White Matter Lesion Assessment in Patients with Cognitive Impairment and Healthy Controls: Reliability Comparisons between Visual Rating, a Manual, and an Automatic Volumetrical MRI Method—The Gothenburg MCI Study

Age-related white matter lesions (WML) are a risk factor for stroke, cognitive decline, and dementia. Different requirements are imposed on methods for the assessment of WML in clinical settings and for research purposes, but reliability analysis is of major importance. In this study, WML assessment...

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Main Authors: Erik Olsson, Niklas Klasson, Josef Berge, Carl Eckerström, Åke Edman, Helge Malmgren, Anders Wallin
Format: Article
Language:English
Published: Wiley 2013-01-01
Series:Journal of Aging Research
Online Access:http://dx.doi.org/10.1155/2013/198471
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author Erik Olsson
Niklas Klasson
Josef Berge
Carl Eckerström
Åke Edman
Helge Malmgren
Anders Wallin
author_facet Erik Olsson
Niklas Klasson
Josef Berge
Carl Eckerström
Åke Edman
Helge Malmgren
Anders Wallin
author_sort Erik Olsson
collection DOAJ
description Age-related white matter lesions (WML) are a risk factor for stroke, cognitive decline, and dementia. Different requirements are imposed on methods for the assessment of WML in clinical settings and for research purposes, but reliability analysis is of major importance. In this study, WML assessment with three different methods was evaluated. In the Gothenburg mild cognitive impairment study, MRI scans from 152 participants were used to assess WML with the Fazekas visual rating scale on T2 images, a manual volumetric method on FLAIR images, and FreeSurfer volumetry on T1 images. Reliability was acceptable for all three methods. For low WML volumes (2/3 of the patients), reliability was overall lower and nonsignificant for the manual volumetric method. Unreliability in the assessment of patients with low WML with manual volumetry may mainly be due to intensity variation in the FLAIR sequence used; hence, intensity standardization and normalization methods must be used for more accurate assessments. The FreeSurfer segmentations resulted in smaller WML volumes than the volumes acquired with the manual method and showed deviations from visible hypointensities in the T1 images, which quite likely reduces validity.
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institution Kabale University
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publishDate 2013-01-01
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record_format Article
series Journal of Aging Research
spelling doaj-art-4d1b1a6d68a741fabf07218c2f2ddbd52025-02-03T05:57:57ZengWileyJournal of Aging Research2090-22042090-22122013-01-01201310.1155/2013/198471198471White Matter Lesion Assessment in Patients with Cognitive Impairment and Healthy Controls: Reliability Comparisons between Visual Rating, a Manual, and an Automatic Volumetrical MRI Method—The Gothenburg MCI StudyErik Olsson0Niklas Klasson1Josef Berge2Carl Eckerström3Åke Edman4Helge Malmgren5Anders Wallin6Department of Neuroscience and Physiology, Institute of Psychiatry and Neurochemistry, The Sahlgrenska Academy, University of Gothenburg, 40530 Gothenburg, SwedenDepartment of Neuroscience and Physiology, Institute of Psychiatry and Neurochemistry, The Sahlgrenska Academy, University of Gothenburg, 40530 Gothenburg, SwedenDepartment of Neuroscience and Physiology, Institute of Psychiatry and Neurochemistry, The Sahlgrenska Academy, University of Gothenburg, 40530 Gothenburg, SwedenDepartment of Neuroscience and Physiology, Institute of Psychiatry and Neurochemistry, The Sahlgrenska Academy, University of Gothenburg, 40530 Gothenburg, SwedenDepartment of Neuroscience and Physiology, Institute of Psychiatry and Neurochemistry, The Sahlgrenska Academy, University of Gothenburg, 40530 Gothenburg, SwedenDepartment of Neuroscience and Physiology, Institute of Psychiatry and Neurochemistry, The Sahlgrenska Academy, University of Gothenburg, 40530 Gothenburg, SwedenDepartment of Neuroscience and Physiology, Institute of Psychiatry and Neurochemistry, The Sahlgrenska Academy, University of Gothenburg, 40530 Gothenburg, SwedenAge-related white matter lesions (WML) are a risk factor for stroke, cognitive decline, and dementia. Different requirements are imposed on methods for the assessment of WML in clinical settings and for research purposes, but reliability analysis is of major importance. In this study, WML assessment with three different methods was evaluated. In the Gothenburg mild cognitive impairment study, MRI scans from 152 participants were used to assess WML with the Fazekas visual rating scale on T2 images, a manual volumetric method on FLAIR images, and FreeSurfer volumetry on T1 images. Reliability was acceptable for all three methods. For low WML volumes (2/3 of the patients), reliability was overall lower and nonsignificant for the manual volumetric method. Unreliability in the assessment of patients with low WML with manual volumetry may mainly be due to intensity variation in the FLAIR sequence used; hence, intensity standardization and normalization methods must be used for more accurate assessments. The FreeSurfer segmentations resulted in smaller WML volumes than the volumes acquired with the manual method and showed deviations from visible hypointensities in the T1 images, which quite likely reduces validity.http://dx.doi.org/10.1155/2013/198471
spellingShingle Erik Olsson
Niklas Klasson
Josef Berge
Carl Eckerström
Åke Edman
Helge Malmgren
Anders Wallin
White Matter Lesion Assessment in Patients with Cognitive Impairment and Healthy Controls: Reliability Comparisons between Visual Rating, a Manual, and an Automatic Volumetrical MRI Method—The Gothenburg MCI Study
Journal of Aging Research
title White Matter Lesion Assessment in Patients with Cognitive Impairment and Healthy Controls: Reliability Comparisons between Visual Rating, a Manual, and an Automatic Volumetrical MRI Method—The Gothenburg MCI Study
title_full White Matter Lesion Assessment in Patients with Cognitive Impairment and Healthy Controls: Reliability Comparisons between Visual Rating, a Manual, and an Automatic Volumetrical MRI Method—The Gothenburg MCI Study
title_fullStr White Matter Lesion Assessment in Patients with Cognitive Impairment and Healthy Controls: Reliability Comparisons between Visual Rating, a Manual, and an Automatic Volumetrical MRI Method—The Gothenburg MCI Study
title_full_unstemmed White Matter Lesion Assessment in Patients with Cognitive Impairment and Healthy Controls: Reliability Comparisons between Visual Rating, a Manual, and an Automatic Volumetrical MRI Method—The Gothenburg MCI Study
title_short White Matter Lesion Assessment in Patients with Cognitive Impairment and Healthy Controls: Reliability Comparisons between Visual Rating, a Manual, and an Automatic Volumetrical MRI Method—The Gothenburg MCI Study
title_sort white matter lesion assessment in patients with cognitive impairment and healthy controls reliability comparisons between visual rating a manual and an automatic volumetrical mri method the gothenburg mci study
url http://dx.doi.org/10.1155/2013/198471
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