Voxel-wise deviations from healthy aging for the detection of region-specific atrophy.
Voxel-wise deviations from healthy aging for the detection of region-specific atrophy.
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DOI：
10.1016/j.nicl.2018.09.013
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发表时间：
2018
期刊：
影响因子：
--
通讯作者：
Alzheimer's Disease Neuroimaging Initiative
中科院分区：
文献类型：
--
作者：
Klöppel S;Yang S;Kellner E;Reisert M;Heimbach B;Urbach H;Linn J;Weidauer S;Andres T;Bröse M;Lahr J;Lützen N;Meyer PT;Peter J;Abdulkadir A;Hellwig S;Egger K;Alzheimer's Disease Neuroimaging Initiative
MRI 扫描中病理性萎缩的识别需要专门的培训，而在专门的中心之外，这种培训很少见。我们试图研究计算机生成的局部灰质（GM）损失或脑液（CSF）体积增加作为与健康衰老的标准化偏差（z分数）的临床有用性，以帮助人类视觉读数或直接检测病理性萎缩。两位经验丰富的神经放射科医生对 30 名阿尔茨海默病 (AD) 患者、30 名额颞叶痴呆 (FTD) 患者、30 名路易体病痴呆 (LBD) 患者和 30 名健康对照 (HC) 患者进行了萎缩评估，以 10 个解剖区域的三点量表作为参考金标准。七名评估者在 MRI 诊断方面的经验各不相同，他们对所有病例进行了一次相同等级的评估，一次使用计算机生成的体积偏差图，一次不使用叠加在解剖切片上的计算机生成的体积偏差图。此外，我们还研究了计算机生成的偏差图本身对于金标准评估者确定的萎缩检测的预测价值。两位黄金标准评估者之间和评估者内部的一致性非常显着（Cohen 的 kappa κ>0.62）。当显示体积偏差图时，其他评分者的评分者内部一致性范围从一般（κ=0.37）到相当大（κ=0.72），平均提高了 0.13（0.57<κ<0.87）。其他七位评估者在包括海马体在内的区域表现出与黄金标准的良好一致性，但在例如海马体等区域的一致性要低得多。顶叶皮质并没有随着萎缩分数的显示而改善。在研究过程中，无论是否存在体素偏差，评分速度都会有所提高。自动检测到的局部体积的大偏差与金标准萎缩读数一致相关，如海马区域接收器操作特征下高达 0.95 的区域所示。当将这些测试特征应用于记忆诊所中常见的患病率时，我们观察到几乎所有预期病例的海马体的阳性或阴性预测值接近或高于 0.9。由脑脊液体积增加得出的体积偏差图通常可以更好地检测萎缩。我们的研究表明，非专家之间的视觉评分一致，并且不会因显示特定区域的体积偏差而进一步增加。在开发诊断工具时应考虑计算机生成的独立于人类交互的局部偏差的高预测价值以及 CSF 相对于基于 GM 的估计的一致优势，并表明其临床实用性远远超出了辅助视觉评估的范围。颞叶萎缩的视觉识别最为准确。组织体积与正常老化的体素偏差很容易实现。主观地显示体素方面的偏差，但不能客观地帮助读者。体素方面的偏差本身与专家读数高度一致。应通过脑 MRI 扫描提供有关组织偏差的信息。
The identification of pathological atrophy in MRI scans requires specialized training, which is scarce outside dedicated centers. We sought to investigate the clinical usefulness of computer-generated representations of local grey matter (GM) loss or increased volume of cerebral fluids (CSF) as normalized deviations (z-scores) from healthy aging to either aid human visual readings or directly detect pathological atrophy. Two experienced neuroradiologists rated atrophy in 30 patients with Alzheimer's disease (AD), 30 patients with frontotemporal dementia (FTD), 30 with dementia due to Lewy-body disease (LBD) and 30 healthy controls (HC) on a three-point scale in 10 anatomical regions as reference gold standard. Seven raters, varying in their experience with MRI diagnostics rated all cases on the same scale once with and once without computer-generated volume deviation maps that were overlaid on anatomical slices. In addition, we investigated the predictive value of the computer generated deviation maps on their own for the detection of atrophy as identified by the gold standard raters. Inter and intra-rater agreements of the two gold standard raters were substantial (Cohen's kappa κ > 0.62). The intra-rater agreement of the other raters ranged from fair (κ = 0.37) to substantial (κ = 0.72) and improved on average by 0.13 (0.57 < κ < 0.87) when volume deviation maps were displayed. The seven other raters showed good agreement with the gold standard in regions including the hippocampus but agreement was substantially lower in e.g. the parietal cortex and did not improve with the display of atrophy scores. Rating speed increased over the course of the study and irrespective of the presentation of voxel-wise deviations. Automatically detected large deviations of local volume were consistently associated with gold standard atrophy reading as shown by an area under the receiver operator characteristic of up to 0.95 for the hippocampus region. When applying these test characteristics to prevalences typically found in a memory clinic, we observed a positive or negative predictive value close to or above 0.9 in the hippocampus for almost all of the expected cases. The volume deviation maps derived from CSF volume increase were generally better in detecting atrophy. Our study demonstrates an agreement of visual ratings among non-experts not further increased by displaying, region-specific deviations of volume. The high predictive value of computer generated local deviations independent from human interaction and the consistent advantages of CSF-over GM-based estimations should be considered in the development of diagnostic tools and indicate clinical utility well beyond aiding visual assessments. The visual identification of atrophy is most accurate in the temporal lobe. Voxel-wise deviations of tissue volume from normal aging is easy to implement. Displaying voxel-wise deviations subjectively but not objectively aids readers. Voxel-wise deviations themselves show high agreement with expert readings. Information on tissue deviations should be provided with cerebral MRI scans.
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DOI：
10.1016/j.jalz.2011.03.005
发表时间：
2011-05
期刊：
Alzheimer's & dementia : the journal of the Alzheimer's Association
影响因子：
--
作者：
McKhann GM;Knopman DS;Chertkow H;Hyman BT;Jack CR Jr;Kawas CH;Klunk WE;Koroshetz WJ;Manly JJ;Mayeux R;Mohs RC;Morris JC;Rossor MN;Scheltens P;Carrillo MC;Thies B;Weintraub S;Phelps CH
通讯作者：
Phelps CH
影响因子：
4
作者：
Claus, Jules J.;Staekenborg, Salka S.;Scheltens, Philip
通讯作者：
Scheltens, Philip
影响因子：
3.7
作者：
Dukart J;Schroeter ML;Mueller K;Alzheimer's Disease Neuroimaging Initiative
通讯作者：
Alzheimer's Disease Neuroimaging Initiative
影响因子：
2.4
作者：
Frings, Lars;Dressel, Katharina;Huell, Michael
通讯作者：
Huell, Michael
影响因子：
14.5
作者：
Kloeppel, Stefan;Stonnington, Cynthia M.;Chu, Carlton;Draganski, Bogdan;Scahill, Rachael I.;Rohrer, Jonathan D.;Fox, Nick C.;Jack, Clifford R., Jr.;Ashburner, John;Frackowiak, Richard S. J.
通讯作者：
Frackowiak, Richard S. J.