TY - JOUR
T1 - The effect of gadolinium-based contrast-agents on automated brain atrophy measurements by FreeSurfer in patients with multiple sclerosis
AU - Lie, Ingrid Anne
AU - Kerklingh, Emma
AU - Wesnes, Kristin
AU - van Nederpelt, David R.
AU - Brouwer, Iman
AU - Torkildsen, Øivind
AU - Myhr, Kjell-Morten
AU - Barkhof, Frederik
AU - Bø, Lars
AU - Vrenken, Hugo
N1 - Funding Information: Ø. Torkildsen and K.M. Myhr are funded by Neuro-SysMed at Haukeland University Hospital and the University of Bergen by a grant from the Research Council of Norway, project number 288164. Funding Information: H. Vrenken has received research grants from Pfizer, Merck Serono, Novartis, and Teva, speaker honoraria from Novartis, and consulting fees from Merck Serono; all funds were paid directly to his institution. Funding Information: The authors thank the OFAMS study group and the patients who participated in the study. The authors also thank Joost P.A. Kuijer PhD. from the Department of Radiology and Nuclear Medicine at Amsterdam UMC, MS Center Amsterdam, Amsterdam Neuroscience, Amsterdam UMC, location VUmc, for help with retrieving and interpreting information regarding MRI scanner details. Funding Information: Open access funding provided by University of Bergen (incl Haukeland University Hospital). K. Wesnes has received funding from Western Norway Regional Health Authority (grant no. #912020). Funding Information: The MS Center Amsterdam is funded through a program grant of the Dutch MS Research Foundation (grant no. MS 18-358f). Funding Information: D.R. van Nederpelt is funded by a joint grant from the Dutch MS Research Foundation and ZonMW (grant no. 446002506) and a grant from Health Holland Life Sciences & Health (grant no. LSHM19053). Funding Information: F. Barkhof is supported by the National Institute for Health Research (NIHR) biomedical research centre at University College London Hospitals NHS Foundation Trust (UCLH). Funding Information: K. Wesnes has received unrestricted research grants from Novartis and Biogen, and speaker honoraria from Biogen. Publisher Copyright: © 2021, The Author(s).
PY - 2022/5
Y1 - 2022/5
N2 - Objective: To determine whether reliable brain atrophy measures can be obtained from post-contrast 3D T1-weighted images in patients with multiple sclerosis (MS) using FreeSurfer. Methods: Twenty-two patients with MS were included, in which 3D T1-weighted MR images were obtained during the same scanner visit, with the same acquisition protocol, before and after administration of gadolinium-based contrast agents (GBCAs). Two FreeSurfer versions (v.6.0.1 and v.7.1.1.) were applied to calculate grey matter (GM) and white matter (WM) volumes and global and regional cortical thickness. The consistency between measures obtained in pre- and post-contrast images was assessed by intra-class correlation coefficient (ICC), the difference was investigated by paired t-tests, and the mean percentage increase or decrease was calculated for total WM and GM matter volume, total deep GM and thalamus volume, and mean cortical thickness. Results: Good to excellent reliability was found between all investigated measures, with ICC ranging from 0.926 to 0.996, all p values < 0.001. GM volumes and cortical thickness measurements were significantly higher in post-contrast images by 3.1 to 17.4%, while total WM volume decreased significantly by 1.7% (all p values < 0.001). Conclusion: The consistency between values obtained from pre- and post-contrast images was excellent, suggesting it may be possible to extract reliable brain atrophy measurements from T1-weighted images acquired after administration of GBCAs, using FreeSurfer. However, absolute values were systematically different between pre- and post-contrast images, meaning that such images should not be compared directly. Potential systematic effects, possibly dependent on GBCA dose or the delay time after contrast injection, should be investigated. Trial registration: Clinical trials.gov. identifier: NCT00360906. Key Points: • The influence of gadolinium-based contrast agents (GBCAs) on atrophy measurements is still largely unknown and challenges the use of a considerable source of historical and prospective real-world data. • In 22 patients with multiple sclerosis, the consistency between brain atrophy measurements obtained from pre- and post-contrast images was excellent, suggesting it may be possible to extract reliable atrophy measurements in T1-weighted images acquired after administration of GBCAs, using FreeSurfer. • Absolute values were systematically different between pre- and post-contrast images, meaning that such images should not be compared directly, and measurements extracted from certain regions (e.g., the temporal pole) should be interpreted with caution.
AB - Objective: To determine whether reliable brain atrophy measures can be obtained from post-contrast 3D T1-weighted images in patients with multiple sclerosis (MS) using FreeSurfer. Methods: Twenty-two patients with MS were included, in which 3D T1-weighted MR images were obtained during the same scanner visit, with the same acquisition protocol, before and after administration of gadolinium-based contrast agents (GBCAs). Two FreeSurfer versions (v.6.0.1 and v.7.1.1.) were applied to calculate grey matter (GM) and white matter (WM) volumes and global and regional cortical thickness. The consistency between measures obtained in pre- and post-contrast images was assessed by intra-class correlation coefficient (ICC), the difference was investigated by paired t-tests, and the mean percentage increase or decrease was calculated for total WM and GM matter volume, total deep GM and thalamus volume, and mean cortical thickness. Results: Good to excellent reliability was found between all investigated measures, with ICC ranging from 0.926 to 0.996, all p values < 0.001. GM volumes and cortical thickness measurements were significantly higher in post-contrast images by 3.1 to 17.4%, while total WM volume decreased significantly by 1.7% (all p values < 0.001). Conclusion: The consistency between values obtained from pre- and post-contrast images was excellent, suggesting it may be possible to extract reliable brain atrophy measurements from T1-weighted images acquired after administration of GBCAs, using FreeSurfer. However, absolute values were systematically different between pre- and post-contrast images, meaning that such images should not be compared directly. Potential systematic effects, possibly dependent on GBCA dose or the delay time after contrast injection, should be investigated. Trial registration: Clinical trials.gov. identifier: NCT00360906. Key Points: • The influence of gadolinium-based contrast agents (GBCAs) on atrophy measurements is still largely unknown and challenges the use of a considerable source of historical and prospective real-world data. • In 22 patients with multiple sclerosis, the consistency between brain atrophy measurements obtained from pre- and post-contrast images was excellent, suggesting it may be possible to extract reliable atrophy measurements in T1-weighted images acquired after administration of GBCAs, using FreeSurfer. • Absolute values were systematically different between pre- and post-contrast images, meaning that such images should not be compared directly, and measurements extracted from certain regions (e.g., the temporal pole) should be interpreted with caution.
KW - Atrophy
KW - Gadolinium
KW - Grey matter
KW - Magnetic resonance imaging
KW - Multiple sclerosis
UR - http://www.scopus.com/inward/record.url?scp=85122257195&partnerID=8YFLogxK
U2 - https://doi.org/10.1007/s00330-021-08405-8
DO - https://doi.org/10.1007/s00330-021-08405-8
M3 - Article
C2 - 34978580
SN - 0938-7994
VL - 32
SP - 3576
EP - 3587
JO - European radiology
JF - European radiology
IS - 5
ER -