Accuracy for Detection of Simulated Lesions

Herskovits, Edward H.; Itoh, Ryuta; Melhem, Elias R.

doi:10.2214/ajr.176.5.1761313

Cited by 39 publications

(12 citation statements)

References 20 publications

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“…Further studies should be designed to show if this protocol could be further streamlined. For brain assessment, we found that, in accordance with the findings of other investigators, T1-weighted inversion-recovery prepared spoiled gradient-echo and T2-weighted FLAIR sequences are important in the detection of white matter lesions (24) and that three-dimensional arterial spin labeling sequences are important in identification of cerebral blood flow abnormalities (25). Our quantitative susceptibility map sequence did not show any hemorrhage in the brain, and diffusion-tensor and resting-state functional MR imaging sequences have not, to our knowledge, been studied extensively in pediatric cancer survivors, although some investigators suggest that they are potentially useful (26,27).…”

Section: Discussionsupporting

confidence: 85%

A PET/MR Imaging Approach for the Integrated Assessment of Chemotherapy-induced Brain, Heart, and Bone Injuries in Pediatric Cancer Survivors: A Pilot Study

et al. 2017

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Purpose To develop a positron emission tomography (PET)/magnetic resonance (MR) imaging protocol for evaluation of the brain, heart, and joints of pediatric cancer survivors for chemotherapy-induced injuries in one session. Materials and Methods Three teams of experts in neuroimaging, cardiac imaging, and bone imaging were tasked to develop a 20–30-minute PET/MR imaging protocol for detection of chemotherapy-induced tissue injuries of the brain, heart, and bone. In an institutional review board–approved, HIPAA-compliant, prospective study from April to July 2016, 10 pediatric cancer survivors who completed chemotherapy underwent imaging of the brain, heart, and bone with a 3-T PET/MR imager. Cumulative chemotherapy doses and clinical symptoms were correlated with the severity of MR imaging abnormalities by using linear regression analyses. MR imaging measures of brain perfusion and metabolism were compared among eight patients who were treated with methotrexate and eight untreated age-matched control subjects by using Wilcoxon rank-sum tests. Results Combined brain, heart, and bone examinations were completed within 90 minutes. Eight of 10 cancer survivors had abnormal findings on brain, heart, and bone images, including six patients with and two patients without clinical symptoms. Cumulative chemotherapy doses correlated significantly with MR imaging measures of left ventricular ejection fraction and end-systolic volume, but not with the severity of brain or bone abnormalities. Methotrexate-treated cancer survivors had significantly lower cerebral blood flow and metabolic activity in key brain areas compared with control subjects. Conclusion The feasibility of a single examination for assessment of chemotherapy-induced injuries of the brain, heart, and joints was shown. Earlier detection of tissue injuries may enable initiation of timely interventions and help to preserve long-term health of pediatric cancer survivors.

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Section: Discussionsupporting

confidence: 85%

A PET/MR Imaging Approach for the Integrated Assessment of Chemotherapy-induced Brain, Heart, and Bone Injuries in Pediatric Cancer Survivors: A Pilot Study

et al. 2017

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“…However, the specificity of PVL for MS among patients with neurological diseases has not been systematically addressed [3]. FLAIR provides increased sensitivity of demyelinating lesion detection especially in the periventricular location as it can differentiate the signal from the CSF, in the lateral ventricles, from the lesion itself [16-18]. Another important issue is the presence of nonspecific T2 hyperintensities adjacent to the frontal horns of the lateral ventricles in healthy subjects, so-called frontal capping, which can be mistakenly counted as PVL [12].…”

Section: Discussionmentioning

confidence: 99%

Are Periventricular Lesions Specific for Multiple Sclerosis?

Casini

Yurashevich

Vanga

et al. 2013

J Neurol Neurophysiol

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Background The presence of periventricular lesions (PVL) on MRI scans is part of the revised McDonald multiple sclerosis (MS) diagnostic criteria. However, PVL can be found in other neurological diseases including stroke and migraine. Migraine is highly prevalent in patients with MS. Objective To determine if PVL are specific for patients with MS compared to stroke and migraine. Methods We studied patients diagnosed with clinically isolated syndrome (CIS), relapsing-remitting MS (RRMS), migraine, and ischemic stroke. The number, location and the volume of PVL were identified on brain MRI scans and analyzed. Results The number and volume of PVL adjacent to the body and the posterior horn of the lateral ventricles were significantly increased on fluid-attenuated inversion recovery MRI in RRMS compared to migraine. There were no significant differences in the total number and volume of PVL in ischemic stroke patients compared to the age-matched RRMS patients nor in the number and volume of PVL adjacent to the anterior and temporal horns of the lateral ventricles on FLAIR images in migraine compared to CIS or RRMS. Conclusion In contrast to PVL adjacent to the body and the posterior horn of the lateral ventricles, PVL adjacent to the anterior and temporal horns of the lateral ventricles may not be specific for CIS/RRMS when compared to migraine, the disease highly prevalent among patients with MS. PVL are not specific for MS when compared to ischemic stroke.

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“…Note that because the segmentation operates strictly on the vector of FLAIR intensity values, it was not necessary to mimic the size or shape characteristics of typical WMH (eg, Ref. 21). …”

Section: Methodsmentioning

confidence: 99%

Automatic segmentation of white matter hyperintensities in the elderly using FLAIR images at 3T

Gibson

Gao

Black

et al. 2010

Magnetic Resonance Imaging

109

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PurposeTo determine the precision and accuracy of an automated method for segmenting white matter hyperintensities (WMH) on fast fluid-attenuated inversion-recovery (FLAIR) images in elderly brains at 3T.Materials and MethodsFLAIR images from 18 individuals (60–82 years, 9 females) with WMH burdens ranging from 1–80 cm3 were used. The protocol included the removal of clearly hyperintense voxels; two-class fuzzy C-means clustering (FCM); and thresholding to segment probable WMH. Two false-positive minimization (FPM) methods using white matter templates were tested. Precision was assessed by adding synthetic hyperintense voxels to brain slices. Accuracy was validated by comparing automatic and manual segmentations. Whole-brain, voxel-wise metrics of similarity, under- and overestimation were used to evaluate both precision and accuracy.ResultsPrecision was high, as the lowest accuracy in the synthetic datasets was 93%. Both FPM strategies successfully improved overall accuracy. Whole-brain accuracy for the FCM segmentation alone ranged from 45%–81%, which improved to 75%–85% using the FPM strategies.ConclusionThe method was accurate across the range of WMH burden typically seen in the elderly. Accuracy levels achieved or exceeded those of other approaches using multispectral and/or more sophisticated pattern recognition methods. J. Magn. Reson. Imaging 2010;31:1311–1322. © 2010 Wiley-Liss, Inc.

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Accuracy for Detection of Simulated Lesions

Cited by 39 publications

References 20 publications

A PET/MR Imaging Approach for the Integrated Assessment of Chemotherapy-induced Brain, Heart, and Bone Injuries in Pediatric Cancer Survivors: A Pilot Study

A PET/MR Imaging Approach for the Integrated Assessment of Chemotherapy-induced Brain, Heart, and Bone Injuries in Pediatric Cancer Survivors: A Pilot Study

Are Periventricular Lesions Specific for Multiple Sclerosis?

Automatic segmentation of white matter hyperintensities in the elderly using FLAIR images at 3T

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