Differentiation of sCJD and vCJD forms by automated analysis of basal ganglia intensity distribution in multisequence MRI of the brain-definition and evaluation of new MRI-based ratios

• Published in: IEEE transactions on medical imaging 2006-08, Vol.25 (8), p.1052-1067
• Main Authors: Linguraru, M.G., Ayache, N., Bardinet, E., Ballester, M.A.G., Galanaud, D., Haik, S., Faucheux, B., Hauw, J.-J., Cozzone, P., Dormont, D., Brandel, J.-P.
• Format: Article
• Language: English
• Subjects: Algorithms; Artificial Intelligence; Basal ganglia; Basal Ganglia - pathology; Brain; Classification; Computer Simulation; Creutzfeldt-Jakob Disease (CJD); Creutzfeldt-Jakob Syndrome - classification; Creutzfeldt-Jakob Syndrome - diagnosis; Diagnosis, Differential; Diseases; Engineering Sciences; Ganglia; grey matter (GM); Human; human visual system model; Humans; Image analysis; Image Enhancement - methods; Image Interpretation, Computer-Assisted - methods; Imaging, Three-Dimensional - methods; Information Storage and Retrieval - methods; intensity quantification; internal nuclei; Magnetic analysis; Magnetic resonance; Magnetic resonance imaging; Magnetic Resonance Imaging - methods; Mathematical models; Models, Biological; multisequence magnetic resonance imaging (MRI) of the brain; normalization; Other; Patients; Pattern Recognition, Automated - methods; Prions; Proteins; registration; Reproducibility of Results; Robustness; segmentation; Sensitivity and Specificity; Smoothing methods; Spongiform encephalopathies; sporadic Creutzfeldt-Jakob Disease (sCJD); Subtraction Technique; variant Creutzfeldt-Jakob Disease (vCJD)
• ISSN: 0278-0062; 1558-254X
• DOI: 10.1109/TMI.2006.876133

We present a method for the analysis of basal ganglia (including the thalamus) for accurate detection of human spongiform encephalopathy in multisequence magnetic resonance imaging (MRI) of the brain. One common feature of most forms of prion protein diseases is the appearance of hyperintensities in the deep grey matter area of the brain in T2-weighted magnetic resonance (MR) images. We employ T1, T2, and Flair-T2 MR sequences for the detection of intensity deviations in the internal nuclei. First, the MR data are registered to a probabilistic atlas and normalized in intensity. Then smoothing is applied with edge enhancement. The segmentation of hyperintensities is performed using a model of the human visual system. For more accurate results, a priori anatomical data from a segmented atlas are employed to refine the registration and remove false positives. The results are robust over the patient data and in accordance with the clinical ground truth. Our method further allows the quantification of intensity distributions in basal ganglia. The caudate nuclei are highlighted as main areas of diagnosis of sporadic Creutzfeldt-Jakob Disease (sCJD), in agreement with the histological data. The algorithm permitted the classification of the intensities of abnormal signals in sCJD patient FLAIR images with a higher hypersignal in caudate nuclei (10/10) and putamen (6/10) than in thalami. Defining normalized MRI measures of the intensity relations between the internal grey nuclei of patients, we robustly differentiate sCJD and variant CJD (vCJD) patients, in an attempt to create an automatic classification tool of human spongiform encephalopathies