Quantification of Cervical Cord Cross-Sectional Area: Which Acquisition, Vertebra Level, and Analysis Software? A Multicenter Repeatability Study on a Traveling Healthy Volunteer

Frontiers in Neurology

Claudia A. M. Gandini Wheeler-Kingshott¹  Maria A. Rocca⁵  Massimo Filippi⁷  Marios Yiannakas⁸  Jaume Sastre-Garriga^1,10  Iman Brouwer^1,11  Hugo Vrenken^1,11  Carsten Lukas^1,12  Barbara Bellenberg^1,12  Paola Valsasina^1,13  Katrin Parmar^1,14  Ludwig Kappos^1,14  Frederik Barkhof^1,15  Àlex Rovira^1,16  Deborah Pareto^1,16  Ferran Prados^1,17 

[1] Behavioral Sciences, University of Pavia, Pavia, Italy;;0Department of Brain &1Brain Connectivity Center, IRCCS Mondino Foundation, Pavia, Italy;2Department of Biomedical Engineering, University of Basel, Allschwig, Switzerland;3Neurology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy;4Vita-Salute San Raffaele University, Milan, Italy;5Neurorehabilitation Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy;6Neurophysiology Service, IRCCS San Raffaele Scientific Institute, Milan, Italy;Department of Medical Physics and Biomedical Engineering, Centre for Medical Image Computing (CMIC), University College London, London, United Kingdom;Department of Neurology–Neuroimmunology, Multiple Sclerosis Center of Catalonia (Cemcat), Hospital Universitari Vall d'Hebron, Barcelona, Spain;Department of Radiology and Nuclear Medicine, Multiple Sclerosis Center Amsterdam, Amsterdam Neuroscience Amsterdam University Medical Centers (UMC), Vrije Universiteit Medical Center (VUmc), Amsterdam, Netherlands;Institute of Neuroradiology, St. Josef Hospital, Ruhr-University Bochum, Bochum, Germany;Neuroimaging Research Unit, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy;Neurological Clinic and Policlinic, Department of Medicine, University Hospital Basel, Basel, Switzerland;Queen Square Multiple Sclerosis Centre, UCL Queen Square Institute of Neurology, University College London, London, United Kingdom;Section of Neuroradiology, Department of Radiology, Hospital Universitari Vall d'Hebron, Barcelona, Spain;e-Health Centre, Universitat Oberta de Catalunya, Barcelona, Spain;

关键词: spinal cord;    cervical cord;    atrophy;    cross-sectional area;    CSA;    MRI;   

DOI  :  10.3389/fneur.2021.693333

来源: DOAJ

【 摘 要 】

Background: Considerable spinal cord (SC) atrophy occurs in multiple sclerosis (MS). While MRI-based techniques for SC cross-sectional area (CSA) quantification have improved over time, there is no common agreement on whether to measure at single vertebral levels or across larger regions and whether upper SC CSA can be reliably measured from brain images.Aim: To compare in a multicenter setting three CSA measurement methods in terms of repeatability at different anatomical levels. To analyze the agreement between measurements performed on the cervical cord and on brain MRI.Method: One healthy volunteer was scanned three times on the same day in six sites (three scanner vendors) using a 3T MRI protocol including sagittal 3D T1-weighted imaging of the brain (covering the upper cervical cord) and of the SC. Images were analyzed using two semiautomated methods [NeuroQLab (NQL) and the Active Surface Model (ASM)] and the fully automated Spinal Cord Toolbox (SCT) on different vertebral levels (C1–C2; C2/3) on SC and brain images and the entire cervical cord (C1–C7) on SC images only.Results: CSA estimates were significantly smaller using SCT compared to NQL and ASM (p < 0.001), regardless of the cord level. Inter-scanner repeatability was best in C1–C7: coefficients of variation for NQL, ASM, and SCT: 0.4, 0.6, and 1.0%, respectively. CSAs estimated in brain MRI were slightly lower than in SC MRI (all p ≤ 0.006 at the C1–C2 level). Despite protocol harmonization between the centers with regard to image resolution and use of high-contrast 3D T1-weighted sequences, the variability of CSA was partly scanner dependent probably due to differences in scanner geometry, coil design, and details of the MRI parameter settings.Conclusion: For CSA quantification, dedicated isotropic SC MRI should be acquired, which yielded best repeatability in the entire cervical cord. In the upper part of the cervical cord, use of brain MRI scans entailed only a minor loss of CSA repeatability compared to SC MRI. Due to systematic differences between scanners and the CSA quantification software, both should be kept constant within a study. The MRI dataset of this study is available publicly to test new analysis approaches.

【 授权许可】

Unknown