Longitudinal spinal cord atrophy in multiple sclerosis using the generalized boundary shift integral
OBJECTIVE:Spinal cord atrophy is a clinically relevant feature of multiple sclerosis (MS), but longitudinal assessments on magnetic resonance imaging using segmentation-based methods suffer from measurement variability, especially in multicenter studies. We compared the generalized boundary shift in...
| Những tác giả chính: | , , , , , , , , , , , , , , , , , |
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| Định dạng: | Journal article |
| Ngôn ngữ: | English |
| Được phát hành: |
Wiley
2019
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| _version_ | 1826287965293248512 |
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| author | Moccia, M Prados, F Filippi, M Rocca, M Valsasina, P Brownlee, W Zecca, C Gallo, A Rovira, A Gass, A Palace, J Lukas, C Vrenken, H Ourselin, S Gandini Wheeler-Kingshott, C Ciccarelli, O Barkhof, F Magnims Study Group |
| author_facet | Moccia, M Prados, F Filippi, M Rocca, M Valsasina, P Brownlee, W Zecca, C Gallo, A Rovira, A Gass, A Palace, J Lukas, C Vrenken, H Ourselin, S Gandini Wheeler-Kingshott, C Ciccarelli, O Barkhof, F Magnims Study Group |
| author_sort | Moccia, M |
| collection | OXFORD |
| description | OBJECTIVE:Spinal cord atrophy is a clinically relevant feature of multiple sclerosis (MS), but longitudinal assessments on magnetic resonance imaging using segmentation-based methods suffer from measurement variability, especially in multicenter studies. We compared the generalized boundary shift integral (GBSI), a registration-based method, with a standard segmentation-based method. METHODS:Baseline and 1-year spinal cord 3-dimensional T1-weighted images (1mm isotropic) were obtained from 282 patients (52 clinically isolated syndrome [CIS], 196 relapsing-remitting MS [RRMS], 34 progressive MS [PMS]), and 82 controls from 8 MAGNIMS (Magnetic Resonance Imaging in Multiple Sclerosis) sites on multimanufacturer and multi-field-strength scans. Spinal Cord Toolbox was used for C2-5 segmentation and cross-sectional area (CSA) calculation. After cord straightening and registration, GBSI measured atrophy based on the probabilistic boundary-shift region of interest. CSA and GBSI percentage annual volume change was calculated. RESULTS:GBSI provided similar rates of atrophy, but reduced measurement variability compared to CSA in all MS subtypes (CIS: -0.95 ± 2.11% vs -1.19 ± 3.67%; RRMS: -1.74 ± 2.57% vs -1.74 ± 4.02%; PMS: -2.29 ± 2.40% vs -1.29 ± 3.20%) and healthy controls (0.02 ± 2.39% vs -0.56 ± 3.77%). GBSI performed better than CSA in differentiating healthy controls from CIS (area under the curve [AUC] = 0.66 vs 0.53; p = 0.03), RRMS (AUC = 0.73 vs 0.59; p < 0.001), PMS (AUC = 0.77 vs 0.53; p < 0.001), and patients with disability progression from patients without progression (AUC = 0.59 vs 0.50; p = 0.04). Sample size to detect 60% treatment effect on spinal cord atrophy over 1 year was lower for GBSI than CSA (CIS: 106 vs 830; RRMS: 95 vs 335; PMS: 44 vs 215; power = 80%; alpha = 5%). INTERPRETATION:The registration-based method (GBSI) allowed better separation between MS patients and healthy controls and improved statistical power, when compared with a conventional segmentation-based method (CSA), although it is still far from perfect. |
| first_indexed | 2024-03-07T02:06:35Z |
| format | Journal article |
| id | oxford-uuid:9f367429-58c2-4871-beb2-9236c04dc62c |
| institution | University of Oxford |
| language | English |
| last_indexed | 2024-03-07T02:06:35Z |
| publishDate | 2019 |
| publisher | Wiley |
| record_format | dspace |
| spelling | oxford-uuid:9f367429-58c2-4871-beb2-9236c04dc62c2022-03-27T00:55:49ZLongitudinal spinal cord atrophy in multiple sclerosis using the generalized boundary shift integralJournal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:9f367429-58c2-4871-beb2-9236c04dc62cEnglishSymplectic Elements at OxfordWiley2019Moccia, MPrados, FFilippi, MRocca, MValsasina, PBrownlee, WZecca, CGallo, ARovira, AGass, APalace, JLukas, CVrenken, HOurselin, SGandini Wheeler-Kingshott, CCiccarelli, OBarkhof, FMagnims Study GroupOBJECTIVE:Spinal cord atrophy is a clinically relevant feature of multiple sclerosis (MS), but longitudinal assessments on magnetic resonance imaging using segmentation-based methods suffer from measurement variability, especially in multicenter studies. We compared the generalized boundary shift integral (GBSI), a registration-based method, with a standard segmentation-based method. METHODS:Baseline and 1-year spinal cord 3-dimensional T1-weighted images (1mm isotropic) were obtained from 282 patients (52 clinically isolated syndrome [CIS], 196 relapsing-remitting MS [RRMS], 34 progressive MS [PMS]), and 82 controls from 8 MAGNIMS (Magnetic Resonance Imaging in Multiple Sclerosis) sites on multimanufacturer and multi-field-strength scans. Spinal Cord Toolbox was used for C2-5 segmentation and cross-sectional area (CSA) calculation. After cord straightening and registration, GBSI measured atrophy based on the probabilistic boundary-shift region of interest. CSA and GBSI percentage annual volume change was calculated. RESULTS:GBSI provided similar rates of atrophy, but reduced measurement variability compared to CSA in all MS subtypes (CIS: -0.95 ± 2.11% vs -1.19 ± 3.67%; RRMS: -1.74 ± 2.57% vs -1.74 ± 4.02%; PMS: -2.29 ± 2.40% vs -1.29 ± 3.20%) and healthy controls (0.02 ± 2.39% vs -0.56 ± 3.77%). GBSI performed better than CSA in differentiating healthy controls from CIS (area under the curve [AUC] = 0.66 vs 0.53; p = 0.03), RRMS (AUC = 0.73 vs 0.59; p < 0.001), PMS (AUC = 0.77 vs 0.53; p < 0.001), and patients with disability progression from patients without progression (AUC = 0.59 vs 0.50; p = 0.04). Sample size to detect 60% treatment effect on spinal cord atrophy over 1 year was lower for GBSI than CSA (CIS: 106 vs 830; RRMS: 95 vs 335; PMS: 44 vs 215; power = 80%; alpha = 5%). INTERPRETATION:The registration-based method (GBSI) allowed better separation between MS patients and healthy controls and improved statistical power, when compared with a conventional segmentation-based method (CSA), although it is still far from perfect. |
| spellingShingle | Moccia, M Prados, F Filippi, M Rocca, M Valsasina, P Brownlee, W Zecca, C Gallo, A Rovira, A Gass, A Palace, J Lukas, C Vrenken, H Ourselin, S Gandini Wheeler-Kingshott, C Ciccarelli, O Barkhof, F Magnims Study Group Longitudinal spinal cord atrophy in multiple sclerosis using the generalized boundary shift integral |
| title | Longitudinal spinal cord atrophy in multiple sclerosis using the generalized boundary shift integral |
| title_full | Longitudinal spinal cord atrophy in multiple sclerosis using the generalized boundary shift integral |
| title_fullStr | Longitudinal spinal cord atrophy in multiple sclerosis using the generalized boundary shift integral |
| title_full_unstemmed | Longitudinal spinal cord atrophy in multiple sclerosis using the generalized boundary shift integral |
| title_short | Longitudinal spinal cord atrophy in multiple sclerosis using the generalized boundary shift integral |
| title_sort | longitudinal spinal cord atrophy in multiple sclerosis using the generalized boundary shift integral |
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