Volumetric brain analysis in neurosurgery: Part 1. Particle filter segmentation of brain and cerebrospinal fluid growth dynamics from MRI and CT images

Mandell, Jason G.; Langelaan, Jack W.; Webb, Andrew; Schiff, Steven J.

doi:10.3171/2014.9.peds12426

Cited by 36 publications

(45 citation statements)

References 25 publications

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“…Since our currently employed metrics-head circumference, cortical mantle thickness, and FOHR-all fail to estimate brain volume well, our findings argue for the incorporation of direct volumetric measurements in the evaluation of hydrocephalus outcomes. With further development of more automated volumetric methods, building upon the technology described in the companion study, 9 the incorporation of brain and fluid volumes will become more feasible in the clinical setting.…”

Section: Discussionmentioning

confidence: 99%

“…Normative growth curves of male and female brain and intra-brain fluid volumes for children and adolescents from 0 to 18 years of age, presented in the companion paper of this series, 9 were calculated using T2-weighted brain MRI data sets from the National Institutes of Health Pediatric MRI Data Repository provided by the Montreal Neurological Institute. 1,17 Brain and Fluid Volume analysis A particle filter image segmentation algorithm was used to calculate brain and fluid volumes for all images.…”

Section: Normal Controlsmentioning

confidence: 99%

“…1,17 Brain and Fluid Volume analysis A particle filter image segmentation algorithm was used to calculate brain and fluid volumes for all images. 9 The goal of this method was to develop an intelligent segmentation tool that could work with both MR and CT images and lead to a more fully automated tool suitable for the calculation of brain volumes in clinical practice. Briefly, this method starts with a pixel classification step to create probability maps of brain and fluid based upon image intensity for each slice.…”

Section: Normal Controlsmentioning

confidence: 99%

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Volumetric brain analysis in neurosurgery: Part 2. Brain and CSF volumes discriminate neurocognitive outcomes in hydrocephalus

Mandell

Kulkarni

Warf

et al. 2015

PED

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OBJECT The evaluation of hydrocephalus remains focused on ventricular size, yet the goal of treatment is to allow for healthy brain development. It is likely that brain volume is more related to cognitive development than is fluid volume in children with hydrocephalus. This study tests this hypothesis by comparing brain and fluid volumes with neurocognitive outcome in pediatric patients with hydrocephalus. METHODS Warf and colleagues previously acquired CT scans for pediatric patients in Uganda with myelomeningocele, measured frontal–occipital horn ratio (FOHR), and administered the modified Bayley Scales of Infant Development, third edition (BSID-III) to measure neurocognitive outcome that did not correlate with FOHR. In this present study, brain and fluid volumes were measured in 33 of these patients, 26 of whom required surgical treatment for hydrocephalus. Linear discrimination analysis (LDA) was used to test whether age-normalized brain and fluid volumes can discriminate neurocognitive outcome. RESULTS Hydrocephalic patients show normal to small brain volumes and substantially larger fluid volumes compared with normal values. FOHR correlates highly with fluid volume (r = 0.84, p < 0.001) and substantially less with brain volume (r = −0.37, p = 0.03), while brain and fluid volumes do not correlate with each other (p = 0.99). Brain and CSF volumes correlated best with fine motor (p = 0.03, p = 0.01), cognitive (p = 0.05, p = 0.09), and expressive communication (p = 0.08, p = 0.08) scores. A combination of these 3 scores was used as a multivariate measure of neurocognitive outcome. Brain volume alone, unlike fluid volume, could discriminate high from low cognitive outcome (by t-test and ANOVA). It was shown that a combination of age-normalized brain and fluid volumes can discriminate neurocognitive outcome by 2-way LDA (p < 0.01) and 3-way LDA (p < 0.01). The multivariate LDA demonstrated the contribution of large fluid volume to a decrement in cognition. CONCLUSIONS Hydrocephalus is treated by normalizing CSF, but normal brain development depends on brain growth. A combination of brain and CSF volumes appears to be significantly more powerful at predicting good versus poor neurocognitive outcomes in patients with hydrocephalus than either volume alone.

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Section: Discussionmentioning

confidence: 99%

Section: Normal Controlsmentioning

confidence: 99%

Section: Normal Controlsmentioning

confidence: 99%

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Volumetric brain analysis in neurosurgery: Part 2. Brain and CSF volumes discriminate neurocognitive outcomes in hydrocephalus

Mandell

Kulkarni

Warf

et al. 2015

PED

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“…1,37 Normative brain parenchymal volumes (including cerebral hemispheres, cerebellum, and brainstem) and intra-brain fluid volumes (including ventricular fluid and fluid contained within the boundary of the brain parenchyma) were calculated previously from 42 data sets from patients ranging from birth to 18 years of age. 19 In this present study, normative right and left temporal lobe volumes were further calculated using data sets from 3 males and 3 females at 6, 10, 14, and 18 years for a total of 24 additional data sets. Although this is the first database of normal developmental brain anatomy available, it is from a North American population, which may not reflect the population and environmental conditions of this East African population studied here.…”

Section: Normal Subjectsmentioning

confidence: 99%

“…In this third of the 3 companion papers, 18,19 we report the measurement of temporal lobe and total brain volumes in 10 pediatric patients treated with temporal lobe resection for TLE at the CURE Children's Hospital of Uganda (CCHU) and previously reported. 3 We then used linear discrimination analysis (LDA) to classify seizure outcome by temporal lobe volumes and normalized total brain volumes.…”

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Volumetric brain analysis in neurosurgery: Part 3. Volumetric CT analysis as a predictor of seizure outcome following temporal lobectomy

Mandell¹,

Hill

Nguyen³

et al. 2015

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OBJECT The incidence of temporal lobe epilepsy (TLE) due to mesial temporal sclerosis (MTS) can be high in developing countries. Current diagnosis of MTS relies on structural MRI, which is generally unavailable in developing world settings. Given widespread effects on temporal lobe structure beyond hippocampal atrophy in TLE, the authors propose that CT volumetric analysis can be used in patient selection to help predict outcomes following resection. METHODS Ten pediatric patients received preoperative CT scans and temporal resections at the CURE Children's Hospital of Uganda. Engel classification of seizure control was determined 12 months postoperatively. Temporal lobe volumes were measured from CT and from normative MR images using the Cavalieri method. Whole brain and fluid volumes were measured using particle filter segmentation. Linear discrimination analysis (LDA) was used to classify seizure outcome by temporal lobe volumes and normalized brain volume. RESULTS Epilepsy patients showed normal to small brain volumes and small temporal lobes bilaterally. A multivariate measure of the volume of each temporal lobe separated patients who were seizure free (Engel Class IA) from those with incomplete seizure control (Engel Class IB/IIB) with LDA (p < 0.01). Temporal lobe volumes also separate normal subjects, patients with Engel Class IA outcomes, and patients with Class IB/IIB outcomes (p < 0.01). Additionally, the authors demonstrated that age-normalized whole brain volume, in combination with temporal lobe volumes, may further improve outcome prediction (p < 0.01). CONCLUSIONS This study shows strong evidence that temporal lobe and brain volume can be predictive of seizure outcome following temporal lobe resection, and that volumetric CT analysis of the temporal lobe may be feasible in lieu of structural MRI when the latter is unavailable. Furthermore, since the authors' methods are modality independent, these findings suggest that temporal lobe and normative brain volumes may further be useful in the selection of patients for temporal lobe resection when structural MRI is available.

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Fully automated measurement of intracranial CSF and brain parenchyma volumes in pediatric hydrocephalus by segmentation of clinical MRI studies

et al. 2023

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BackgroundBrain parenchyma (BP) and intracranial cerebrospinal fluid (iCSF) volumes measured by fully automated segmentation of clinical brain MRI studies may be useful for the diagnosis and follow‐up of pediatric hydrocephalus. However, previously published segmentation techniques either rely on dedicated sequences, not routinely used in clinical practice, or on spatial normalization, which has limited accuracy when severe brain distortions, such as in hydrocephalic patients, are present.PurposeWe developed a fully automated method to measure BP and iCSF volumes from clinical brain MRI studies of pediatric hydrocephalus patients, exploiting the complementary information contained in T2‐ and T1‐weighted images commonly used in clinical practice.MethodsThe proposed procedure, following skull‐stripping of the combined volumes, performed using a multiparametric method to obtain a reliable definition of the inner skull profile, maximizes the CSF‐to‐parenchyma contrast by dividing the T2w‐ by the T1w‐ volume after full‐scale dynamic rescaling, thus allowing separation of iCSF and BP through a simple thresholding routine.ResultsValidation against manual tracing on 23 studies (four controls and 19 hydrocephalic patients) showed excellent concordance (ICC > 0.98) and spatial overlap (Dice coefficients ranging from 77.2% for iCSF to 96.8% for intracranial volume). Accuracy was comparable to the intra‐operator reproducibility of manual segmentation, as measured in 14 studies processed twice by the same experienced neuroradiologist. Results of the application of the algorithm to a dataset of 63 controls and 57 hydrocephalic patients (19 with parenchymal damage), measuring volumes’ changes with normal development and in hydrocephalic patients, are also reported for demonstration purposes.ConclusionsThe proposed approach allows fully automated segmentation of BP and iCSF in clinical studies, also in severely distorted brains, enabling to assess age‐ and disease‐related changes in intracranial tissue volume with an accuracy comparable to expert manual segmentation.

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Volumetric brain analysis in neurosurgery: Part 1. Particle filter segmentation of brain and cerebrospinal fluid growth dynamics from MRI and CT images

Cited by 36 publications

References 25 publications

Volumetric brain analysis in neurosurgery: Part 2. Brain and CSF volumes discriminate neurocognitive outcomes in hydrocephalus

Volumetric brain analysis in neurosurgery: Part 2. Brain and CSF volumes discriminate neurocognitive outcomes in hydrocephalus

Volumetric brain analysis in neurosurgery: Part 3. Volumetric CT analysis as a predictor of seizure outcome following temporal lobectomy

Fully automated measurement of intracranial CSF and brain parenchyma volumes in pediatric hydrocephalus by segmentation of clinical MRI studies

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