Automated vs manual delineations of regions of interest- a comparison in commercially available perfusion MRI software

BMC Medical Imaging

Jochen B Fiebach¹  Peter Brunecker¹  Benjamin Hotter¹  Helena Bros¹  Carina Soemmer²  Ann-Christin Ostwaldt³  Ivana Galinovic¹ 

[1] Center for Stroke Research Berlin, Charité-Universitätsmedizin Berlin, Campus Benjamin Franklin, Hindenburgdamm 30, 12200, Berlin, Germany;Charité-Universitätsmedizin, Berlin, Charitéplatz 1, 10117, Berlin, Germany;International Graduate Program Medical Neurosciences, Charite-Universitätsmedizin, Berlin, Luisenstrasse 56, 10117, Berlin, Germany

关键词: Acute ischemic stroke;    Perfusion MRI;    Magnetic resonance imaging;   

Others  :  1092094
DOI  :  10.1186/1471-2342-12-16

 received in 2011-08-24, accepted in 2012-05-21,  发布年份 2012

【 摘 要 】

Background

In perfusion magnetic resonance imaging a manual approach to delineation of regions of interest is, due to rater bias and time intensive operator input, clinically less favorable than an automated approach would be. The goal of our study was to compare the performances of these approaches.

Methods

Using Stroketool, PMA and Perfscape/Neuroscape perfusion maps of cerebral blood flow, mean transit time and Tmax were created for 145 patients with acute ischemic stroke. Volumes of hypoperfused tissue were calculated using both a manual and an automated protocol, and the results compared between methods.

Results

The median difference between the automatically and manually derived volumes was up to 210 ml in Perfscape/Neuroscape, 123 ml in PMA and 135 ml in Stroketool. Correlation coefficients between perfusion volumes and radiological and clinical outcome were much lower for the automatic volumes than for the manually derived ones.

Conclusions

The agreement of the two methods was very poor, with the automated use producing falsely exaggerated volumes of hypoperfused tissue. Software improvements are necessary to enable highly automated protocols to credibly assess perfusion deficits.

【 授权许可】

   
2012 Galinovic et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

【 参考文献 】

• [1]Hacke W, Albers G, Al-Rawi Y, Bogousslavsky J, Davalos A, Eliasziw M, et al.: The Desmoteplase in Acute Ischemic Stroke Trial (DIAS): a phase II MRI-based 9-hour window acute stroke thrombolysis trial with intravenous desmoteplase. Stroke 2005, 36:66-73.
• [2]Kohrmann M, Juttler E, Fiebach JB, Huttner HB, Siebert S, Schwark C, et al.: MRI versus CT-based thrombolysis treatment within and beyond the 3 h time window after stroke onset: a cohort study. Lancet Neurol 2006, 5:661-667.
• [3]Galinovic I, Ostwaldt AC, Soemmer C, Bros H, Hotter B, Brunecker P, et al.: Search for a map and threshold in perfusion MRI to accurately predict tissue fate: a protocol for assessing lesion growth in patients with a persistent vessel occlusion. Cerebrovasc Dis 2011, 32:186-193.
• [4]Olivot JM, Mlynash M, Thijs VN, Kemp S, Lansberg MG, Wechsler L, et al.: Optimal Tmax threshold for predicting penumbral tissue in acute stroke. Stroke 2009, 40:469-475.
• [5]Kosior RK, Kosior JC, Frayne R: Improved dynamic susceptibility contrast (DSC)-MR perfusion estimates by motion correction. J Magn Reson Imaging 2007, 26:1167-72.
• [6]Kim J, Leirab EC, Callison RC, Ludwiga B, Moritani T, Magnotta VA, Madsen MT: Toward fully automated processing of dynamic susceptibility contrast perfusion MRI for acute ischemic cerebral stroke. Comput Methods Programs Biomed 2010, 98:204-213.
• [7]Yamada K, Wu O, Gonzalez RG, Bakker D, Copen WA, Weisskoff RM, Rosen BR, Yagi K, Nishimura T, Sorensen AG: Magnetic resonance perfusion-weighted imaging of acute cerebral infarction: effect of the calculation methods and underlying vasculopathy. Stroke 2002, 33(1):87-94.
• [8]Galinovic I, Brunecker P, Ostwaldt AC, Soemmer C, Hotter B, Fiebach JB: Fully automated postprocessing carries a risk of substantial overestimation of perfusion deficits in acute stroke magnetic resonance imaging. Cerebrovasc Dis 2011, 31:408-413.