of Medicine, NYU Langone Health, New York, New York
| | - Ponnada A Narayana
- Department of Diagnostic and Interventional Imaging, McGovern Medical School, University of Texas Health Science Center at Houston, Houston, Texas
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18
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Cadotte DW, Akbar MA, Fehlings MG, Stroman PW, Cohen-Adad J. What Has Been Learned from Magnetic Resonance Imaging Examination of the Injured Human Spinal Cord: A Canadian Perspective. J Neurotrauma 2019; 35:1942-1957. [PMID: 30074873 DOI: 10.1089/neu.2018.5903] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Magnetic resonance imaging (MRI) has transformed the way surgeons and researchers study and treat spinal cord injury. In this narrative review, we explore the historical context of imaging the human spinal cord and describe how MRI has evolved from providing the first visualization of the human spinal cord in the 1980s to a remarkable set of imaging tools today. The article focuses in particular on the role of Canadian researchers to this field. We begin by outlining the clinical context of traumatic injury to the human spinal cord and describe why current MRI standards fall short when it comes to treating this disabling condition. Parts 2 and 3 of this work explore an exciting and dramatic shift in the use of MRI technology to aid in our understanding and treatment of traumatic injury to the spinal cord. We explore the use of functional imaging (part 2) and structural imaging (part 3) and explore how these techniques have evolved, how they are used, and the challenges that we face for continued refinement and application to patients who live with the neurological and functional deficits caused by injury to the delicate spinal cord.
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Affiliation(s)
- David W Cadotte
- 1 University of Calgary Spine Program, Division of Neurosurgery, Department of Clinical Neurosciences, University of Calgary , Foothills Medical Centre, Calgary, Alberta, Canada
| | - M Ali Akbar
- 2 Department of Surgery, Division of Neurosurgery and Spinal Program, Toronto Western Hospital, University of Toronto , Toronto, Ontario, Canada
| | - Michael G Fehlings
- 2 Department of Surgery, Division of Neurosurgery and Spinal Program, Toronto Western Hospital, University of Toronto , Toronto, Ontario, Canada
| | - Patrick W Stroman
- 3 Centre for Neuroscience Studies, Queens University , Kingston, Ontario, Canada
| | - Julien Cohen-Adad
- 4 NeuroPoly Lab, Institute of Biomedical Engineering , Polytechnique Montreal, Montreal, Quebéc, Canada .,5 Functional Neuroimaging Unit, CRIUGM, Université de Montréal , Montreal, Quebéc, Canada
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19
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Tsagkas C, Horvath A, Altermatt A, Pezold S, Weigel M, Haas T, Amann M, Kappos L, Sprenger T, Bieri O, Cattin P, Parmar K. Automatic Spinal Cord Gray Matter Quantification: A Novel Approach. AJNR Am J Neuroradiol 2019; 40:1592-1600. [PMID: 31439628 DOI: 10.3174/ajnr.a6157] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2018] [Accepted: 06/25/2019] [Indexed: 12/12/2022]
Abstract
BACKGROUND AND PURPOSE Currently, accurate and reproducible spinal cord GM segmentation remains challenging and a noninvasive broadly accepted reference standard for spinal cord GM measurements is still a matter of ongoing discussion. Our aim was to assess the reproducibility and accuracy of cervical spinal cord GM and WM cross-sectional area measurements using averaged magnetization inversion recovery acquisitions images and a fully-automatic postprocessing segmentation algorithm. MATERIALS AND METHODS The cervical spinal cord of 24 healthy subjects (14 women; mean age, 40 ± 11 years) was scanned in a test-retest fashion on a 3T MR imaging system. Twelve axial averaged magnetization inversion recovery acquisitions slices were acquired over a 48-mm cord segment. GM and WM were both manually segmented by 2 experienced readers and compared with an automatic variational segmentation algorithm with a shape prior modified for 3D data with a slice similarity prior. Precision and accuracy of the automatic method were evaluated using coefficients of variation and Dice similarity coefficients. RESULTS The mean GM area was 17.20 ± 2.28 mm2 and the mean WM area was 72.71 ± 7.55 mm2 using the automatic method. Reproducibility was high for both methods, while being better for the automatic approach (all mean automatic coefficients of variation, ≤4.77%; all differences, P < .001). The accuracy of the automatic method compared with the manual reference standard was excellent (mean Dice similarity coefficients: 0.86 ± 0.04 for GM and 0.90 ± 0.03 for WM). The automatic approach demonstrated similar coefficients of variation between intra- and intersession reproducibility as well as among all acquired spinal cord slices. CONCLUSIONS Our novel approach including the averaged magnetization inversion recovery acquisitions sequence and a fully-automated postprocessing segmentation algorithm demonstrated an accurate and reproducible spinal cord GM and WM segmentation. This pipeline is promising for both the exploration of longitudinal structural GM changes and application in clinical settings in disorders affecting the spinal cord.
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Affiliation(s)
- C Tsagkas
- From the Neurologic Clinic and Policlinic (C.T., M.A., L.K., T.S., K.P.), Department of Medicine and Biomedical Engineering.,Translational Imaging in Neurology Basel (C.T., A.A., M.A., M.W., L.K., K.P.), Department of Medicine and Biomedical Engineering.,Medical Image Analysis Center (C.T., A.A., M.A.), Basel, Switzerland
| | - A Horvath
- Department of Biomedical Engineering (A.H., A.A., S.P., M.W., O.B., P.C.), University of Basel, Allschwil, Switzerland
| | - A Altermatt
- Translational Imaging in Neurology Basel (C.T., A.A., M.A., M.W., L.K., K.P.), Department of Medicine and Biomedical Engineering.,Medical Image Analysis Center (C.T., A.A., M.A.), Basel, Switzerland.,Department of Biomedical Engineering (A.H., A.A., S.P., M.W., O.B., P.C.), University of Basel, Allschwil, Switzerland
| | - S Pezold
- Department of Biomedical Engineering (A.H., A.A., S.P., M.W., O.B., P.C.), University of Basel, Allschwil, Switzerland
| | - M Weigel
- Translational Imaging in Neurology Basel (C.T., A.A., M.A., M.W., L.K., K.P.), Department of Medicine and Biomedical Engineering.,Division of Radiological Physics (M.W., T.H., O.B.), Department of Radiology.,Department of Biomedical Engineering (A.H., A.A., S.P., M.W., O.B., P.C.), University of Basel, Allschwil, Switzerland
| | - T Haas
- Division of Radiological Physics (M.W., T.H., O.B.), Department of Radiology
| | - M Amann
- From the Neurologic Clinic and Policlinic (C.T., M.A., L.K., T.S., K.P.), Department of Medicine and Biomedical Engineering.,Translational Imaging in Neurology Basel (C.T., A.A., M.A., M.W., L.K., K.P.), Department of Medicine and Biomedical Engineering.,Division of Diagnostic and Interventional Neuroradiology (M.A.), Department of Radiology, University Hospital Basel, University of Basel, Basel, Switzerland.,Medical Image Analysis Center (C.T., A.A., M.A.), Basel, Switzerland
| | - L Kappos
- From the Neurologic Clinic and Policlinic (C.T., M.A., L.K., T.S., K.P.), Department of Medicine and Biomedical Engineering.,Translational Imaging in Neurology Basel (C.T., A.A., M.A., M.W., L.K., K.P.), Department of Medicine and Biomedical Engineering
| | - T Sprenger
- From the Neurologic Clinic and Policlinic (C.T., M.A., L.K., T.S., K.P.), Department of Medicine and Biomedical Engineering.,Department of Neurology (T.S.), DKD HELIOS Klinik, Wiesbaden, Germany
| | - O Bieri
- Division of Radiological Physics (M.W., T.H., O.B.), Department of Radiology.,Department of Biomedical Engineering (A.H., A.A., S.P., M.W., O.B., P.C.), University of Basel, Allschwil, Switzerland
| | - P Cattin
- Department of Biomedical Engineering (A.H., A.A., S.P., M.W., O.B., P.C.), University of Basel, Allschwil, Switzerland
| | - K Parmar
- From the Neurologic Clinic and Policlinic (C.T., M.A., L.K., T.S., K.P.), Department of Medicine and Biomedical Engineering .,Translational Imaging in Neurology Basel (C.T., A.A., M.A., M.W., L.K., K.P.), Department of Medicine and Biomedical Engineering
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20
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Conrad BN, Barry RL, Rogers BP, Maki S, Mishra A, Thukral S, Sriram S, Bhatia A, Pawate S, Gore JC, Smith SA. Multiple sclerosis lesions affect intrinsic functional connectivity of the spinal cord. Brain 2019; 141:1650-1664. [PMID: 29648581 DOI: 10.1093/brain/awy083] [Citation(s) in RCA: 40] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2017] [Accepted: 02/04/2018] [Indexed: 11/13/2022] Open
Abstract
Patients with multiple sclerosis present with focal lesions throughout the spinal cord. There is a clinical need for non-invasive measurements of spinal cord activity and functional organization in multiple sclerosis, given the cord's critical role in the disease. Recent reports of spontaneous blood oxygenation level-dependent fluctuations in the spinal cord using functional MRI suggest that, like the brain, cord activity at rest is organized into distinct, synchronized functional networks among grey matter regions, likely related to motor and sensory systems. Previous studies looking at stimulus-evoked activity in the spinal cord of patients with multiple sclerosis have demonstrated increased levels of activation as well as a more bilateral distribution of activity compared to controls. Functional connectivity studies of brain networks in multiple sclerosis have revealed widespread alterations, which may take on a dynamic trajectory over the course of the disease, with compensatory increases in connectivity followed by decreases associated with structural damage. We build upon this literature by examining functional connectivity in the spinal cord of patients with multiple sclerosis. Using ultra-high field 7 T imaging along with processing strategies for robust spinal cord functional MRI and lesion identification, the present study assessed functional connectivity within cervical cord grey matter of patients with relapsing-remitting multiple sclerosis (n = 22) compared to a large sample of healthy controls (n = 56). Patient anatomical images were rated for lesions by three independent raters, with consensus ratings revealing 19 of 22 patients presented with lesions somewhere in the imaged volume. Linear mixed models were used to assess effects of lesion location on functional connectivity. Analysis in control subjects demonstrated a robust pattern of connectivity among ventral grey matter regions as well as a distinct network among dorsal regions. A gender effect was also observed in controls whereby females demonstrated higher ventral network connectivity. Wilcoxon rank-sum tests detected no differences in average connectivity or power of low frequency fluctuations in patients compared to controls. The presence of lesions was, however, associated with local alterations in connectivity with differential effects depending on columnar location. The patient results suggest that spinal cord functional networks are generally intact in relapsing-remitting multiple sclerosis but that lesions are associated with focal abnormalities in intrinsic connectivity. These findings are discussed in light of the current literature on spinal cord functional MRI and the potential neurological underpinnings.
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Affiliation(s)
- Benjamin N Conrad
- Neuroscience Graduate Program, Vanderbilt Brain Institute, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Robert L Barry
- Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Charlestown, MA, USA.,Department of Radiology, Harvard Medical School, Boston, MA, USA
| | - Baxter P Rogers
- Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, TN, USA.,Vanderbilt University Institute of Imaging Science, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Satoshi Maki
- Vanderbilt University Institute of Imaging Science, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Arabinda Mishra
- Vanderbilt University Institute of Imaging Science, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Saakshi Thukral
- Vanderbilt University Institute of Imaging Science, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Subramaniam Sriram
- Department of Neurology, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Aashim Bhatia
- Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Siddharama Pawate
- Department of Neurology, Vanderbilt University Medical Center, Nashville, TN, USA
| | - John C Gore
- Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, TN, USA.,Vanderbilt University Institute of Imaging Science, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Seth A Smith
- Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, TN, USA.,Vanderbilt University Institute of Imaging Science, Vanderbilt University Medical Center, Nashville, TN, USA
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21
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Casserly C, Seyman EE, Alcaide-Leon P, Guenette M, Lyons C, Sankar S, Svendrovski A, Baral S, Oh J. Spinal Cord Atrophy in Multiple Sclerosis: A Systematic Review and Meta-Analysis. J Neuroimaging 2018; 28:556-586. [PMID: 30102003 DOI: 10.1111/jon.12553] [Citation(s) in RCA: 71] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2018] [Revised: 07/12/2018] [Accepted: 07/16/2018] [Indexed: 01/18/2023] Open
Abstract
BACKGROUND AND PURPOSE Spinal cord atrophy (SCA) is an important emerging outcome measure in multiple sclerosis (MS); however, there is limited consensus on the magnitude and rate of atrophy. The objective of this study was to synthesize the available data on measures of SCA in MS. METHODS Using published guidelines, relevant literature databases were searched between 1977 and 2017 for case-control or cohort studies reporting a quantitative measure of SCA in MS patients. Random-effects models pooled cross-sectional measures and longitudinal rates of SCA in MS and healthy controls (HCs). Student's t-test assessed differences between pooled measures in patient subgroups. Heterogeneity was assessed using DerSimonian and Laird's Q-test and the I 2 -index. RESULTS A total of 1,465 studies were retrieved including 94 that met inclusion and exclusion criteria. Pooled estimates of mean cervical spinal cord (SC) cross-sectional area (CSA) in all MS patients, relapsing-remitting MS (RRMS), all progressive MS, secondary progressive MS (SPMS), primary-progressive MS (PPMS), and HC were: 73.07 mm2 (95% CI [71.52-74.62]), 78.88 mm2 (95% CI [76.92-80.85]), 69.72 mm2 (95% CI [67.96-71.48]), 68.55 mm2 (95% CI [65.43-71.66]), 70.98 mm2 (95% CI [68.78-73.19]), and 80.87 mm2 (95% C I [78.70-83.04]), respectively. Pooled SC-CSA was greater in HC versus MS (P < .001) and RRMS versus progressive MS (P < .001). SCA showed moderate correlations with global disability in cross-sectional studies (r-value with disability score range [-.75 to -.22]). In longitudinal studies, the pooled annual rate of SCA was 1.78%/year (95%CI [1.28-2.27]). CONCLUSIONS The SC is atrophied in MS. The magnitude of SCA is greater in progressive versus relapsing forms and correlates with clinical disability. The pooled estimate of annual rate of SCA is greater than reported rates of brain atrophy in MS. These results demonstrate that SCA is highly relevant as an imaging outcome in MS clinical trials.
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Affiliation(s)
- Courtney Casserly
- Division of Neurology, Department of Medicine, St Michael's Hospital, University of Toronto, Toronto, Ontario, Canada.,Department of Neurology, London Health Sciences Centre, Western University, London, Ontario, Canada
| | - Estelle E Seyman
- Division of Neurology, Department of Medicine, St Michael's Hospital, University of Toronto, Toronto, Ontario, Canada
| | - Paula Alcaide-Leon
- Division of Neuroradiology, Department of Medical Imaging, St. Michael's Hospital, University of Toronto, Toronto, Ontario, Canada
| | - Melanie Guenette
- Division of Neurology, Department of Medicine, St Michael's Hospital, University of Toronto, Toronto, Ontario, Canada
| | - Carrie Lyons
- Division of Neurology, Department of Medicine, St Michael's Hospital, University of Toronto, Toronto, Ontario, Canada
| | - Stephanie Sankar
- Division of Neurology, Department of Medicine, St Michael's Hospital, University of Toronto, Toronto, Ontario, Canada
| | - Anton Svendrovski
- Division of Neurology, Department of Medicine, St Michael's Hospital, University of Toronto, Toronto, Ontario, Canada
| | - Stefan Baral
- Department of Epidemiology, Johns Hopkins School of Public Health, Baltimore, MD
| | - Jiwon Oh
- Division of Neurology, Department of Medicine, St Michael's Hospital, University of Toronto, Toronto, Ontario, Canada.,Department of Neurology, Johns Hopkins University, Baltimore, MD
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22
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Sinnecker T, Granziera C, Wuerfel J, Schlaeger R. Future Brain and Spinal Cord Volumetric Imaging in the Clinic for Monitoring Treatment Response in MS. Curr Treat Options Neurol 2018; 20:17. [PMID: 29679165 DOI: 10.1007/s11940-018-0504-7] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
PURPOSE OF REVIEW Volumetric analysis of brain imaging has emerged as a standard approach used in clinical research, e.g., in the field of multiple sclerosis (MS), but its application in individual disease course monitoring is still hampered by biological and technical limitations. This review summarizes novel developments in volumetric imaging on the road towards clinical application to eventually monitor treatment response in patients with MS. RECENT FINDINGS In addition to the assessment of whole-brain volume changes, recent work was focused on the volumetry of specific compartments and substructures of the central nervous system (CNS) in MS. This included volumetric imaging of the deep brain structures and of the spinal cord white and gray matter. Volume changes of the latter indeed independently correlate with clinical outcome measures especially in progressive MS. Ultrahigh field MRI and quantitative MRI added to this trend by providing a better visualization of small compartments on highly resolving MR images as well as microstructural information. New developments in volumetric imaging have the potential to improve sensitivity as well as specificity in detecting and hence monitoring disease-related CNS volume changes in MS.
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Affiliation(s)
- Tim Sinnecker
- Neurologic Clinic and Policlinic, Departments of Medicine, Clinical Research and Biomedical Engineering, University Hospital Basel and University of Basel, Petersgraben 4, 4031, Basel, Switzerland
- Translational Imaging in Neurology (ThINK) Basel, Department of Medicine and Biomedical Engineering, University Hospital Basel and University of Basel, Basel, Switzerland
- Medical Image Analysis Center Basel AG, Basel, Switzerland
- NeuroCure Clinical Research Center, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Cristina Granziera
- Neurologic Clinic and Policlinic, Departments of Medicine, Clinical Research and Biomedical Engineering, University Hospital Basel and University of Basel, Petersgraben 4, 4031, Basel, Switzerland
- Translational Imaging in Neurology (ThINK) Basel, Department of Medicine and Biomedical Engineering, University Hospital Basel and University of Basel, Basel, Switzerland
| | - Jens Wuerfel
- Medical Image Analysis Center Basel AG, Basel, Switzerland
- NeuroCure Clinical Research Center, Charité Universitätsmedizin Berlin, Berlin, Germany
- Berlin Ultrahigh Field Facility, Max Delbrück Center for Molecular Medicine, Berlin, Germany
| | - Regina Schlaeger
- Neurologic Clinic and Policlinic, Departments of Medicine, Clinical Research and Biomedical Engineering, University Hospital Basel and University of Basel, Petersgraben 4, 4031, Basel, Switzerland.
- Translational Imaging in Neurology (ThINK) Basel, Department of Medicine and Biomedical Engineering, University Hospital Basel and University of Basel, Basel, Switzerland.
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23
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Spinal cord gray matter segmentation using deep dilated convolutions. Sci Rep 2018; 8:5966. [PMID: 29654236 PMCID: PMC5899127 DOI: 10.1038/s41598-018-24304-3] [Citation(s) in RCA: 62] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2017] [Accepted: 03/28/2018] [Indexed: 12/12/2022] Open
Abstract
Gray matter (GM) tissue changes have been associated with a wide range of neurological disorders and were recently found relevant as a biomarker for disability in amyotrophic lateral sclerosis. The ability to automatically segment the GM is, therefore, an important task for modern studies of the spinal cord. In this work, we devise a modern, simple and end-to-end fully-automated human spinal cord gray matter segmentation method using Deep Learning, that works both on in vivo and ex vivo MRI acquisitions. We evaluate our method against six independently developed methods on a GM segmentation challenge. We report state-of-the-art results in 8 out of 10 evaluation metrics as well as major network parameter reduction when compared to the traditional medical imaging architectures such as U-Nets.
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24
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Cohen-Adad J. Microstructural imaging in the spinal cord and validation strategies. Neuroimage 2018; 182:169-183. [PMID: 29635029 DOI: 10.1016/j.neuroimage.2018.04.009] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2017] [Revised: 03/02/2018] [Accepted: 04/06/2018] [Indexed: 12/13/2022] Open
Abstract
In vivo histology using magnetic resonance imaging (MRI) is a newly emerging research field that aims to non-invasively characterize tissue microstructure. The implications of in vivo histology are many, from discovering novel biomarkers to studying human development, to providing tools for disease diagnosis and monitoring the effects of novel treatments on tissue. This review focuses on quantitative MRI (qMRI) techniques that are used to map spinal cord microstructure. Opening with a rationale for non-invasive imaging of the spinal cord, this article continues with a brief overview of the existing MRI techniques for axon and myelin imaging, followed by the specific challenges and potential solutions for acquiring and processing such data. The final part of this review focuses on histological validation, with suggested tissue preparation, acquisition and processing protocols for large-scale microscopy.
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Affiliation(s)
- J Cohen-Adad
- NeuroPoly Lab, Institute of Biomedical Engineering, Polytechnique Montreal, Montreal, QC, Canada; Functional Neuroimaging Unit, CRIUGM, Université de Montréal, Montreal, QC, Canada.
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25
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Moccia M, de Stefano N, Barkhof F. Imaging outcome measures for progressive multiple sclerosis trials. Mult Scler 2017; 23:1614-1626. [PMID: 29041865 PMCID: PMC5650056 DOI: 10.1177/1352458517729456] [Citation(s) in RCA: 49] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2017] [Accepted: 07/28/2017] [Indexed: 11/16/2022]
Abstract
Imaging markers that are reliable, reproducible and sensitive to neurodegenerative changes in progressive multiple sclerosis (MS) can enhance the development of new medications with a neuroprotective mode-of-action. Accordingly, in recent years, a considerable number of imaging biomarkers have been included in phase 2 and 3 clinical trials in primary and secondary progressive MS. Brain lesion count and volume are markers of inflammation and demyelination and are important outcomes even in progressive MS trials. Brain and, more recently, spinal cord atrophy are gaining relevance, considering their strong association with disability accrual; ongoing improvements in analysis methods will enhance their applicability in clinical trials, especially for cord atrophy. Advanced magnetic resonance imaging (MRI) techniques (e.g. magnetization transfer ratio (MTR), diffusion tensor imaging (DTI), spectroscopy) have been included in few trials so far and hold promise for the future, as they can reflect specific pathological changes targeted by neuroprotective treatments. Positron emission tomography (PET) and optical coherence tomography have yet to be included. Applications, limitations and future perspectives of these techniques in clinical trials in progressive MS are discussed, with emphasis on measurement sensitivity, reliability and sample size calculation.
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Affiliation(s)
- Marcello Moccia
- NMR Research Unit, Queen Square MS Centre, UCL Institute of Neurology, University College London, London, UK; Multiple Sclerosis Clinical Care and Research Centre, Department of Neuroscience, Reproductive Sciences and Odontostomatology, University of Naples Federico II, Naples, Italy
| | - Nicola de Stefano
- Department of Medicine, Surgery and Neuroscience, University of Siena, Siena, Italy
| | - Frederik Barkhof
- NMR Research Unit, Queen Square MS Centre, UCL Institute of Neurology, University College London, London, UK; Translational Imaging Group, UCL Institute of Healthcare Engineering, University College London, London, UK; Department of Radiology and Nuclear Medicine, VU University Medical Center, Amsterdam, The Netherlands
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26
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Battiston M, Schneider T, Prados F, Grussu F, Yiannakas MC, Ourselin S, Gandini Wheeler-Kingshott CAM, Samson RS. Fast and reproducible in vivo T 1 mapping of the human cervical spinal cord. Magn Reson Med 2017; 79:2142-2148. [PMID: 28736946 DOI: 10.1002/mrm.26852] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2017] [Revised: 07/04/2017] [Accepted: 07/05/2017] [Indexed: 12/16/2022]
Abstract
PURPOSE To develop a fast and robust method for measuring T1 in the whole cervical spinal cord in vivo, and to assess its reproducibility. METHODS A spatially nonselective adiabatic inversion pulse is combined with zonally oblique-magnified multislice echo-planar imaging to produce a reduced field-of-view inversion-recovery echo-planar imaging protocol. Multi- inversion time data are obtained by cycling slice order throughout sequence repetitions. Measurement of T1 is performed using 12 inversion times for a total protocol duration of 7 min. Reproducibility of regional T1 estimates is assessed in a scan-rescan experiment on five heathy subjects. RESULTS Regional mean (standard deviation) T1 was: 1108.5 (±77.2) ms for left lateral column, 1110.1 (±83.2) ms for right lateral column, 1150.4 (±102.6) ms for dorsal column, and 1136.4 (±90.8) ms for gray matter. Regional T1 estimates showed good correlation between sessions (Pearson correlation coefficient = 0.89 (P value < 0.01); mean difference = 2 ms, 95% confidence interval ± 20 ms); and high reproducibility (intersession coefficient of variation approximately 1% in all the regions considered, intraclass correlation coefficient = 0.88 (P value < 0.01, confidence interval 0.71-0.95)). CONCLUSIONS T1 estimates in the cervical spinal cord are reproducible using inversion-recovery zonally oblique-magnified multislice echo-planar imaging. The short acquisition time and large coverage of this method paves the way for accurate T1 mapping for various spinal cord pathologies. Magn Reson Med 79:2142-2148, 2018. © 2017 The Authors Magnetic Resonance in Medicine published by Wiley Periodicals, Inc. on behalf of International Society for Magnetic Resonance in Medicine. This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
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Affiliation(s)
- Marco Battiston
- NMR Research Unit, Queen Square MS Center, Department of Neuroinflammation, UCL Institute of Neurology, University College London, London, United Kingdom
| | | | - Ferran Prados
- NMR Research Unit, Queen Square MS Center, Department of Neuroinflammation, UCL Institute of Neurology, University College London, London, United Kingdom.,Translational Imaging Group, Center for Medical Image Computing, Department of Medical Physics and Biomedical Engineering, University College London, London, United Kingdom
| | - Francesco Grussu
- NMR Research Unit, Queen Square MS Center, Department of Neuroinflammation, UCL Institute of Neurology, University College London, London, United Kingdom
| | - Marios C Yiannakas
- NMR Research Unit, Queen Square MS Center, Department of Neuroinflammation, UCL Institute of Neurology, University College London, London, United Kingdom
| | - Sebastien Ourselin
- Translational Imaging Group, Center for Medical Image Computing, Department of Medical Physics and Biomedical Engineering, University College London, London, United Kingdom
| | - Claudia A M Gandini Wheeler-Kingshott
- NMR Research Unit, Queen Square MS Center, Department of Neuroinflammation, UCL Institute of Neurology, University College London, London, United Kingdom.,Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy.,Brain MRI 3T Mondino Research Center, C. Mondino National Neurological Institute, Pavia, Italy
| | - Rebecca S Samson
- NMR Research Unit, Queen Square MS Center, Department of Neuroinflammation, UCL Institute of Neurology, University College London, London, United Kingdom
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27
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Cawley N, Tur C, Prados F, Plantone D, Kearney H, Abdel-Aziz K, Ourselin S, Wheeler-Kingshott CAMG, Miller DH, Thompson AJ, Ciccarelli O. Spinal cord atrophy as a primary outcome measure in phase II trials of progressive multiple sclerosis. Mult Scler 2017; 24:932-941. [DOI: 10.1177/1352458517709954] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Objectives: To measure the development of spinal cord (SC) atrophy over 1 year in patients with progressive multiple sclerosis (PMS) and determine the sample sizes required to demonstrate a reduction in spinal cord cross-sectional area (SC-CSA) as an outcome measure in clinical trials. Methods: In total, 44 PMS patients (26 primary progressive multiple sclerosis (PPMS), 18 secondary progressive multiple sclerosis (SPMS)) and 29 healthy controls (HCs) were studied at baseline and 12 months. SC-CSA was measured using the three-dimensional (3D) fast field echo sequences acquired at 3T and the active surface model. Multiple linear regressions were used to investigate changes in imaging measurements. Results: PPMS patients had shorter disease duration, lower Expanded Disability Status Scale (EDSS) and larger SC-CSA than SPMS patients. All patients together showed a significantly greater decrease in percentage SC-CSA change than HCs, which was driven by the PPMS. All patients deteriorated over 1 year, but no association was found between percentage SC-CSA change and clinical changes. The sample size per arm required to detect a 50% treatment effect over 1 year, at 80% power, was 57 for PPMS and 546 for SPMS. Conclusion: SC-CSA may become an outcome measure in trials of PPMS patients, when they are at an early stage of the disease, have moderate disability and modest SC atrophy.
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Affiliation(s)
- Niamh Cawley
- Queen Square MS Centre, Department of Neuroinflammation, UCL Institute of Neurology, University College London (UCL), London, UK
| | - Carmen Tur
- Queen Square MS Centre, Department of Neuroinflammation, UCL Institute of Neurology, University College London (UCL), London, UK
| | - Ferran Prados
- Queen Square MS Centre, Department of Neuroinflammation, UCL Institute of Neurology, University College London (UCL), London, UK/Translational Imaging Group, Centre for Medical Image Computing (CMIC), Department of Medical Physics and Biomedical Engineering, University College London (UCL), London, UK
| | - Domenico Plantone
- Queen Square MS Centre, Department of Neuroinflammation, UCL Institute of Neurology, University College London (UCL), London, UK
| | - Hugh Kearney
- Queen Square MS Centre, Department of Neuroinflammation, UCL Institute of Neurology, University College London (UCL), London, UK
| | - Khaled Abdel-Aziz
- Queen Square MS Centre, Department of Neuroinflammation, UCL Institute of Neurology, University College London (UCL), London, UK
| | - Sebastian Ourselin
- Translational Imaging Group, Centre for Medical Image Computing (CMIC), Department of Medical Physics and Biomedical Engineering, University College London (UCL), London, UK
| | | | - David H Miller
- Queen Square MS Centre, Department of Neuroinflammation, UCL Institute of Neurology, University College London (UCL), London, UK/UCL Hospitals Biomedical Research Centre, London, UK
| | - Alan J Thompson
- Queen Square MS Centre, Department of Neuroinflammation, UCL Institute of Neurology, University College London (UCL), London, UK/UCL Hospitals Biomedical Research Centre, London, UK
| | - Olga Ciccarelli
- Queen Square MS Centre, Department of Neuroinflammation, UCL Institute of Neurology, University College London (UCL), London, UK/UCL Hospitals Biomedical Research Centre, London, UK
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28
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Prados F, Ashburner J, Blaiotta C, Brosch T, Carballido-Gamio J, Cardoso MJ, Conrad BN, Datta E, Dávid G, Leener BD, Dupont SM, Freund P, Wheeler-Kingshott CAMG, Grussu F, Henry R, Landman BA, Ljungberg E, Lyttle B, Ourselin S, Papinutto N, Saporito S, Schlaeger R, Smith SA, Summers P, Tam R, Yiannakas MC, Zhu A, Cohen-Adad J. Spinal cord grey matter segmentation challenge. Neuroimage 2017; 152:312-329. [PMID: 28286318 PMCID: PMC5440179 DOI: 10.1016/j.neuroimage.2017.03.010] [Citation(s) in RCA: 63] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2016] [Revised: 01/27/2017] [Accepted: 03/06/2017] [Indexed: 11/26/2022] Open
Abstract
An important image processing step in spinal cord magnetic resonance imaging is the ability to reliably and accurately segment grey and white matter for tissue specific analysis. There are several semi- or fully-automated segmentation methods for cervical cord cross-sectional area measurement with an excellent performance close or equal to the manual segmentation. However, grey matter segmentation is still challenging due to small cross-sectional size and shape, and active research is being conducted by several groups around the world in this field. Therefore a grey matter spinal cord segmentation challenge was organised to test different capabilities of various methods using the same multi-centre and multi-vendor dataset acquired with distinct 3D gradient-echo sequences. This challenge aimed to characterize the state-of-the-art in the field as well as identifying new opportunities for future improvements. Six different spinal cord grey matter segmentation methods developed independently by various research groups across the world and their performance were compared to manual segmentation outcomes, the present gold-standard. All algorithms provided good overall results for detecting the grey matter butterfly, albeit with variable performance in certain quality-of-segmentation metrics. The data have been made publicly available and the challenge web site remains open to new submissions. No modifications were introduced to any of the presented methods as a result of this challenge for the purposes of this publication.
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Affiliation(s)
- Ferran Prados
- Translational Imaging Group, Centre for Medical Image Computing (CMIC), Department of Medical Physics and Bioengineering, University College London, Malet Place Engineering Building, London WC1E 6BT, UK; NMR Research Unit, Queen Square MS Centre, Department of Neuroinflammation, UCL Institute of Neurology, University College London, Russell Square, London WC1B 5EH, UK.
| | - John Ashburner
- Wellcome Trust Centre for Neuroimaging, University College London, Queen Square, London WC1N 3BG, UK
| | - Claudia Blaiotta
- Wellcome Trust Centre for Neuroimaging, University College London, Queen Square, London WC1N 3BG, UK
| | - Tom Brosch
- Department of Electrical and Computer Engineering, University of British Columbia, Vancouver, BC, Canada V6T 1Z4
| | | | - Manuel Jorge Cardoso
- Translational Imaging Group, Centre for Medical Image Computing (CMIC), Department of Medical Physics and Bioengineering, University College London, Malet Place Engineering Building, London WC1E 6BT, UK; Dementia Research Centre, Department of Neurodegenerative Disease, UCL Institute of Neurology, University College London, Queen Square, London WC1N 3BG, UK
| | - Benjamin N Conrad
- Department of Electrical Engineering, Computer Science, Biomedical Engineering, Radiology and Radiological Sciences, Institute of Image Science at Vanderbilt University, Nashville, TN, USA
| | - Esha Datta
- Department of Neurology, University of California San Francisco, San Francisco, CA, USA
| | - Gergely Dávid
- Spinal Cord Injury Center Balgrist, University Hospital Zurich, University of Zurich, Switzerland
| | | | - Sara M Dupont
- NeuroPoly Lab, Polytechnique Montreal, Montreal, QC, Canada
| | - Patrick Freund
- Spinal Cord Injury Center Balgrist, University Hospital Zurich, University of Zurich, Switzerland
| | - Claudia A M Gandini Wheeler-Kingshott
- NMR Research Unit, Queen Square MS Centre, Department of Neuroinflammation, UCL Institute of Neurology, University College London, Russell Square, London WC1B 5EH, UK; Brain MRI 3T Centre, C. Mondino National Neurological Institute, Pavia, Italy; Department of Brain and Behavioural Sciences, University of Pavia, Italy
| | - Francesco Grussu
- NMR Research Unit, Queen Square MS Centre, Department of Neuroinflammation, UCL Institute of Neurology, University College London, Russell Square, London WC1B 5EH, UK
| | - Roland Henry
- Department of Neurology, University of California San Francisco, San Francisco, CA, USA
| | - Bennett A Landman
- Department of Electrical Engineering, Computer Science, Biomedical Engineering, Radiology and Radiological Sciences, Institute of Image Science at Vanderbilt University, Nashville, TN, USA
| | - Emil Ljungberg
- Department of Medicine, University of British Columbia, Vancouver, BC, Canada V6T 2B5
| | - Bailey Lyttle
- Institute of Imaging Science, Vanderbilt University, Nashville, TN, USA
| | - Sebastien Ourselin
- Translational Imaging Group, Centre for Medical Image Computing (CMIC), Department of Medical Physics and Bioengineering, University College London, Malet Place Engineering Building, London WC1E 6BT, UK; Dementia Research Centre, Department of Neurodegenerative Disease, UCL Institute of Neurology, University College London, Queen Square, London WC1N 3BG, UK
| | - Nico Papinutto
- Department of Neurology, University of California San Francisco, San Francisco, CA, USA
| | | | - Regina Schlaeger
- Department of Neurology, University of California San Francisco, San Francisco, CA, USA
| | - Seth A Smith
- Department of Radiology and Radiological Sciences, Biomedical Engineering, Ophthalmology, Institute of Imaging Science, Vanderbilt University, Nashville, TN, USA
| | - Paul Summers
- Department of Radiology, European Institute of Oncology, University of Modena and Reggio Emilia, 41121, Modena, MO, Italy
| | - Roger Tam
- Department of Radiology, UBC MS/MRI Research Group, University of British Columbia, Vancouver, BC, Canada V6T 2B5
| | - Marios C Yiannakas
- NMR Research Unit, Queen Square MS Centre, Department of Neuroinflammation, UCL Institute of Neurology, University College London, Russell Square, London WC1B 5EH, UK
| | - Alyssa Zhu
- Department of Neurology, University of California San Francisco, San Francisco, CA, USA
| | - Julien Cohen-Adad
- NeuroPoly Lab, Polytechnique Montreal, Montreal, QC, Canada; Functional Neuroimaging Unit, CRIUGM, Université de Montréal, Montreal, QC, Canada.
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29
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Fully automated grey and white matter spinal cord segmentation. Sci Rep 2016; 6:36151. [PMID: 27786306 PMCID: PMC5082365 DOI: 10.1038/srep36151] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2016] [Accepted: 10/06/2016] [Indexed: 12/03/2022] Open
Abstract
Axonal loss in the spinal cord is one of the main contributing factors to irreversible clinical disability in multiple sclerosis (MS). In vivo axonal loss can be assessed indirectly by estimating a reduction in the cervical cross-sectional area (CSA) of the spinal cord over time, which is indicative of spinal cord atrophy, and such a measure may be obtained by means of image segmentation using magnetic resonance imaging (MRI). In this work, we propose a new fully automated spinal cord segmentation technique that incorporates two different multi-atlas segmentation propagation and fusion techniques: The Optimized PatchMatch Label fusion (OPAL) algorithm for localising and approximately segmenting the spinal cord, and the Similarity and Truth Estimation for Propagated Segmentations (STEPS) algorithm for segmenting white and grey matter simultaneously. In a retrospective analysis of MRI data, the proposed method facilitated CSA measurements with accuracy equivalent to the inter-rater variability, with a Dice score (DSC) of 0.967 at C2/C3 level. The segmentation performance for grey matter at C2/C3 level was close to inter-rater variability, reaching an accuracy (DSC) of 0.826 for healthy subjects and 0.835 people with clinically isolated syndrome MS.
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Dupont SM, De Leener B, Taso M, Le Troter A, Nadeau S, Stikov N, Callot V, Cohen-Adad J. Fully-integrated framework for the segmentation and registration of the spinal cord white and gray matter. Neuroimage 2016; 150:358-372. [PMID: 27663988 DOI: 10.1016/j.neuroimage.2016.09.026] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2016] [Revised: 08/23/2016] [Accepted: 09/12/2016] [Indexed: 10/21/2022] Open
Abstract
The spinal cord white and gray matter can be affected by various pathologies such as multiple sclerosis, amyotrophic lateral sclerosis or trauma. Being able to precisely segment the white and gray matter could help with MR image analysis and hence be useful in further understanding these pathologies, and helping with diagnosis/prognosis and drug development. Up to date, white/gray matter segmentation has mostly been done manually, which is time consuming, induces a bias related to the rater and prevents large-scale multi-center studies. Recently, few methods have been proposed to automatically segment the spinal cord white and gray matter. However, no single method exists that combines the following criteria: (i) fully automatic, (ii) works on various MRI contrasts, (iii) robust towards pathology and (iv) freely available and open source. In this study we propose a multi-atlas based method for the segmentation of the spinal cord white and gray matter that addresses the previous limitations. Moreover, to study the spinal cord morphology, atlas-based approaches are increasingly used. These approaches rely on the registration of a spinal cord template to an MR image, however the registration usually doesn't take into account the spinal cord internal structure and thus lacks accuracy. In this study, we propose a new template registration framework that integrates the white and gray matter segmentation to account for the specific gray matter shape of each individual subject. Validation of segmentation was performed in 24 healthy subjects using T2*-weighted images, in 8 healthy subjects using diffusion weighted images (exhibiting inverted white-to-gray matter contrast compared to T2*-weighted), and in 5 patients with spinal cord injury. The template registration was validated in 24 subjects using T2*-weighted data. Results of automatic segmentation on T2*-weighted images was in close correspondence with the manual segmentation (Dice coefficient in the white/gray matter of 0.91/0.71 respectively). Similarly, good results were obtained in data with inverted contrast (diffusion-weighted image) and in patients. When compared to the classical template registration framework, the proposed framework that accounts for gray matter shape significantly improved the quality of the registration (comparing Dice coefficient in gray matter: p=9.5×10-6). While further validation is needed to show the benefits of the new registration framework in large cohorts and in a variety of patients, this study provides a fully-integrated tool for quantitative assessment of white/gray matter morphometry and template-based analysis. All the proposed methods are implemented in the Spinal Cord Toolbox (SCT), an open-source software for processing spinal cord multi-parametric MRI data.
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Affiliation(s)
- Sara M Dupont
- NeuroPoly Lab, Polytechnique Montreal, Montreal, QC, Canada
| | | | - Manuel Taso
- Aix-Marseille Université, CNRS, CRMBM UMR 7339, Marseille, France; AP-HM, Hopital de la Timone, Pôle d'imagerie médicale, CEMEREM, Marseille, France
| | - Arnaud Le Troter
- Aix-Marseille Université, CNRS, CRMBM UMR 7339, Marseille, France; AP-HM, Hopital de la Timone, Pôle d'imagerie médicale, CEMEREM, Marseille, France
| | - Sylvie Nadeau
- Pathokinesiology Laboratory, Centre for Interdisciplinary Research in Rehabilitation, Institut de réadaptation Gingras-Lindsay-de-Montréal- CIUSSS Centre-Sud-de-l'Île-de-Montréal, Montreal, QC, Canada; School of Rehabilitation, Université de Montréal, Montreal, QC, Canada
| | - Nikola Stikov
- NeuroPoly Lab, Polytechnique Montreal, Montreal, QC, Canada; Montreal Heart Institute, Montreal, QC, Canada
| | - Virginie Callot
- Aix-Marseille Université, CNRS, CRMBM UMR 7339, Marseille, France; AP-HM, Hopital de la Timone, Pôle d'imagerie médicale, CEMEREM, Marseille, France
| | - Julien Cohen-Adad
- NeuroPoly Lab, Polytechnique Montreal, Montreal, QC, Canada; Functional Neuroimaging Unit, CRIUGM, Université de Montréal, Montreal, QC, Canada.
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