Ronja C. Berg1, Thomas Amthor2, Irene Vavasour3, Mariya Doneva2, and Christine Preibisch1
1Department of Neuroradiology, School of Medicine, Technical University of Munich, Munich, Germany, 2Philips Research Europe, Hamburg, Germany, 3Department of Radiology, University of British Columbia, Vancouver, BC, Canada
Synopsis
Myelin water fraction (MWF) mapping provides
information on myelin concentration, which can be affected by neurological
diseases. Most commonly, a non-negative least squares (NNLS) algorithm is used
to obtain MWF. A faster alternative is the Sparsity Promoting Iterative Joint
NNLS (SPIJN) algorithm.
Here, we compared both methods in several brain regions from healthy
participants and normal-appearing and lesion tissue from MS patients (EDSS
0-1.5). We found that NNLS-based lesion-average MWF was rather comparable to
white matter while SPIJN-based MWF was lower. Thus, SPIJN could be more sensitive to demyelination
in lesions but comparisons to gold standard techniques are clearly needed.
Introduction
Various
neurological diseases can affect and degrade myelin and thereby impair the
conduction of nerve signals. One such disease is multiple sclerosis (MS), an
inflammatory demyelinating disease that damages myelin and nerve fibers1.
Precise knowledge of the myelin concentration is essential to better understand
and treat such diseases. A valuable MRI based method for determining the myelin
concentration is myelin water fraction (MWF) mapping2-3.
Commonly, a non-negative least squares (NNLS) algorithm4 is used
to calculate MWF from multi-echo spin-echo data. A new and faster method for
MWF determination is the Sparsity Promoting Iterative Joint NNLS (SPIJN)
algorithm5 that uses a joint sparsity constraint and enables
inclusion of phase data.
In a
previous study, we investigated how the SPIJN algorithm (using either magnitude
data only or complex data) compares to the NNLS method for MWF mapping in
healthy WM regions6. Here, we additionally evaluated all three
algorithms in a cohort of MS patients and investigated their performance in
healthy, normal-appearing, and lesion tissue.Methods
Five healthy
volunteers (aged 32±3y, 3f/2m) and
five MS patients (aged 33±6y, 2f/3m; 4 relapsing-remitting
MS, 1 clinically
isolated syndrome; disease duration: 3-15y, average=9.4y; expanded
disability status scale: 0-1.5, average =1.1) were scanned on a Philips 3T
Ingenia Elition using a 32-channel head coil. The scan protocol comprised a 3D
gradient- and spin-echo (GRASE) sequence for myelin water imaging (MWI), FLAIR,
and MPRAGE. The scan parameters of the GRASE sequence were TE1/ΔTE/TR =
8/8/1120ms, 48 echoes, 1x2x5mm³ resolution, 20 slices, and a=90°. Data processing was performed using a non-negative least squares
(NNLS) algorithm4 including stimulated echo correction7
and two variants of the Sparsity Promoting Iterative Joint NNLS5
algorithm. The mSPIJN variant used only magnitude data for MWF calculation, the
cSPIJN variant additionally included phase information.
In MS patients, lesions were segmented
automatically using the lesion growth algorithm8 from the lesion
segmentation tool9 for SPM1210. Lesions were defined as regions
with lesion probabilities >0.5 and the peri-lesional tissue (‘Peri-Lesion’)
as a 3-voxel wide shell surrounding lesions within normal-appearing white
matter (WM). Whole-brain gray matter (GM) and WM masks were derived from MPRAGE
data using SPM12’s segment module thresholded at tissue probability >0.5.
Additionally, several WM tracts from the JHU DTI-based white-matter atlas11-12 were combined into five MW regions (corpus callosum, internal capsule,
corona radiata, external capsule, and cingulum). All volumes-of-interest (VOIs)
were co-registered to the GRASE data using either SPM12’s co-register (whole-brain
GM and WM, lesion masks) or normalize module (JHU VOIs) and nearest-neighbor
interpolation. Lesion-voxels were excluded from all non-lesion VOIs.Results
MWF maps
calculated using the three algorithms appeared visually similar. However, they
slightly differed, especially in voxels segmented as lesions (Fig.1). In most
lesions, SPIJN-based MWF was lower than NNLS-based MWF (Fig.2A-B). Phase like patterns can be seen in the difference and overlay
images of cSPJIN and both NNLS and mSPJIN (Fig.2B-C).
In most
investigated VOIs, VOI-average MWF values from different MWF algorithms showed
the same tendencies (highest MWF in the internal capsule and lowest in the
external capsule and cingulum) across WM regions (Fig.3). However, MWF values
of lesion segmentations were clearly decreased compared to WM MWF in both SPIJN
variants, while NNLS-based MWF was rather comparable between lesions and WM
(Fig.3). In non-lesion tissue, VOI-average MWF values were slightly higher for
SPIJN reconstructions, especially for mSPIJN (Fig.3) and the pooled standard
deviation across all voxels of all participants was slightly lower for SPIJN
than for NNLS (Fig.4). Bland-Altman evaluations revealed highest agreement
between both SPIJN algorithms and lowest agreement between NNLS and mSPIJN
(Fig.5).Discussion
In healthy and normal-appearing brain
regions, VOI-average SPIJN-based MWF was slightly higher than NNLS-based MWF. cSPIJN
showed a somewhat better agreement with NNLS than mSPIJN probably achieved by
eliminating bias when including phase data in the processing. Whole-brain WM and
GM MWF values of all three methods correlated well with literature ranging from
0.118-0.156 in WM13-14 and 0.038±0.064 in GM13. Differences were found in the MWF of lesion segmentations with
NNLS resulting in MWF values almost comparable to WM while SPIJN revealed much
lower MWF values almost comparable to GM. Previous studies have found decreased
average MWF in lesions compared to WM ranging mostly from 0.041 to 0.04613-15 but also reaching values up to 0.08516,
which roughly correlate with our average lesion MWF. However, large differences
have been reported between MWF values of individual lesions ranging between 0
and ~0.1114 or 0 and 0.1715. In this preliminary
study including only five MS patients, it is hardly possible to determine why
NNLS-based MWF yielded higher MWF in lesions than SPIJN-based MWF. One possible
explanation could be a low degree of demyelination within the lesions of our
cohort of MS patients that had a comparatively low EDSS (0-1.5). Further studies
are urgently needed that compare not only NNLS3,17 but
also SPIJN MWF in lesions with gold standard histology to evaluate the fidelity
of MWF values from both methods.Conclusion
SPIJN yielded higher contrast between normal-appearing
or healthy brain tissue and lesions compared to NNLS. Comparisons with gold
standard techniques are needed to disentangle processing-based differences in MWF
from microstructural effects influencing the degree of demyelination within
lesions.Acknowledgements
Ronja Berg was
supported by a PhD grant from the Friedrich-Ebert-Stiftung.References
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