TY - JOUR
T1 - Clinical applicability of quantitative atrophy measures on MRI in patients suspected of Alzheimer’s disease
AU - Ingala, Silvia
AU - van Maurik, Ingrid S.
AU - Altomare, Daniele
AU - Wurm, Raphael
AU - Dicks, Ellen
AU - van Schijndel, Ronald A.
AU - Zwan, Marissa
AU - Bouwman, Femke
AU - Schoonenboom, Niki
AU - Boelaarts, Leo
AU - Roks, Gerwin
AU - van Marum, Rob
AU - van Harten, Barbera
AU - van Uden, Inge
AU - Claus, Jules
AU - Wottschel, Viktor
AU - Vrenken, Hugo
AU - Wattjes, Mike P.
AU - van der Flier, Wiesje M.
AU - Barkhof, Frederik
N1 - Funding Information: The authors would like to acknowledge all the patients that have donated their data and the personnel that contributed to the data collection, as this research would not have been possible without their time and dedication. Moreover, we would like to thank Bertjan Kerklaan, Henry Weinstein, and Jooske Boomsma for their contribution to this study. ABIDE study group : Amsterdam, The Netherlands (Alzheimer Center and Department of Neurology, Amsterdam Neuroscience, VU University Medical Center): Wiesje M. van der Flier, PhD, Philip Scheltens, MD, PhD, Femke H. Bouwman, MD, PhD, Marissa D. Zwan, PhD, Ingrid S. van Maurik, MSc, Arno de Wilde, MD, Wiesje Pelkmans, MSc, Rosha Babapour Mofrad, MSc, Silvia Ingala, MSc, Colin Groot, MSc, Ellen Dicks, MSc, Els Dekkers (Department of Radiology and Nuclear Medicine, Amsterdam Neuroscience, VU University Medical Center) Bart N.M. van Berckel, MD, PhD, Charlotte E. Teunissen, PhD, Eline A. Willemse, MSc (Department of Medical Psychology, University of Amsterdam, Academic Medical Center) Ellen M. Smets, PhD, Leonie N.C. Visser, PhD, Marleen Kunneman, PhD, Sophie Pelt, Sanne Schepers, MSc, Laxini Murugesu, MSc, Bahar Azizi, MSc, Anneke Hellinga, MSc (BV Cyclotron) E. van Lier, MSc; Haarlem, The Netherlands (Spaarne Gasthuis) Niki M. Schoonenboom, MD, PhD; Utrecht, The Netherlands (Department of Neurology and Neurosurgery, Brain Center Rudolf Magnus, University Medical Center Utrecht) Geert Jan Biessels, MD, PhD, Jurre H. Verwer, MSc (Department of Geriatrics, University Medical Center Utrecht) Dieneke H. Koek, MD, PhD (Department of Radiology and Nuclear Medicine) Monique G. Hobbelink, MD (Vilans, Center of Expertise in long term care) Mirella M. Minkman, PhD, Cynthia S. Hofman, PhD, Ruth Pel, MSc; Meppel, The Netherlands (Espria) Esther Kuiper, MSc; Berlin, Germany (Piramal Imaging GmbH) Andrew Stephens, MD, PhD; Rotrkreuz, Switzerland (Roche Diagnostics International Ltd.) Richard Bartra-Utermann, MD. Memory clinic panel : The members of the memory clinic panel are as follows: Niki M. Schoonenboom, MD, PhD (Spaarne Gasthuis, Haarlem); Barbera van Harten, MD, PhD, Niek Verwey, MD, PhD, Peter van Walderveen, MD (Medisch Centrum Leeuwarden, Leeuwarden); Ester Korf, MD, PhD (Admiraal de Ruyter Ziekenhuis, Vlissingen); Gerwin Roks, MD, PhD (Sint Elisabeth Ziekenhuis, Tilburg); Bertjan Kerklaan, MD, PhD (Onze Lieve Vrouwe Gasthuis, Amsterdam); Leo Boelaarts, MD (Medisch Centrum Alkmaar, Alkmaar); Annelies. W.E. Weverling, MD (Diaconessenhuis, Leiden); Rob J. van Marum, MD, PhD (Jeroen Bosch Ziekenhuis, ‘s-Hertogenbosch); Jules J. Claus, MD, PhD (Tergooi Ziekenhuis, Hilversum); Koos Keizer, MD, PhD (Catherina Ziekenhuis, Eindhoven). Funding Information: Prof. Frederik Barkhof received payment and honoraria from Bayer, Biogen, TEVA, Merck-Serono, Novartis, Roche, IXICO Ltd, GeNeuro, and Combinostics for consulting; research support via grants from EU/EFPIA Innovative Medicines Initiative Joint Undertaking (AMYPAD consortium), EuroPOND (H2020), UK MS Society, Dutch MS Society, PICTURE. Funding Information: Research of the Alzheimer Center Amsterdam is part of the neurodegeneration research program of Amsterdam Neuroscience. The Alzheimer Center Amsterdam is supported by Stichting Alzheimer Nederland and Stichting VUmc fonds. WF is recipient of ZonMW Memorabel (ABIDE; project no. 733050201), a project in the context of the Dutch Deltaplan Dementie. This project has received support from the following EU/EFPIA Innovative Medicines Initiatives Joint Undertakings: EPAD grant no. 115736 (European Prevention of Alzheimer’s Dementia Consortium). WvdF and FB are recipients of a JPND grand for E-DADS (project number 733051106). FB was supported by the NIHR Biomedical Research Centre at UCLH. Publisher Copyright: © 2022, The Author(s).
PY - 2022/11
Y1 - 2022/11
N2 - Objectives: Neurodegeneration in suspected Alzheimer’s disease can be determined using visual rating or quantitative volumetric assessments. We examined the feasibility of volumetric measurements of gray matter (GMV) and hippocampal volume (HCV) and compared their diagnostic performance with visual rating scales in academic and non-academic memory clinics. Materials and methods: We included 231 patients attending local memory clinics (LMC) in the Netherlands and 501 of the academic Amsterdam Dementia Cohort (ADC). MRI scans were acquired using local protocols, including a T1-weighted sequence. Quantification of GMV and HCV was performed using FSL and FreeSurfer. Medial temporal atrophy and global atrophy were assessed with visual rating scales. ROC curves were derived to determine which measure discriminated best between cognitively normal (CN), mild cognitive impairment (MCI), and Alzheimer’s dementia (AD). Results: Patients attending LMC (age 70.9 ± 8.9 years; 47% females; 19% CN; 34% MCI; 47% AD) were older, had more cerebrovascular pathology, and had lower GMV and HCV compared to those of the ADC (age 64.9 ± 8.2 years; 42% females; 35% CN, 43% MCI, 22% AD). While visual ratings were feasible in > 95% of scans in both cohorts, quantification was achieved in 94–98% of ADC, but only 68–85% of LMC scans, depending on the software. Visual ratings and volumetric outcomes performed similarly in discriminating CN vs AD in both cohorts. Conclusion: In clinical settings, quantification of GM and hippocampal atrophy currently fails in up to one-third of scans, probably due to lack of standardized acquisition protocols. Diagnostic accuracy is similar for volumetric measures and visual rating scales, making the latter suited for clinical practice. Summary statement: In a real-life clinical setting, volumetric assessment of MRI scans in dementia patients may require acquisition protocol optimization and does not outperform visual rating scales. Key Points: • In a real-life clinical setting, the diagnostic performance of visual rating scales is similar to that of automatic volumetric quantification and may be sufficient to distinguish Alzheimer’s disease groups. • Volumetric assessment of gray matter and hippocampal volumes from MRI scans of patients attending non-academic memory clinics fails in up to 32% of cases. • Clinical MR acquisition protocols should be optimized to improve the output of quantitative software for segmentation of Alzheimer’s disease–specific outcomes.
AB - Objectives: Neurodegeneration in suspected Alzheimer’s disease can be determined using visual rating or quantitative volumetric assessments. We examined the feasibility of volumetric measurements of gray matter (GMV) and hippocampal volume (HCV) and compared their diagnostic performance with visual rating scales in academic and non-academic memory clinics. Materials and methods: We included 231 patients attending local memory clinics (LMC) in the Netherlands and 501 of the academic Amsterdam Dementia Cohort (ADC). MRI scans were acquired using local protocols, including a T1-weighted sequence. Quantification of GMV and HCV was performed using FSL and FreeSurfer. Medial temporal atrophy and global atrophy were assessed with visual rating scales. ROC curves were derived to determine which measure discriminated best between cognitively normal (CN), mild cognitive impairment (MCI), and Alzheimer’s dementia (AD). Results: Patients attending LMC (age 70.9 ± 8.9 years; 47% females; 19% CN; 34% MCI; 47% AD) were older, had more cerebrovascular pathology, and had lower GMV and HCV compared to those of the ADC (age 64.9 ± 8.2 years; 42% females; 35% CN, 43% MCI, 22% AD). While visual ratings were feasible in > 95% of scans in both cohorts, quantification was achieved in 94–98% of ADC, but only 68–85% of LMC scans, depending on the software. Visual ratings and volumetric outcomes performed similarly in discriminating CN vs AD in both cohorts. Conclusion: In clinical settings, quantification of GM and hippocampal atrophy currently fails in up to one-third of scans, probably due to lack of standardized acquisition protocols. Diagnostic accuracy is similar for volumetric measures and visual rating scales, making the latter suited for clinical practice. Summary statement: In a real-life clinical setting, volumetric assessment of MRI scans in dementia patients may require acquisition protocol optimization and does not outperform visual rating scales. Key Points: • In a real-life clinical setting, the diagnostic performance of visual rating scales is similar to that of automatic volumetric quantification and may be sufficient to distinguish Alzheimer’s disease groups. • Volumetric assessment of gray matter and hippocampal volumes from MRI scans of patients attending non-academic memory clinics fails in up to 32% of cases. • Clinical MR acquisition protocols should be optimized to improve the output of quantitative software for segmentation of Alzheimer’s disease–specific outcomes.
KW - Alzheimer's disease
KW - Alzheimer’s disease
KW - Gray matter volume (GMV)
KW - Hippocampal volume (HCV)
KW - Magnetic resonance imaging (MRI)
KW - Visual rating scales
UR - http://www.scopus.com/inward/record.url?scp=85131048724&partnerID=8YFLogxK
U2 - https://doi.org/10.1007/s00330-021-08503-7
DO - https://doi.org/10.1007/s00330-021-08503-7
M3 - Article
C2 - 35639148
SN - 0938-7994
VL - 32
SP - 7789
EP - 7799
JO - European Radiology
JF - European Radiology
IS - 11
ER -