Establishing pathological cut-offs for lateral ventricular volume expansion rates
Background: A percent brain volume change (PBVC) cut-off of −0.4% per year has been proposed to distinguish between pathological and physiological changes in multiple sclerosis (MS). Unfortunately, standardized PBVC measurement is not always feasible on scans acquired outside research studies or aca...
| Main Authors: | , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2018-01-01
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| Series: | NeuroImage: Clinical |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2213158218300433 |
| _version_ | 1818838416827088896 |
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| author | Michael G. Dwyer Jesper Hagemeier Niels Bergsland Dana Horakova Jonathan R. Korn Nasreen Khan Tomas Uher Jennie Medin Diego Silva Manuela Vaneckova Eva Kubala Havrdova Robert Zivadinov |
| author_facet | Michael G. Dwyer Jesper Hagemeier Niels Bergsland Dana Horakova Jonathan R. Korn Nasreen Khan Tomas Uher Jennie Medin Diego Silva Manuela Vaneckova Eva Kubala Havrdova Robert Zivadinov |
| author_sort | Michael G. Dwyer |
| collection | DOAJ |
| description | Background: A percent brain volume change (PBVC) cut-off of −0.4% per year has been proposed to distinguish between pathological and physiological changes in multiple sclerosis (MS). Unfortunately, standardized PBVC measurement is not always feasible on scans acquired outside research studies or academic centers. Percent lateral ventricular volume change (PLVVC) is a strong surrogate measure of PBVC, and may be more feasible for atrophy assessment on real-world scans. However, the PLVVC rate corresponding to the established PBVC cut-off of −0.4% is unknown. Objective: To establish a pathological PLVVC expansion rate cut-off analogous to −0.4% PBVC. Methods: We used three complementary approaches. First, the original follow-up-length-weighted receiver operating characteristic (ROC) analysis method establishing whole brain atrophy rates was adapted to a longitudinal ventricular atrophy dataset of 177 relapsing-remitting MS (RRMS) patients and 48 healthy controls. Second, in the same dataset, SIENA PBVCs were used with non-linear regression to directly predict the PLVVC value corresponding to −0.4% PBVC. Third, in an unstandardized, real world dataset of 590 RRMS patients from 33 centers, the cut-off maximizing correspondence to PBVC was found. Finally, correspondences to clinical outcomes were evaluated in both datasets. Results: ROC analysis suggested a cut-off of 3.09% (AUC = 0.83, p < 0.001). Non-linear regression R2 was 0.71 (p < 0.001) and a − 0.4% PBVC corresponded to a PLVVC of 3.51%. A peak in accuracy in the real-world dataset was found at a 3.51% PLVVC cut-off. Accuracy of a 3.5% cut-off in predicting clinical progression was 0.62 (compared to 0.68 for PBVC). Conclusions: Ventricular expansion of between 3.09% and 3.51% on T2-FLAIR corresponds to the pathological whole brain atrophy rate of 0.4% for RRMS. A conservative cut-off of 3.5% performs comparably to PBVC for clinical outcomes. Keywords: Brain atrophy, Ventricular volume, Pathological cutoff, Multiple sclerosis, NEDA |
| first_indexed | 2024-12-19T03:38:03Z |
| format | Article |
| id | doaj.art-043a9280fcbf40a292d1e4263123cb93 |
| institution | Directory Open Access Journal |
| issn | 2213-1582 |
| language | English |
| last_indexed | 2024-12-19T03:38:03Z |
| publishDate | 2018-01-01 |
| publisher | Elsevier |
| record_format | Article |
| series | NeuroImage: Clinical |
| spelling | doaj.art-043a9280fcbf40a292d1e4263123cb932022-12-21T20:37:19ZengElsevierNeuroImage: Clinical2213-15822018-01-0118494501Establishing pathological cut-offs for lateral ventricular volume expansion ratesMichael G. Dwyer0Jesper Hagemeier1Niels Bergsland2Dana Horakova3Jonathan R. Korn4Nasreen Khan5Tomas Uher6Jennie Medin7Diego Silva8Manuela Vaneckova9Eva Kubala Havrdova10Robert Zivadinov11Buffalo Neuroimaging Analysis Center, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, NY, USA; Corresponding author at: Buffalo Neuroimaging Analysis Center, University at Buffalo, State University of New York, 100 High Street, Buffalo, NY 14203, USA.Buffalo Neuroimaging Analysis Center, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, NY, USABuffalo Neuroimaging Analysis Center, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, NY, USADepartment of Neurology and Center of Clinical Neuroscience, First Faculty of Medicine, Charles University and General University Hospital in Prague, Czech RepublicQuintilesIMS, Burlington, MA, USAQuintilesIMS, Basel, SwitzerlandDepartment of Neurology and Center of Clinical Neuroscience, First Faculty of Medicine, Charles University and General University Hospital in Prague, Czech RepublicNovartis Pharmaceuticals AG, Basel, SwitzerlandNovartis Pharmaceuticals AG, Basel, SwitzerlandDepartment of Radiology, First Faculty of Medicine, Charles University and General University Hospital, Prague, Czech RepublicDepartment of Neurology and Center of Clinical Neuroscience, First Faculty of Medicine, Charles University and General University Hospital in Prague, Czech RepublicBuffalo Neuroimaging Analysis Center, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, NY, USA; Translational Imaging Center at Clinical and Translational Science Institute, University at Buffalo, State University of New York, Buffalo, NY, USABackground: A percent brain volume change (PBVC) cut-off of −0.4% per year has been proposed to distinguish between pathological and physiological changes in multiple sclerosis (MS). Unfortunately, standardized PBVC measurement is not always feasible on scans acquired outside research studies or academic centers. Percent lateral ventricular volume change (PLVVC) is a strong surrogate measure of PBVC, and may be more feasible for atrophy assessment on real-world scans. However, the PLVVC rate corresponding to the established PBVC cut-off of −0.4% is unknown. Objective: To establish a pathological PLVVC expansion rate cut-off analogous to −0.4% PBVC. Methods: We used three complementary approaches. First, the original follow-up-length-weighted receiver operating characteristic (ROC) analysis method establishing whole brain atrophy rates was adapted to a longitudinal ventricular atrophy dataset of 177 relapsing-remitting MS (RRMS) patients and 48 healthy controls. Second, in the same dataset, SIENA PBVCs were used with non-linear regression to directly predict the PLVVC value corresponding to −0.4% PBVC. Third, in an unstandardized, real world dataset of 590 RRMS patients from 33 centers, the cut-off maximizing correspondence to PBVC was found. Finally, correspondences to clinical outcomes were evaluated in both datasets. Results: ROC analysis suggested a cut-off of 3.09% (AUC = 0.83, p < 0.001). Non-linear regression R2 was 0.71 (p < 0.001) and a − 0.4% PBVC corresponded to a PLVVC of 3.51%. A peak in accuracy in the real-world dataset was found at a 3.51% PLVVC cut-off. Accuracy of a 3.5% cut-off in predicting clinical progression was 0.62 (compared to 0.68 for PBVC). Conclusions: Ventricular expansion of between 3.09% and 3.51% on T2-FLAIR corresponds to the pathological whole brain atrophy rate of 0.4% for RRMS. A conservative cut-off of 3.5% performs comparably to PBVC for clinical outcomes. Keywords: Brain atrophy, Ventricular volume, Pathological cutoff, Multiple sclerosis, NEDAhttp://www.sciencedirect.com/science/article/pii/S2213158218300433 |
| spellingShingle | Michael G. Dwyer Jesper Hagemeier Niels Bergsland Dana Horakova Jonathan R. Korn Nasreen Khan Tomas Uher Jennie Medin Diego Silva Manuela Vaneckova Eva Kubala Havrdova Robert Zivadinov Establishing pathological cut-offs for lateral ventricular volume expansion rates NeuroImage: Clinical |
| title | Establishing pathological cut-offs for lateral ventricular volume expansion rates |
| title_full | Establishing pathological cut-offs for lateral ventricular volume expansion rates |
| title_fullStr | Establishing pathological cut-offs for lateral ventricular volume expansion rates |
| title_full_unstemmed | Establishing pathological cut-offs for lateral ventricular volume expansion rates |
| title_short | Establishing pathological cut-offs for lateral ventricular volume expansion rates |
| title_sort | establishing pathological cut offs for lateral ventricular volume expansion rates |
| url | http://www.sciencedirect.com/science/article/pii/S2213158218300433 |
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