MRT bei neurodegenerativen Erkrankungen

Urbach, Horst; Egger, Karl

doi:10.1055/a-1125-7455

Cited by 3 publications

(3 citation statements)

References 7 publications

(7 reference statements)

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“…Despite the low number of patients and the retrospective data collection this single-center proof of concept study shows that NPH patients can be automatically detected with a high accuracy similar to human ratings. This detection is helpful as a NPH pattern often interferes with voxel-based morphometry to detect region-specific atrophy [ 28 ]; however, use needs to be confirmed by a larger and more structured data assessment. In this context, the comparison of the SVM prediction score with a recently published visual imaging score (iNPH Radscale) would be worthwhile [ 29 ].…”

Section: Discussionmentioning

confidence: 99%

SVM-Based Normal Pressure Hydrocephalus Detection

et al. 2021

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Background and Purpose As magnetic resonance imaging (MRI) signs of normal pressure hydrocephalus (NPH) may precede clinical symptoms we sought to evaluate an algorithm that automatically detects this pattern. Methods A support vector machine (SVM) was trained in 30 NPH patients treated with ventriculoperitoneal shunts and 30 healthy controls. For comparison, four neuroradiologists visually assessed sagittal MPRAGE images and graded them as no NPH pattern, possible NPH pattern, or definite NPH pattern. Results Human accuracy to visually detect a NPH was between 0.85 and 0.97. Interobserver agreement was substantial (κ = 0.656). Accuracy of the SVM algorithm was 0.93 and AUROC 0.99. Among 272 prespecified regions, gray matter and CSF volumes of both caudate, the right parietal operculum, the left basal forebrain, and the 4th ventricle showed the highest discriminative power to separate a NPH and a no NPH pattern. Conclusion A NPH pattern can be reliably detected using a support vector machine (SVM). Its role in the work-up of asymptomatic patients or neurodegenerative disease has to be evaluated.

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Section: Discussionmentioning

confidence: 99%

SVM-Based Normal Pressure Hydrocephalus Detection

et al. 2021

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“…Mit der Möglichkeit, multiplanare Reformatierungen aus isotropen MRT- aber auch aus CT-Datensätzen herstellen zu können, wurde dann die Erkennung spezifischer Atrophiemuster verbessert, sodass primäre Demenzerkrankungen und hier hauptsächlich der Morbus Alzheimer diagnostiziert werden konnten. In einem nächsten Schritt wurden weniger ausgeprägte Atrophiemuster durch den Voxel- und Regionen-basierten Vergleich mit gleichaltrigen Gesunden herausgearbeitet und KI-basierte Diagnosewahrscheinlichkeiten implementiert 3 4 . Schließlich sollen nach dem Abschluss von Phase-III-Studien und der Zulassung durch die FDA Alzheimer-Patienten in frühen Stadien der Erkrankung (mit mutmaßlich gering ausgeprägten Atrophien) mit monoklonalen Antikörpern behandelt werden, die das im Hirnparenchym abgelagerte Amyloid „herauswaschen“ sollen.…”

Section: Abkürzungenunclassified

“…The ability to create multiplanar reconstructions from isotropic MRI as well as CT datasets improved the detection of specific patterns of atrophy so that the primary types of dementia, primarily Alzheimer’s disease, were able to be diagnosed. In a next step, less pronounced patterns of atrophy were identified based on a voxel- and region-based comparison with healthy subjects of the same age and AI-based diagnosis probabilities were implemented 3 4 . Finally, after the conclusion of phase III studies and approval by the FDA, Alzheimer’s patients in early stages of the disease (presumably with minimal atrophy) are to be treated with monoclonal antibodies to clear amyloid deposits in the brain parenchyma.…”

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Imaging of Amyloid-Related Imaging Abnormalities (ARIA)

Urbach,

Linn,

Hattingen

et al. 2023

Rofo

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Patients with Alzheimer’s disease (AD) can now be treated with monoclonal antibodies aiming at clearing amyloid plaques from the brain parenchyma. Weeks after initiation of this drug therapy, patients may develop so-called amyloid-related imaging abnormalities (ARIA) on MRI. ARIA comprise vasogenic edema and leptomeningeal effusions (ARIA-E) as well as microbleeds and superficial hemosiderosis (ARIA-H). The prevalence is drug- and dose-dependent (up to 40 % of patients), the apolipoprotein E4 variant and concomitant cerebral amyloid angiopathy (CAA) increase the risk. With regard to MRI characteristics, ARIA strongly resembles the so-called inflammatory subtype of CAA (CAA-ri). While patients with CAA-ri are typically detected due to symptoms such as headaches, lethargy, confusion, and rarely epileptic seizures, around 20 % of ARIA patients show symptoms. Management of ARIA is not yet clearly established. In asymptomatic patients, discontinuation of the drug might be sufficient. Key points: Citation Format

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Increased interstitial fluid in periventricular and deep white matter hyperintensities in patients with suspected idiopathic normal pressure hydrocephalus

Rau

Reisert

Kellner

et al. 2021

Sci Rep

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Periventricular white matter changes are common in patients with idiopathic normal pressure hydrocephalus (iNPH) and considered to represent focally elevated interstitial fluid. We compared diffusion measures in periventricular hyperintensities in patients with imaging features of iNPH to patients without. The hypothesis is that periventricular hyperintensities in patients with presumed iNPH show higher water content than in patients without imaging features of iNPH. 21 patients with iNPH Radscale 7–12 (“high probability of iNPH”) and 10 patients with iNPH Radscale 2–4 (“low probability of iNPH”) were examined with a neurodegeneration imaging protocol including a diffusion microstructure imaging sequence. Periventricular hyperintensities and deep white matter hyperintensities were segmented and diffusion measures were compared. In patients with imaging features of iNPH, the free water content in periventricular hyperintensities was significantly higher compared to the control group (p = 0.005). This effect was also detectable in deep white matter hyperintensities (p = 0.024). Total brain volumes and total gray or white matter volumes did not differ between the groups. Periventricular cap free water fraction was highly discriminative regarding patients with presumed iNPH and controls with an ROC AUC of 0.933. Quantitative diffusion microstructure imaging shows elevated water content in periventricular hyperintensities in patients with imaging features of iNPH, which could be the imaging correlate for pathologic fluid accumulation and may be used as an imaging biomarker in the future.

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MRT bei neurodegenerativen Erkrankungen

Cited by 3 publications

References 7 publications

SVM-Based Normal Pressure Hydrocephalus Detection

SVM-Based Normal Pressure Hydrocephalus Detection

Imaging of Amyloid-Related Imaging Abnormalities (ARIA)

Increased interstitial fluid in periventricular and deep white matter hyperintensities in patients with suspected idiopathic normal pressure hydrocephalus

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