Kotikalapudi Raviteja1, Pascal Martin2, Niels K Focke2, and Benjamin Bender1
1Diagnostic and Interventional Neuroradiology, University Hospital Tübingen, Tübingen, Germany, 2Neurology and Epileptology, University Hospital Tübingen, Tübingen, Germany
Synopsis
An
ideal classification of brain tissue structures as segmented gray
matter (GM) has been a challenge while using standard T1-weighted
image. One of the important ways of addressing this issue would be to
use additional information from multispectral imaging such as T2- and
T2-weighted FLAIR images. We evaluated the effect of multispectral
segmentation on GM segmentation using SPM12 VBM and compared it with
T1-only segmentation. We found that T1-segmentation overestimates
dura, meninges and vessels as GM. This problem was successfully
addressed by multispectral segmentation, which should be used as a
segmentation model for future VBM studies.
Purpose
The
purpose of this study was to validate multispectral segmentation of
gray matter, based on a combination of T1, T2 and FLAIR images and
evaluate its effect in comparison with T1-only segmentation, using
voxel based morphometry (VBM).Methods
We
scanned 77 healthy controls on a 3T scanner (Skyra, Siemens,
Erlangen) with a 32-channel head coil. The acquisition consisted of
3D T1-weighted MPRAGE (TI = 900 ms, α
= 80,
TE = 2.32 ms, TR = 2300 ms, GRAPPA = 2), 3D T2-weighted SPACE (α
= 1200,
TE = 4.08 ms, TR = 3200 ms, GRAPPA = 2) and 3D inversion recovery
prepared SPACE with a FLAIR contrast (TI = 1800 ms, α
= 1200,TE
= 3. 87 ms, TR = 5000 ms, GRAPPA = 2) scans with an isotropic
resolution of 0.9mm3.
We used SPM12, which allows for a simultaneous inclusion of
multispectral data for extracting gray matter (GM ), white matter
(WM) and cerebrospinal fluid (CSF). Along with T1-only segmentation,
we performed multispectral segmentation on intermodality combination
models; T1+T2, T1+FLAIR, T2+FLAIR and T1+T2+FLAIR in controls. To
achieve a first validation of multispectral segmentation, we assessed
already known age-related volume changes in GM in healthy
subjects (n=77).
For
this purpose, absolute GM, WM and CSF volumes were calculated using SPM12 and GM volumes
were normalized to total intracranial volumes (TIV=GM+WM+CSF) of respective subjects.
Later, a linear polynomial function was used for regression
analysis in all models for the gray matter estimation with respect to age, and root mean
square error (RMSE) was calculated. Furthermore,
VBM analysis was performed on all 5 models to account for group level
comparison of GM volume changes in multispectral models against
T1-only model, using a two-sample t-test at p<0.05 (FWE),
corrected for multiple comparisons.Results
We
found that all segmentation models showed a strong negative
correlation between age and GM volume, when fitted to a 2nd
order linear polynomial function. But among all models, T1+T2+FLAIR
with an RMSE =0.018, showed the best fit to the regression function
(Figure 1, Figure 2). VBM analysis for GM volume changes revealed
consistently, a significant increase in GM volume, especially in dura,
meninges and vessels for T1 compared to all multispectral models
(Figure 3).Discussion
In
comparison to adjusted R2,
which is a relative measure of fit, we assessed the performance of
all models for age-GM correlations using RMSE as it provides the absolute
fit to the regression function. All the models showed a significant
gray matter atrophy with an increasing age, which is in line with
previous studies (1,2). We found that T1+T2+FLAIR showed the best
age-GM correlations in comparison to rest of the models. In a
detailed visual analysis of the individual cases by an expert
neuroradiologist, the T1-only segmentation overestimated GM and CSF
outside the brain by falsely applying the GM and CSF tissue class to
vessels, meninges, and parts of the dura . These findings were in
agreement with our VBM based GM volume changes pertaining to group
level comparisons. These findings were also in line with
previous studies which showed that dura and cortex are iso-intense in T1-weighted images (3),
a problem addressed by multispectral segmentation (4).Conclusion
In summary, multispectral
segmentation, especially T1+T2+FLAIR showed a better age-gray matter
correlation in comparison to rest of the models. At the cortical
level, we found a significant overestimation of gray matter through
T1 segmentation in comparison to all multispectral segmentation
models, for non brain tissues of dura, meninges as well as vessels.Acknowledgements
This study received intramural research funding by the medical faculty of the University of Tübingen (AKF 321-0-1).
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