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A Novel Mricompatible Brain Ventricle Phantom for Validation of Segmentation and Volumetry Methods

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A Novel Mricompatible Brain Ventricle Phantom for Validation of Segmentation and Volumetry Methods CME JOURNAL OF MAGNETIC RESONANCE IMAGING 36:476–482 (2012) Original Research A Novel MRI-Compatible Brain Ventricle Phantom for Validation of Segmentation and Volumetry Methods Amanda F. Khan, MSc,1,2 John J. Drozd, PhD,2 Robert K. Moreland, MSc,2,3 Robert M. Ta, MSc,1,2 Michael J. Borrie, MB ChB,3,4 Robert Bartha, PhD1,2* and the Alzheimer’s Disease Neuroimaging Initiative Purpose: To create a standardized, MRI-compatible, life- Conclusion: The phantom represents a simple, realistic sized phantom of the brain ventricles to evaluate ventricle and objective method to test the accuracy of lateral ventri- segmentation methods using T1-weighted MRI. An objec- cle segmentation methods and we project it can be tive phantom is needed to test the many different segmen- extended to other anatomical structures. tation programs currently used to measure ventricle vol- Key Words: 3T; brain phantom; MRI; ventricle; software umes in patients with Alzheimer’s disease. validation; segmentation Materials and Methods: A ventricle model was con- J. Magn. Reson. Imaging 2012;36:476–482. structed from polycarbonate using a digital mesh of the VC 2012 Wiley Periodicals, Inc. ventricles created from the 3 Tesla (T) MRI of a subject with Alzheimer’s disease. The ventricle was placed in a brain mold and surrounded with material composed of VOLUMETRY HAS DEMONSTRATED that large mor- 2% agar in water, 0.01% NaCl and 0.0375 mM gadopente- phological changes occur in the brain during the tate dimeglumine to match the signal intensity properties course of Alzheimer’s disease (AD) (1). In particular, of brain tissue in 3T T -weighted MRI. The 3T T -weighted 1 1 enlargement of the lateral ventricles (cerebrospinal images of the phantom were acquired and ventricle seg- mentation software was used to measure ventricle fluid-filled cavities in the interior of the cerebral hemi- volume. spheres) has been consistently demonstrated and may be among the most sensitive of imaging bio- Results: The images acquired of the phantom successfully markers of AD progression (2). This enlargement is a replicated in vivo signal intensity differences between the consequence of the disease process; as surrounding ventricle and surrounding tissue in T1-weighted images and were robust to segmentation. The ventricle volume was healthy brain tissues atrophy, there is a correspond- quantified to 99% accuracy at 1-mm voxel size. ing increase in cerebrospinal fluid (CSF) within the ventricles. Currently, major efforts are under way to develop disease altering treatments for AD. The next generation of clinical trials for such compounds will 1Medical Biophysics, Medical Sciences Building, The University of benefit from objective methods, such as ventricle volu- Western Ontario, London, ON, Canada. metry, to evaluate their effect on ventricular volume 2Robarts Research Institute, The University of Western Ontario, London, ON, Canada. and potential disease modification. Volumetry may 3Schulich School of Medicine and Dentistry, Clinical Skills Building, provide an outcome measure that could reliably dis- The University of Western Ontario, London, ON, Canada. tinguish between disease-modifying effects and purely 4 Aging, Rehabilitation and Geriatric Care, Lawson Health Research symptomatic relief. Enlargement of the ventricles is Institute, London ON, Canada. Data used in preparation of this article were obtained from the Alz- also characteristic of other medical conditions such heimer’s Disease Neuroimaging Initiative (ADNI) database (adni.lo- as schizophrenia, Parkinson’s disease, hydrocepha- ni.ucla.edu). As such, the investigators within the ADNI contributed lus, and trauma to the brain (3–6). Ventricular mea- to the design and implementation of ADNI and/or provided data but did not participate in analysis or writing of this report. A complete surement many be relevant to these conditions and listing of ADNI investigators can be found at: http://adni.loni.u- related new treatment approaches as well. cla.edu/wp-content/uploads/how_to_apply/ADNI_Authorship_List.pdf Semiautomatic and fully automatic software has Contract grant sponsor: National Institutes of Health; Contract grant numbers: U01 AG024904, P30 AG010129, K01 AG030514. been developed to quantify ventricular volume, (along *Address reprint requests to: R.B., Imaging Research Laboratories, with other brain structures) using MRI scans acquired Robarts Research Institute, Schulich School of Medicine and Den- from patients with AD. Such programs include Free- tistry, The University of Western Ontario, 100 Perth Drive, London, surfer, Amira (Visage Imaging, Inc., San Diego, CA) ON, Canada N6A 5K8. E-mail: [email protected] Received June 14, 2011; Accepted January 11, 2012. and 3D Slicer (7,8). Measurement of ventricular vol- DOI 10.1002/jmri.23612 ume is particularly amenable to segmentation due to View this article online at wileyonlinelibrary.com. the high signal intensity contrast between CSF and VC 2012 Wiley Periodicals, Inc. 476 MRI Brain Ventricle Segmentation Phantom 477 surrounding brain tissue in T1-weighted MRI. When simulate brain tissue, and sodium chloride (NaCl) to segmentation is performed in serial MRI scans of a modulate conductivity. patient, such quantification methods must be sensi- The purpose of the current study was to construct tive to very small volumetric changes in a complex 3D a physical phantom that could be used as a gold structure. However, absolute quantitative validation of standard to validate and compare different ventricle image segmentation using in vivo data from patient segmentation algorithms. Our phantom is the first scans is impossible because the exact volume of the physical phantom of the entire lateral ventricles for lateral ventricles is unknown. To remedy this situa- this purpose, known to the authors. The methodology tion, a phantom can be used. described can also be extended to produce new physi- Physical phantoms are real models that can be cal phantoms that model other disease pathologies imaged or simulated to test the performance of a seg- that present signal voids in MRI images. mentation method. One example of a physical ventri- cle phantom, by Chen et al (9), only modeled a single hemisphere of the brain and only half of the lateral MATERIALS AND METHODS ventricles (left ventricle). As well, their tissue mimick- The phantom was constructed in two stages and con- ing solution did not match the T1 relaxation time con- sisted of a ventricle component and tissue model. The stants of brain tissue. In another example, Turkington phantom was designed to accurately mimic the in vivo et al (10) designed a 19-layer water-fillable cylinder signal intensity difference between that of the ventri- phantom to mimic white matter, gray matter and ven- cle and surrounding brain tissue. The signal intensity tricle perfusion rates, called the Hoffman phantom. difference was chosen to be replicated because often However, because layers of their phantom were large it is this difference that segmentation algorithms rely (6.4-mm thick) compared with voxel resolution, their on to identify ventricular voxels. phantom had to be positioned so that layers of the phantom were parallel to transaxial slices to avoid discontinuities in edges. The Hoffman phantom also Ventricle Construction has not been used for ventricle segmentation and Data used in the preparation of this article were instead has been designed to test the registration of obtained from the Alzheimer’s Disease Neuroimaging positron emission tomography (PET), single photon Initiative (ADNI) database (adni.loni.ucla.edu). The emission computed tomography (SPECT), and MRI ADNI was launched in 2003 by the National Institute images and activity distributions in PET (11). Digital on Aging (NIA), the National Institute of Biomedical phantoms are similar, except that a digital phantom Imaging and Bioengineering (NIBIB), the Food and is an image representation of a phantom that does Drug Administration (FDA), private pharmaceutical not physically exist. Such phantoms are simulated companies and nonprofit organizations, as a $60 mil- MR images of the brain based on a series of registered lion, 5-year public-private partnership. The primary MRI scans. Digital phantoms with simulated data, goal of ADNI has been to test whether serial MRI, however, can suffer from an oversimplicity of phantom positron emission tomography (PET), other biological geometry, improper treatment of edge effects leading markers, and clinical and neuropsychological assess- to tissue mixing in voxels and the improper modeling ment can be combined to measure the progression of of the data acquisition method (12,13). Physical phan- mild cognitive impairment (MCI) and early Alzheimer’s disease. toms, on the other hand, are superior as they allow A ventricle representing a typical subject with Alz- the fabrication of a controlled shape with known vol- heimer’s disease was modeled by identifying an 80- ume, from materials with predictable MRI properties. year-old female representative subject (007_S_1339) Physical phantoms are composed of synthetic materi- from the ADNI database. This patient had a lateral als that have a magnetic resonance signal that mimics ventricle volume of 48.8 cm3 which was measured that of human tissue and represent a completely from their 1.5 Tesla (T) T1-weighted MRI (processed objective measure to assess algorithm performance. It with the ADNI GradWarp, B1 Correction, N3 Correc- is important then, to validate the accuracy and preci- tion and scaling factor)
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