Automated Brain Volumetry in Patients With Memory Impairment: Comparison of Conventional and Ultrafast 3D T1-Weighted MRI Sequences Using Two Software Packages

Heo, Young Jin; Baek, Hye Jin; Skare, Stefan; Lee, Ho‐Joon; Kim, Dong-Hyun; Kim, Junho; Yoon, Sojeong

doi:10.2214/ajr.21.27043

Cited by 8 publications

(8 citation statements)

References 31 publications

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“…Volumetry and segmentation are useful to assess brain atrophy of MS patients and are usually established with software requiring a sequence with high contrast between gray and white matter such as 3D GRE T1-WI. 26 For this use, the MRI protocol should include precontrast 3D GRE T1-WI and contrast-enhanced 3D TSE T1-WI. To our knowledge, active MS lesions do not display a high T1 SI before contrast injection, thus a precontrast 3D TSE T1-WI sequence is not necessary.…”

Section: Discussionmentioning

confidence: 99%

Contrast-Enhanced 3D Spin Echo T1-Weighted Sequence Outperforms 3D Gradient Echo T1-Weighted Sequence for the Detection of Multiple Sclerosis Lesions on 3.0 T Brain MRI

et al. 2022

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BackgroundUsing reliable contrast-enhanced T1 sequences is crucial to detect enhancing brain lesions for multiple sclerosis (MS) at the time of diagnosis and over follow-up. Contrast-enhanced 3D gradient-recalled echo (GRE) T1-weighted imaging (WI) and 3D turbo spin echo (TSE) T1-WI are both available for clinical practice and have never been compared within the context of this diagnosis.PurposeThe aim of this study was to compare contrast-enhanced 3D GRE T1-WI and 3D TSE T1-WI for the detection of enhancing lesions in the brains of MS patients.MethodsThis single-center prospective study enrolled patients with MS who underwent a 3.0 T brain MRI from August 2017 to April 2021 for follow-up. Contrast-enhanced 3D GRE T1-WI and 3D TSE T1-WI were acquired in randomized order. Two independent radiologists blinded to all data reported all contrast-enhanced lesions in each sequence. Their readings were compared with a reference standard established by a third expert neuroradiologist. Interobserver agreement, contrast ratio, and contrast-to-noise ratio were calculated for both sequences.ResultsA total of 158 MS patients were included (mean age, 40 ± 11 years; 95 women). Significantly more patients had at least 1 contrast-enhanced lesion on 3D TSE T1-WI than on 3D GRE T1-WI for both readers (61/158 [38.6%] vs 48/158 [30.4%] and 60/158 [38.6%] vs 47/158 [29.7%], P < 0.001). Significantly more contrast-enhanced lesions per patient were detected on 3D TSE T1-WI (mean 2.47 vs 1.56 and 2.56 vs 1.39, respectively, P < 0.001). Interobserver agreement was excellent for both sequences, κ = 0.96 (confidence interval [CI], 0.91–1.00) for 3D TSE T1-WI and 0.92 (CI, 0.86–0.99) for 3D GRE T1-WI. Contrast ratio and contrast-to-noise ratio were significantly higher on 3D TSE T1-WI (0.84 vs 0.53, P < 0.001, and 87.9 vs 57.8, P = 0.03, respectively).ConclusionsAt 3.0 T, contrast-enhanced 3D TSE-T1-WI supports the detection of significantly more enhancing lesions than 3D GRE T1-WI and should therefore be used for MS patients requiring contrast-enhanced examination.

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Section: Discussionmentioning

confidence: 99%

Contrast-Enhanced 3D Spin Echo T1-Weighted Sequence Outperforms 3D Gradient Echo T1-Weighted Sequence for the Detection of Multiple Sclerosis Lesions on 3.0 T Brain MRI

et al. 2022

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“…Two recent studies found that NeuroQuant R and FreeSurfer showed fair to excellent reliability for all brain regions except the putamen (Yim et al, 2021) and pallidum (Yim et al, 2021;Heo et al, 2022).…”

Section: Reliability Of Neuroquant R and Neurogage Rmentioning

confidence: 99%

Updated Review of the Evidence Supporting the Medical and Legal Use of NeuroQuant® and NeuroGage® in Patients With Traumatic Brain Injury

Ross

Seabaugh

et al. 2022

Front. Hum. Neurosci.

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Over 40 years of research have shown that traumatic brain injury affects brain volume. However, technical and practical limitations made it difficult to detect brain volume abnormalities in patients suffering from chronic effects of mild or moderate traumatic brain injury. This situation improved in 2006 with the FDA clearance of NeuroQuant®, a commercially available, computer-automated software program for measuring MRI brain volume in human subjects. More recent strides were made with the introduction of NeuroGage®, commercially available software that is based on NeuroQuant® and extends its utility in several ways. Studies using these and similar methods have found that most patients with chronic mild or moderate traumatic brain injury have brain volume abnormalities, and several of these studies found—surprisingly—more abnormal enlargement than atrophy. More generally, 102 peer-reviewed studies have supported the reliability and validity of NeuroQuant® and NeuroGage®. Furthermore, this updated version of a previous review addresses whether NeuroQuant® and NeuroGage® meet the Daubert standard for admissibility in court. It concludes that NeuroQuant® and NeuroGage® meet the Daubert standard based on their reliability, validity, and objectivity. Due to the improvements in technology over the years, these brain volumetric techniques are practical and readily available for clinical or forensic use, and thus they are important tools for detecting signs of brain injury.

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“…Although the results of recent studies revealed good-to-excellent correlations between different volumetric software packages, significant differences were observed between the measured brain volumes. This underscores the need for careful attention during interpretation [3,7,[12][13][14].…”

Section: Introductionmentioning

confidence: 97%

“…These software packages automatically measure regional brain volumes or cortical thicknesses in a simpler and more intuitive manner over time [2,3]. With the increasing use of volumetric software, several studies have compared NeuroQuant ® (NQ) and FreeSurfer (FS) as representative products for brain volumetry [4][5][6][7]. NQ has several advantages over FS, such as shorter total processing time, user-friendly workflow, and direct interaction with the PACS server.…”

Section: Introductionmentioning

confidence: 99%

“…On the other hand, FS is freely available, adaptable, and commonly used in research settings as users can manually edit any errors detected in the automated region of interest (ROI) and perform additional volumetric analyses through further manual segmentation of the ROI [9]. In previous studies, significant differences have been observed in certain volume measurements between the two methods, as NQ provided larger volumes of brain regions than FS for large structures such as the intracranial volume, forebrain parenchyma, lateral ventricles, and cerebellum [4][5][6][7]9]. In real-world practice, automated brain volumetry improves diagnostic accuracy across various fields, such as clinical psychiatry and neurology, where diagnosis often relies on subjective self-reports and test results [10,11].…”

Section: Introductionmentioning

confidence: 99%

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Comparison of Inter-Method Agreement and Reliability for Automatic Brain Volumetry Using Three Different Clinically Available Software Packages

Choi,

Heo,

Baek

et al. 2024

Medicina

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Background and Objectives: No comparative study has evaluated the inter-method agreement and reliability between Heuron AD and other clinically available brain volumetric software packages. Hence, we aimed to investigate the inter-method agreement and reliability of three clinically available brain volumetric software packages: FreeSurfer (FS), NeuroQuant® (NQ), and Heuron AD (HAD). Materials and Methods: In this study, we retrospectively included 78 patients who underwent conventional three-dimensional (3D) T1-weighed imaging (T1WI) to evaluate their memory impairment, including 21 with normal objective cognitive function, 24 with mild cognitive impairment, and 33 with Alzheimer’s disease (AD). All 3D T1WI scans were analyzed using three different volumetric software packages. Repeated-measures analysis of variance, intraclass correlation coefficient, effect size measurements, and Bland–Altman analysis were used to evaluate the inter-method agreement and reliability. Results: The measured volumes demonstrated substantial to almost perfect agreement for most brain regions bilaterally, except for the bilateral globi pallidi. However, the volumes measured using the three software packages showed significant mean differences for most brain regions, with consistent systematic biases and wide limits of agreement in the Bland–Altman analyses. The pallidum showed the largest effect size in the comparisons between NQ and FS (5.20–6.93) and between NQ and HAD (2.01–6.17), while the cortical gray matter showed the largest effect size in the comparisons between FS and HAD (0.79–1.91). These differences and variations between the software packages were also observed in the subset analyses of 45 patients without AD and 33 patients with AD. Conclusions: Despite their favorable reliability, the software-based brain volume measurements showed significant differences and systematic biases in most regions. Thus, these volumetric measurements should be interpreted based on the type of volumetric software used, particularly for smaller structures. Moreover, users should consider the replaceability-related limitations when using these packages in real-world practice.

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Automated Brain Volumetry in Patients With Memory Impairment: Comparison of Conventional and Ultrafast 3D T1-Weighted MRI Sequences Using Two Software Packages

Cited by 8 publications

References 31 publications

Contrast-Enhanced 3D Spin Echo T1-Weighted Sequence Outperforms 3D Gradient Echo T1-Weighted Sequence for the Detection of Multiple Sclerosis Lesions on 3.0 T Brain MRI

Contrast-Enhanced 3D Spin Echo T1-Weighted Sequence Outperforms 3D Gradient Echo T1-Weighted Sequence for the Detection of Multiple Sclerosis Lesions on 3.0 T Brain MRI

Updated Review of the Evidence Supporting the Medical and Legal Use of NeuroQuant® and NeuroGage® in Patients With Traumatic Brain Injury

Comparison of Inter-Method Agreement and Reliability for Automatic Brain Volumetry Using Three Different Clinically Available Software Packages

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