Novel Multi-Linear Quantitative Brain Volume Formula For Manual Radiological Evaluation Of Brain Atrophy

Abstract

Background The brain is a dynamic organ that develops and involutes in volume. The process of volume loss known as brain atrophy commonly occurs in elderly. However, some conditions have been implicated to provoke this paradoxical process in childhood and making it important to have methods and techniques of quantifying brain volume. Automated quantitative methods are very important in brain atrophy assessment but these tools have limited availability in developing countries. The simplified linear radiological methods are poorly reproducible and hence there is a need to develop an alternative formula that is reproducible and applicable at all healthcare levels. Methods The multi-linear diagonal brain fraction formula (DBF) was designed from dimensions of brain relative to skull. To test a developed formula, a total of 347 subjects aged between 0 and 18 years who had brain CT scans performed at the health facilities in Northern Tanzania were recruited and subjected to a systematic measurement of their brains in a diagonal brain fashion. Results Out of 347 patients evaluated, 62 subjects (17.8%) were found to be cases of brain atrophy. The three radiological measurements which included sulcal width (SW), ventricular width (VW) and Evans Index (EI) were concurrently performed. SW and VW showed good age correlation while EI showed no significant correlation with age. Similar tests were extended to diagonal brain fraction (DBF) and skull vertical horizontal ratio (VHR) in which DBF showed significant correlation. Conclusions The DBF formula shows significant ability of differentiating changes of brain volume suggesting that it can be utilized as an alternative brain fraction quantification method bearing technical simplicity in assessing gross brain volume with the ability to classify degrees of brain atrophy into mild, moderate, severe and very severe stages.