Interscanner variation in brain MRI lesion load measurements in MS: Implications for clinical trials

被引:73
作者
Filippi, M
vanWaesberghe, JH
Horsfield, MA
Bressi, S
Gasperini, C
Yousry, TA
GawneCain, ML
Morrissey, SP
Rocca, MA
Barkhof, F
Nijeholt, GJLA
Bastianello, S
Miller, DH
机构
[1] FREE UNIV AMSTERDAM HOSP,DEPT DIAGNOST RADIOL,DUTCH MS MR CTR,NL-1007 MB AMSTERDAM,NETHERLANDS
[2] UNIV LEICESTER,DIV MED PHYS,LEICESTER,LEICS,ENGLAND
[3] UNIV ROMA LA SAPIENZA,DEPT NEUROL,ROME,ITALY
[4] UNIV ROMA LA SAPIENZA,DEPT NEURORADIOL,ROME,ITALY
[5] UNIV MUNICH,KLINIKUM GROSSHADERN,DEPT NEURORADIOL,D-8000 MUNICH,GERMANY
[6] UNIV LONDON,INST NEUROL,NMR RES UNIT,LONDON,ENGLAND
[7] UNIV WURZBURG,DEPT NEUROL,D-8700 WURZBURG,GERMANY
关键词
D O I
10.1212/WNL.49.2.371
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
We evaluated the effect of interscanner variation on brain MRI-measured lesion volumes and measurement reproducibility in MS. Twenty clinically definite MS patients were each scanned on two or three scanners (a total of 14 scanners were used). In addition, a formalin-fixed MS brain was studied on eight scanners from different manufacturers and with different field strengths. For the formalin-fixed MS brain, on each machine we obtained two scans with slice thicknesses of 5 and 3 mm. Only 5-mm-thick slices were obtained from patients. The lesion volume present on each scan was evaluated three times by a single observer in random order, using a local thresholding technique. In two groups of eight patients scanned on machines with different field strengths, the mean lesion volumes present on scans obtained at 1.5 T were significantly higher than those measured on scans obtained with machines operating at 0.5 and 1.0 T (p < 0.01). When a single observer repeatedly evaluated the same scan, a median intraobserver agreement of 98.7% (95% CI, 97.9 to 99.1) was achieved. However, when the observer evaluated the scans from different MRI scanners, the agreement (an interscanner agreement) fell to 91.1% (CI, 90.2 to 94.1). When only scanners operating at 1.5 T were considered, the median interscanner agreement was 96.7% (CI, 95 to 97.5). Also, for the formalin-fixed MS brain, the intraobserver agreements obtained with both slice thicknesses were significantly higher than the corresponding interscanner agreements. The interscanner agreement, but not the intraobserver agreement, obtained with a slice thickness of 3 mm was higher than that obtained with a slice thickness of 5 mm. Our results indicate that lesion volume measurements in MS are influenced significantly by the use of different MR scanners and that a patient included in a serial study should be always scanned with the same MR machine using 3-mm thick slices.
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收藏
页码:371 / 377
页数:7
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