Author Of 1 Presentation
P0571 - Evaluating agreement between Mean Upper Cervical Cord Area measurements from 3D-FLAIR and 3D-T1 brain images (ID 1030)
Abstract
Background
Cervical spinal cord atrophy is an MRI biomarker of neurodegeneration and in MS it correlates with disability and disease progression. The Mean Upper Cervical Cord Area (MUCCA) can be used to measure this atrophy. Recently there has been an increasing interest towards calculating the MUCCA from MR brain images. It has been shown that MUCCA measurements calculated from brain T1-weighted images are comparable with those calculated from cervical cord T1-weighted images. Moreover, gadolinium (Gd) administration seems to have no effect on these measurements.
Objectives
To evaluate the correlation and the agreement between MUCCA measurements calculated from 3D-FLAIR and 3D-T1 post Gd brain images.
Methods
We used the images of 20 patients with Progressive MS who underwent a 1.5 T MRI as a routine radiological follow-up. 3D- FLAIR and post Gd 3D-T1 brain images were acquired. In our study, MUCCA was defined as the mean cross-sectional area (CSA) of a 12.8 mm long section of the cervical spinal cord, starting from the tip of the C1 vertebra. 3D-FLAIR and 3D-T1 were co-registered and resampled to the same voxel size. The MUCCA and the CSA per slice were compared.
Results
The mean difference between the MUCCA measurements from FLAIR and T1 images was 1.12 mm2 (1.9 %), range -3.13 mm2 (5.4 %) - 4.18 mm2 (7.2%). High positive correlation was observed between the MUCCA measurements from FLAIR and T1 images (r= .976 , p < .0001) and between the CSA per slice measurements from FLAIR and T1 images (r = .940 , p < .0001). High agreement was shown also by inspection of the Bland Altman plot.
Conclusions
Excellent correlation was observed between the MUCCA from 3D-FLAIR and post Gd 3D-T1 brain images. Hence 3D-FLAIR brain images, which are largely used in routine radiological follow-up, may be used to measure the MUCCA, allowing retrospective studies on spinal cord atrophy in addition to prospective ones. Further studies are needed to validate this approach, especially comparing 3D-FLAIR brain images with 3D-T1 spinal cord images.