2D phase‐sensitive inversion recovery imaging to measure in vivo spinal cord gray and white matter areas in clinically feasible acquisition times

Papinutto, Nico; Schlaeger, Regina; Panara, Valentina; Caverzasi, Eduardo; Ahn, Sinyeob; Johnson, Kevin; Zhu, Alyssa H.; Stern, W.; Laub, Gerhard; Henry, Roland G.

doi:10.1002/jmri.24819

Cited by 31 publications

(71 citation statements)

References 54 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…25,26 Our group recently developed a sensitive method to detect SC GM atrophy based on 2D-PSIR image acquisitions that enable reliable assessment of TCAs, GM and WM structures in clinically feasible scanning times (<2min/level). 27 Using this method, we demonstrated that the upper cervical SC GM can be reduced in RMS in the absence of WM atrophy, and that GM atrophy is substantially more pronounced in PMS compared to RMS. 28 In addition, the cervical SC GM area was inversely correlated with disability.…”

Section: Introductionmentioning

confidence: 87%

See 1 more Smart Citation

Association Between Thoracic Spinal Cord Gray Matter Atrophy and Disability in Multiple Sclerosis

et al. 2015

Self Cite

View full text Add to dashboard Cite

IMPORTANCE In multiple sclerosis (MS), upper cervical cord gray matter (GM) atrophy correlates more strongly with disability than does brain or cord white matter (WM) atrophy. The corresponding relationships in the thoracic cord are unknown owing to technical difficulties in assessing GM and WM compartments by conventional magnetic resonance imaging techniques.OBJECTIVES To investigate the associations between MS disability and disease type with lower thoracic cord GM and WM areas using phase-sensitive inversion recovery magnetic resonance imaging at 3T, as well as to compare these relationships with those obtained at upper cervical levels. DESIGN, SETTING, AND PARTICIPANTSBetween July 2013 and March 2014, a total of 142 patients with MS (aged 25-75 years; 86 women) and 20 healthy control individuals were included in this cross-sectional observational study conducted at an academic university hospital. MAIN OUTCOMES AND MEASURESTotal cord areas (TCAs), GM areas, and WM areas at the disc levels C2/C3, C3/C4, T8/9, and T9/10. Area differences between groups were assessed, with age and sex as covariates.RESULTS Patients with relapsing MS (RMS) had smaller thoracic cord GM areas than did ageand sex-matched control individuals (mean differences [coefficient of variation (COV)]: 0.98 mm 2 [9.2%]; P = .003 at T8/T9 and 0.93 mm 2 [8.0%]; P = .01 at T9/T10); however, there were no significant differences in either the WM area or TCA. Patients with progressive MS showed smaller GM areas (mean differences [COV]: 1.02 mm 2 [10.6%]; P < .001 at T8/T9 and 1.37 mm 2 [13.2%]; P < .001 at T9/T10) and TCAs (mean differences [COV]: 3.66 mm 2 [9.0%]; P < .001 at T8/T9 and 3.04 mm 2 [7.2%]; P = .004 at T9/T10) compared with patients with RMS. All measurements (GM, WM, and TCA) were inversely correlated with Expanded Disability Status Scale score. Thoracic cord GM areas were correlated with lower limb function. In multivariable models (which also included cord WM areas and T2 lesion number, brain WM volumes, brain T1 and fluid-attenuated inversion recovery lesion loads, age, sex, and disease duration), cervical cord GM areas had the strongest correlation with Expanded Disability Status Scale score followed by thoracic cord GM area and brain GM volume.CONCLUSIONS AND RELEVANCE Thoracic cord GM atrophy can be detected in vivo in the absence of WM atrophy in RMS. This atrophy is more pronounced in progressive MS than RMS and correlates with disability and lower limb function. Our results indicate that remarkable cord GM atrophy is present at multiple cervical and lower thoracic levels and, therefore, may reflect widespread cord GM degeneration.

show abstract

Section: Introductionmentioning

confidence: 87%

“…Reliability assessments have previously been published for this segmentation methodology. 27 Based on these results, GM and TCA assessments were made by a single reader (RS), who was masked to the clinical data. TCA measurements were performed in a semi-automated fashion.…”

Section: Design and Methodsmentioning

confidence: 99%

Association Between Thoracic Spinal Cord Gray Matter Atrophy and Disability in Multiple Sclerosis

et al. 2015

Self Cite

View full text Add to dashboard Cite

show abstract

“…A number of clinically feasible MRI acquisition protocols have been proposed recently, which allow the clear distinction between GM and WM in the SC . However, their use is currently restricted to the mid‐ and upper SC due to technical challenges associated with imaging lower levels of the SC.…”

Section: Introductionmentioning

confidence: 99%

“…5 A number of clinically feasible MRI acquisition protocols have been proposed recently, which allow the clear distinc-tion between GM and WM in the SC. [6][7][8] However, their use is currently restricted to the mid-and upper SC due to technical challenges associated with imaging lower levels of the SC. For instance, due to the anatomical location of the lower SC, longer examination times are often required in order to achieve sufficient coverage and signal-to-noise ratio (SNR) for high-resolution imaging.…”

Section: Introductionmentioning

confidence: 99%

Gray vs. White Matter Segmentation of the Conus Medullaris: Reliability and Variability in Healthy Volunteers

Yiannakas

Liechti

Budtarad

et al. 2018

Journal of Neuroimaging

View full text Add to dashboard Cite

BACKGROUND AND PURPOSE Magnetic resonance imaging (MRI)‐derived spinal cord (SC) gray and white matter (GM/WM) volume are useful indirect measures of atrophy and neurodegeneration over time, typically obtained in the upper SC. Neuropathological evidence suggests that in certain neurological conditions, early degeneration may occur as low as the sacral SC. In this study, the feasibility of GM/WM segmentation of the conus medullaris (CM) was assessed in vivo. METHODS Twenty‐three healthy volunteers (11 female, mean age 47 years) underwent high‐resolution 3T MRI of the CM using a 3‐dimensional fast field echo sequence. Reproducibility of the volume measurements was assessed in 5 subjects (2 female, 25‐37 years) by one rater who repeated the analysis 3 times and also with 2 additional raters working independently in order to calculate the intra‐ and interrater coefficient of variation (COV), respectively. Furthermore, the influence of age, gender, spine and SC metrics on tissue‐specific measures of the CM was investigated. RESULTS Volumetric CM analyses (N = 23) for the SC, GM, and WM revealed a mean (SD) total volume of CM‐TV = 1746.9 (296.7) mm3, CM‐GM‐TV = 731.2 (106.0) mm3, and CM‐WM‐TV = 1014.6 (211.3) mm3, respectively. The intra‐rater COV for measuring the CM‐TV and CM‐GM‐TV was 3.38% and 7.42%, respectively; the interrater COV was 3.43% and 10.80%, respectively. Using age, gender, spine and SC metrics in regression models substantially reduced group variability for CM‐TV, CM‐WM‐TV, and CM‐GM‐TV by up to 39.2%, 42.7%, and 21.2%, respectively. CONCLUSIONS The results from this study demonstrate the feasibility of obtaining tissue‐specific volume measurements in the CM by means of MRI with good reproducibility and provide normative data for future applications in neurological diseases affecting the lower SC.

show abstract

“…In the past, there were first attempts toward this differentiation using a series of acquisition approaches. [9][10][11][12] More recently an averaged magnetization inversion recovery acquisitions (AMIRA) sequence was proposed, delivering a notable SC GM/WM contrast while maintaining short acquisition times at the same time. 13 The latter is especially important for imaging small-sized structures (like the SC GM/WM) in patients with disabilities having a short time window in which they can lie still.…”

mentioning

confidence: 99%

Automatic Spinal Cord Gray Matter Quantification: A Novel Approach

Tsagkas¹,

Horvath²,

Altermatt³

et al. 2019

AJNR Am J Neuroradiol

View full text Add to dashboard Cite

BACKGROUND AND PURPOSE: Currently, accurate and reproducible spinal cord GM segmentation remains challenging and a noninvasive broadly accepted reference standard for spinal cord GM measurements is still a matter of ongoing discussion. Our aim was to assess the reproducibility and accuracy of cervical spinal cord GM and WM cross-sectional area measurements using averaged magnetization inversion recovery acquisitions images and a fully-automatic postprocessing segmentation algorithm. MATERIALS AND METHODS: The cervical spinal cord of 24 healthy subjects (14 women; mean age, 40 Ϯ 11 years) was scanned in a test-retest fashion on a 3T MR imaging system. Twelve axial averaged magnetization inversion recovery acquisitions slices were acquired over a 48-mm cord segment. GM and WM were both manually segmented by 2 experienced readers and compared with an automatic variational segmentation algorithm with a shape prior modified for 3D data with a slice similarity prior. Precision and accuracy of the automatic method were evaluated using coefficients of variation and Dice similarity coefficients. RESULTS: The mean GM area was 17.20 Ϯ 2.28 mm 2 and the mean WM area was 72.71 Ϯ 7.55 mm 2 using the automatic method. Reproducibility was high for both methods, while being better for the automatic approach (all mean automatic coefficients of variation, Յ4.77%; all differences, P Ͻ .001). The accuracy of the automatic method compared with the manual reference standard was excellent (mean Dice similarity coefficients: 0.86 Ϯ 0.04 for GM and 0.90 Ϯ 0.03 for WM). The automatic approach demonstrated similar coefficients of variation between intra-and intersession reproducibility as well as among all acquired spinal cord slices. CONCLUSIONS: Our novel approach including the averaged magnetization inversion recovery acquisitions sequence and a fully-automated postprocessing segmentation algorithm demonstrated an accurate and reproducible spinal cord GM and WM segmentation. This pipeline is promising for both the exploration of longitudinal structural GM changes and application in clinical settings in disorders affecting the spinal cord. ABBREVIATIONS: AMIRA ϭ averaged magnetization inversion recovery acquisitions; CV ϭ coefficient of variation; DSC ϭ Dice similarity coefficient; HD ϭ Hausdorff distance; SC ϭ spinal cord T he human spinal cord (SC) can be affected by numerous neurologic disorders of variable pathophysiology (eg, genetic, inflammatory, demyelinating, degenerative, and so forth), 1,2 and MR imaging is a valuable part of the diagnostic work-up in patients with suspected intramedullary pathology. 3,4 SC gray matter and white matter can be involved to a various extent not only among different SC disorders but also among patients with the same disease (eg, multiple sclerosis, amyotrophic lateral sclerosis). 5,6 Hence, quantification of SC compartments may add to our understanding of SC pathology 5,6 and hopefully help in the management of individual patients in the future. However, the SC presents additional challenges for MR...

show abstract

2D phase‐sensitive inversion recovery imaging to measure in vivo spinal cord gray and white matter areas in clinically feasible acquisition times

Cited by 31 publications

References 54 publications

Association Between Thoracic Spinal Cord Gray Matter Atrophy and Disability in Multiple Sclerosis

Association Between Thoracic Spinal Cord Gray Matter Atrophy and Disability in Multiple Sclerosis

Gray vs. White Matter Segmentation of the Conus Medullaris: Reliability and Variability in Healthy Volunteers

Automatic Spinal Cord Gray Matter Quantification: A Novel Approach

Contact Info

Product

Resources

About