On the computational assessment of white matter hyperintensity progression: difficulties in method selection and bias field correction performance on images with significant white matter pathology.

Introduction: Subtle inhomogeneities in the scanner's magnetic fields (B and B) alter the intensity levels of the structural magnetic resonance imaging (MRI) affecting the volumetric assessment of WMH changes. Here, we investigate the influence that (1) correcting the images for the B inhomogeneitie...

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Published in:Neuroradiology Vol. 58; no. 5; pp. 475 - 486
Main Authors: Valdés Hernández, Maria, González-Castro, Victor, Ghandour, Dina, Wang, Xin, Doubal, Fergus, Muñoz Maniega, Susana, Armitage, Paul, Wardlaw, Joanna
Format: diagnostic images research tables/charts Journal Article
Published: Springer Nature May2016
Online Access:View this record in EBSCOhost
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      pub: Springer Nature
      place: New York, New York
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        10.1007/s00234-016-1648-3
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        atl: On the computational assessment of white matter hyperintensity progression: difficulties in method selection and bias field correction performance on images with significant white matter pathology.
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          Valdés Hernández, Maria
          González-Castro, Victor
          Ghandour, Dina
          Wang, Xin
          Doubal, Fergus
          Muñoz Maniega, Susana
          Armitage, Paul
          Wardlaw, Joanna
        affil: Department of Neuroimaging Sciences, Centre for Clinical Brian Sciences, Chancellor's Building, 49 Little France Crescent Edinburgh EH16 4SB UK
      sug:
        subj:
          Magnetic Resonance Imaging
          Selection Bias
          Time
          Weights and Measures
          Magnetic Fields
      ab: Introduction: Subtle inhomogeneities in the scanner's magnetic fields (B and B) alter the intensity levels of the structural magnetic resonance imaging (MRI) affecting the volumetric assessment of WMH changes. Here, we investigate the influence that (1) correcting the images for the B inhomogeneities (i.e. bias field correction (BFC)) and (2) selection of the WMH change assessment method can have on longitudinal analyses of WMH progression and discuss possible solutions. Methods: We used brain structural MRI from 46 mild stroke patients scanned at stroke onset and 3 years later. We tested three BFC approaches: FSL-FAST, N4 and exponentially entropy-driven homomorphic unsharp masking (ED-HUM) and analysed their effect on the measured WMH change. Separately, we tested two methods to assess WMH changes: measuring WMH volumes independently at both time points semi-automatically (MCMxxxVI) and subtracting intensity-normalised FLAIR images at both time points following image gamma correction. We then combined the BFC with the computational method that performed best across the whole sample to assess WMH changes. Results: Analysis of the difference in the variance-to-mean intensity ratio in normal tissue between BFC and uncorrected images and visual inspection showed that all BFC methods altered the WMH appearance and distribution, but FSL-FAST in general performed more consistently across the sample and MRI modalities. The WMH volume change over 3 years obtained with MCMxxxVI with vs. without FSL-FAST BFC did not significantly differ (medians(IQR)(with BFC) = 3.2(6.3) vs. 2.9(7.4)ml (without BFC), p = 0.5), but both differed significantly from the WMH volume change obtained from subtracting post-processed FLAIR images (without BFC)(7.6(8.2)ml, p < 0.001). This latter method considerably inflated the WMH volume change as subtle WMH at baseline that became more intense at follow-up were counted as increase in the volumetric change. Conclusions: Measurement of WMH volume change remains challenging. Although the overall volumetric change was not significantly affected by the application of BFC, these methods distorted the image intensity distribution affecting subtle WMH. Subtracting the FLAIR images at both time points following gamma correction seems a promising technique but is adversely affected by subtle WMH. It is important to take into account not only the changes in volume but also in the signal intensity.
      pubtype: Academic Journal
      doctype:
        diagnostic images
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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