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      Whole Brain Volume Measured from 1.5T versus 3T MRI in Healthy Subjects and Patients with Multiple Sclerosis

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          ABSTRACT

          BACKGROUND

          Whole brain atrophy is a putative outcome measure in monitoring relapsing‐remitting multiple sclerosis (RRMS). With the ongoing MRI transformation from 1.5T to 3T, there is an unmet need to calibrate this change. We evaluated brain parenchymal volumes (BPVs) from 1.5T versus 3T in MS and normal controls (NC).

          METHODS

          We studied MS [ n = 26, age (mean, range) 43 (21‐55), 22 (85%) RRMS, Expanded Disability Status Scale (EDSS) 1.98 (0‐6.5), timed 25 foot walk (T25FW) 5.95 (3.2‐33.0 seconds)] and NC [ n = 9, age 45 (31‐53)]. Subjects underwent 1.5T (Phillips) and 3T (GE) 3‐dimensional T1‐weighted scans to derive normalized BPV from an automated SIENAX pipeline. Neuropsychological testing was according to consensus panel recommendations.

          RESULTS

          BPV‐1.5T was higher than BPV‐3T [mean (95% CI) + 45.7 mL (+35.3, +56.1), P < .00001], most likely due to improved tissue‐CSF contrast at 3T. BPV‐3T showed a larger volume decrease and larger effect size in detecting brain atrophy in MS versus NC [−74.5 mL (−126.5, −22.5), P = .006, d = .92] when compared to BPV‐1.5T [−51.3.1 mL (−99.8, −2.8), P = .04, d = .67]. Correlations between BPV‐1.5T and EDSS ( r = −.43, P = .027) and BPV‐3T and EDSS ( r = −.49, P = .011) and between BPV‐1.5T and T25FW ( r = −.46, P = .018) and BPV‐3T and T25FW ( r = −.56, P = .003) slightly favored 3T. BPV‐cognition correlations were significant ( P < .05) for 6 of 11 subscales to a similar degree at 1.5T ( r range = .44‐.58) and 3T ( r range = .43‐.53).

          CONCLUSIONS

          Field strength may impact whole brain volume measurements in patients with MS though the differences are not too divergent between 1.5T and 3T.

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          Most cited references18

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          The Multiple Sclerosis Functional Composite Measure (MSFC): an integrated approach to MS clinical outcome assessment. National MS Society Clinical Outcomes Assessment Task Force.

          Clinical outcome assessment in Multiple Sclerosis (MS) is challenging due to the diversity and fluctuating nature of MS symptoms. Traditional clinical scales such as the EDSS are inadequate in their assessment of key clinical dimensions of MS (e.g. , cognitive function), and they have psychometric limitations as well. Based on analyses of pooled data from natural history studies and from placebo groups in clinical trials, the National MS Society's Clinical Outcomes Assessment Task Force recently proposed a new multidimensional clinical outcome measure, the MS Functional Composite (MSFC). The MSFC comprises quantitative functional measures of three key clinical dimensions of MS: leg function/ambulation, arm/hand function, and cognitive function. Scores on component measures are converted to standard scores (z-scores), which are averaged to form a single MSFC score. Preliminary analyses confirm that: (1) the three clinical dimensions of the MSFC are relatively independent; (2) the MSFC is sensitive to clinical changes over 1- and 2-year intervals; and (3) the MSFC has acceptable criterion validity (i.e., predicts both concurrent and subsequent EDSS change). The advantages and potential limitations of incorporating quantitative functional outcome measures such as the MSFC into collaborative databases are discussed.
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            Minimal neuropsychological assessment of MS patients: a consensus approach.

            Cognitive impairment is common in multiple sclerosis (MS), yet patients seen in MS clinics and neurologic practices are not routinely assessed neuropsychologically. In part, poor utilization of NP services may be attributed to a lack of consensus among neuropsychologists regarding the optimal approach for evaluating MS patients. An expert panel composed of neuropsychologists and psychologists from the United States, Canada, United Kingdom, and Australia was convened by the Consortium of MS Centers (CMSC) in April, 2001. Our objectives were to: (a) propose a minimal neuropsychological (NP) examination for clinical monitoring of MS patients and research, and (b) identify strategies for improving NP assessment of MS patients in the future. The panel reviewed pertinent literature on MS-related cognitive dysfunction, considered psychometric factors relevant to NP assessment, defined the purpose and optimal characteristics of a minimal NP examination in MS, and rated the psychometric and practical properties of 36 candidate NP measures based on available literature. A 90-minute NP battery, the Minimal Assessment of Cognitive Function in MS (MACFIMS), emerged from this discussion. The MACFIMS is composed of seven neuropsychological tests, covering five cognitive domains commonly impaired in MS (processing speed/working memory, learning and memory, executive function, visual-spatial processing, and word retrieval). It is supplemented by a measure of estimated premorbid cognitive ability. Recommendations for assessing other factors that may potentially confound interpretation of NP data (e.g., visual/sensory/motor impairment, fatigue, and depression) are offered, as well as strategies for improving NP assessment of MS patients in the future.
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              Normalized accurate measurement of longitudinal brain change.

              Quantitative measurement of change in brain size and shape (e.g., to estimate atrophy) is an important current area of research. New methods of change analysis attempt to improve robustness, accuracy, and extent of automation. A fully automated method has been developed that achieves high estimation accuracy. A fully automated method of longitudinal change analysis is presented here, which automatically segments brain from nonbrain in each image, registers the two brain images while using estimated skull images to constrain scaling and skew, and finally estimates brain surface motion by tracking surface points to subvoxel accuracy. The method described has been shown to be accurate ( approximately 0.2% brain volume change error) and to achieve high robustness (no failures in several hundred analyses over a range of different data sets).
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                Author and article information

                Journal
                J Neuroimaging
                J Neuroimaging
                10.1111/(ISSN)1552-6569
                JON
                Journal of Neuroimaging
                John Wiley and Sons Inc. (Hoboken )
                1051-2284
                1552-6569
                Jan-Feb 2016
                28 June 2015
                : 26
                : 1 ( doiID: 10.1111/jon.2016.26.issue-1 )
                : 62-67
                Affiliations
                [ 1 ] Departments of Neurology, Brigham and Women's Hospital, Laboratory for Neuroimaging Research Partners MS Center, Harvard Medical School Boston MA
                [ 2 ] Departments of Radiology, Brigham and Women's Hospital, Laboratory for Neuroimaging Research Partners MS Center, Harvard Medical School Boston MA
                Author notes
                [*] [* ] Correspondence: Address correspondence to Rohit Bakshi, Laboratory for Neuroimaging Research, One Brookline Place, Brookline, MA 02445, USA. E‐mail: rbakshi@ 123456post.harvard.edu .
                Article
                JON12271
                10.1111/jon.12271
                4755143
                26118637
                39faa9ee-22e9-48e0-83e4-e5f271e863f8
                © 2015 The Authors. Journal of Neuroimaging published by Wiley Periodicals, Inc. on behalf of American Society of Neuroimaging

                This is an open access article under the terms of the Creative Commons Attribution‐NonCommercial License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.

                History
                : 27 January 2015
                : 16 March 2015
                : 18 March 2015
                Page count
                Pages: 6
                Funding
                Funded by: National Multiple Sclerosis Society
                Award ID: RG3798A2
                Categories
                Short Communication
                Short Communications
                Custom metadata
                2.0
                jon12271
                January/February 2016
                Converter:WILEY_ML3GV2_TO_NLMPMC version:4.9.1 mode:remove_FC converted:07.07.2016

                multiple sclerosis,brain volume,atrophy,cognitive impairment,disability,3t,mri

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