Clinical feasibility of longitudinal lateral ventricular volume measurements on T2-FLAIR across MRI scanner changes

Dejan Jakimovski; Robert Zivadinov; Niels Bergsland; Deepa P Ramasamy; Jesper Hagemeier; Antonia Valentina Genovese; David Hojnacki; Bianca Weinstock-Guttman; Michael G Dwyer

doi:10.1016/j.nicl.2020.102554

Clinical feasibility of longitudinal lateral ventricular volume measurements on T2-FLAIR across MRI scanner changes

Neuroimage Clin. 2021:29:102554. doi: 10.1016/j.nicl.2020.102554. Epub 2021 Jan 4.

Authors

Dejan Jakimovski¹, Robert Zivadinov², Niels Bergsland³, Deepa P Ramasamy¹, Jesper Hagemeier¹, Antonia Valentina Genovese⁴, David Hojnacki⁵, Bianca Weinstock-Guttman⁵, Michael G Dwyer⁶

Affiliations

¹ Buffalo Neuroimaging Analysis Center, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, NY, USA.
² Buffalo Neuroimaging Analysis Center, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, NY, USA; Center for Biomedical Imaging at Clinical Translational Science Institute, University at Buffalo, State University of New York, Buffalo, NY, USA.
³ Buffalo Neuroimaging Analysis Center, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, NY, USA; IRCCS, Fondazione Don Carlo Gnocchi ONLUS, Milan, Italy.
⁴ Institute of Radiology, Department of Clinical Surgical Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy.
⁵ Jacobs Comprehensive MS Treatment and Research Center, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences University at Buffalo, Buffalo, NY, USA.
⁶ Buffalo Neuroimaging Analysis Center, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, NY, USA; Center for Biomedical Imaging at Clinical Translational Science Institute, University at Buffalo, State University of New York, Buffalo, NY, USA. Electronic address: mgdwyer@bnac.net.

Abstract

Background: Greater brain atrophy is associated with disability progression (DP) in patients with multiple sclerosis (PwMS). However, methodological challenges limit its routine clinical use.

Objective: To determine the feasibility of atrophy measures as markers of DP in PwMS scanned across different MRI field strengths.

Methods: A total of 980 PwMS were scanned on either 1.5 T or 3.0 T MRI scanners. Demographic and clinical data were retrospectively collected, and the presence of DP was determined according to standard clinical trial criteria. Lateral ventricular volume (LVV) change was measured with the NeuroSTREAM technique on clinical routine T2-FLAIR images. Percent brain volume change (PBVC) was measured using SIENA and ventricular cerebrospinal fluid (vCSF) % change was measured using VIENA and SIENAX algorithms on 3D T1-weighted images (WI). Stable vs. DP PwMS were compared using analysis of covariance (ANCOVA). Mixed modeling determined the effect of MRI scanner change on MRI-derived atrophy measures.

Results: Longitudinal LVV analysis was successful in all PwMS. SIENA-based PBVC and VIENA-based changes failed in 37.6% of cases, while SIENAX-based vCSF failed in 12.9% of cases. PwMS with DP (n = 241) had significantly greater absolute (20.9% vs. 8.7%, d = 0.66, p < 0.001) and annualized LVV % change (4.1% vs. 2.3%, d = 0.27, p < 0.001) when compared to stable PwMS (n = 739). In subjects with both analyses available, both 3D-T1 and T2-FLAIR-based analyses differentiated PwMS with DP (n = 149). However, only NeuroSTREAM and VIENA-based LVV/vCSF were able to show greater atrophy in PwMS that were scanned on different scanners. PBVC and SIENAX-based vCSF % changes were significantly affected by scanner change (Beta = -0.16, t-statistics = -2.133, p = 0.033 and Beta = -2.08, t-statistics = -4.084, p < 0.001), whereas no MRI scanner change effects on NeuroSTREAM-based PLVVC and VIENA-based vCSF % change were noted.

Conclusions: LVV-based atrophy on T2-FLAIR is a clinically relevant measure in spite of MRI scanner changes and mild disability levels.

Keywords: Disability progression; Lateral ventricular volume; MRI; MRI field strength; Multiple sclerosis; Whole brain atrophy.

MeSH terms

Atrophy / pathology
Brain / diagnostic imaging
Brain / pathology
Disease Progression
Feasibility Studies
Humans
Magnetic Resonance Imaging*
Multiple Sclerosis* / diagnostic imaging
Multiple Sclerosis* / pathology
Retrospective Studies

Grants and funding

UL1 TR001412/TR/NCATS NIH HHS/United States