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This Article Figures Only Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via CrossRef Citing Articles via Google Scholar Google Scholar Articles by Duan, Y. Articles by Guttmann, C.R.G. Search for Related Content PubMed PubMed Citation Articles by Duan, Y. Articles by Guttmann, C.R.G. Hotlight (NEW!) What's Hotlight? American Journal of Neuroradiology 29:340-346, February 2008 © 2008 American Society of Neuroradiology BRAIN Segmentation of Subtraction Images for the Measurement of Lesion Change in Multiple Sclerosis Y. Duan a ,b , P.G. Hildenbrand a ,c , M.P. Sampat a , D.F. Tate a ,d , I. Csapo a , B. Moraal e , R. Bakshi a , F. Barkhof e , D.S. Meier a and C.R.G. Guttmann a a Center for Neurological Imaging, Departments of Radiology and Neurology, Brigham and Women's Hospital, Harvard Medical School, Boston, Mass b Department of Radiology, Second Hospital, China Medical University, Shenyang, Liaoning, China c Department of Radiology, Neuroradiology Division, Lahey Clinic, Burlington, Mass d Center for AIDS Research, Warren Alpert Medical School, Brown University, Providence, R.I e MS Center Amsterdam, Department of Radiology, VU University Medical Center, De Boelelaan, Amsterdam, the Netherlands Please address correspondence to Charles R.G. Guttmann, Center for Neurological Imaging, Brigham and Women's Hospital, 221 Longwood Ave, RF 394, Boston, MA 02115; e-mail: guttmann@bwh.harvard.edu BACKGROUND AND PURPOSE: Lesion volume change (LVC) assessment is essential in monitoring MS progression. LVC is usually measured by independently segmenting serial MR imaging examinations. Subtraction imaging has been proposed for improved visualization and characterization of lesion change. We compare segmentation of subtraction images (SSEG) with serial single time-point conventional segmentation (CSEG) by assessing the LVC relationship to brain atrophy and disease duration, as well as scan-rescan reproducibility and annual rates of lesion accrual. MATERIALS AND METHODS: Pairs of scans were acquired 1.5 to 4.7 years apart in 21 patients with multiple sclerosis (MS). Scan-rescan MR images were acquired within 30 minutes in 10 patients with MS. LVC was measured with CSEG and SSEG after coregistration and normalization. Coefficient of variation (COV) and Bland-Altman analyses estimated method reproducibility. Spearman rank correlations probed associations between LVC and other measures. RESULTS: Atrophy rate and net LVC were associated for SSEG ( R = –0.446; P < .05) but not when using CSEG ( R = –0.180; P = .421). Disease duration did not show an association with net lesion volume change per year measured by CSEG ( R = –0.360; P = .11) but showed an inverse correlation with SSEG-derived measurements ( R = –0.508; P < .05). Scan-rescan COV was lower for SSEG (0.98% ± 1.55%) than for CSEG (8.64% ± 9.91%). CONCLUSION: SSEG unveiled a relationship between T2 LVC and concomitant brain atrophy and demonstrated significantly higher measurement reproducibility. SSEG, a promising tool providing detailed analysis of subtle alterations in lesion size and intensity, may provide critical outcome measures for clinical trials of novel treatments, and may provide further insight into progression patterns in MS. This article has been cited by other articles: B. Moraal, M. P. Wattjes, J. J. G. Geurts, D. L. Knol, R. A. van Schijndel, P. J. W. Pouwels, H. Vrenken, and F. Barkhof Improved Detection of Active Multiple Sclerosis Lesions: 3D Subtraction Imaging Radiology, April 1, 2010; 255(1): 154 - 163. Abstract Full Text PDF B. Moraal, D. S. Meier, P. A. Poppe, J. J. G. Geurts, H. Vrenken, W. M. A. Jonker, D. L. Knol, R. A. van Schijndel, P. J. W. Pouwels, C. Pohl, et al. Subtraction MR Images in a Multiple Sclerosis Multicenter Clinical Trial Setting Radiology, February 1, 2009; 250(2): 506 - 514. Abstract Full Text PDF Home Subscribe Author Instructions Submit Online Search the AJNR Archives Feedback Help Copyright © 2010 by the American Society of Neuroradiology. Print ISSN: 0195-6108 Online ISSN: 1936-959X
American Journal of Neuroradiology – American Journal of Neuroradiology
Published: Feb 1, 2008
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