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<meta name="DC.Title" content="The Impact of Lesion In-Painting and Registration Methods on Voxel-Based Morphometry in Detecting Regional Cerebral Gray Matter Atrophy in Multiple Sclerosis" />
<meta name="DC.Identifier" content="10.3174/ajnr.A3083" />
<meta name="DC.Date" content="2012-09-01" />
<meta name="DC.Publisher" content="American Journal of Neuroradiology" />
<meta name="DC.Rights" content="© 2012 by American Journal of Neuroradiology. Indicates open access to non-subscribers at www.ajnr.org" />
<meta name="DC.AccessRights" content="open-access" />
<meta name="DC.Description" content="BACKGROUND AND PURPOSE: VBM has been widely used to study GM atrophy in MS. MS lesions lead to segmentation and registration errors that may affect the reliability of VBM results. Improved segmentation and registration have been demonstrated by WM LI before segmentation. DARTEL appears to improve registration versus the USM. Our aim was to compare the performance of VBM-DARTEL versus VBM-USM and the effect of LI in the regional analysis of GM atrophy in MS.

MATERIALS AND METHODS: 3T T1 MR imaging scans were acquired from 26 patients with RRMS and 28 age-matched NC. LI replaced WM lesions with normal-appearing WM intensities before image segmentation. VBM analysis was performed in SPM8 by using DARTEL and USM with and without LI, allowing the comparison of 4 VBM methods (DARTEL + LI, DARTEL − LI, USM + LI, and USM − LI). Accuracy of VBM was assessed by using NMI, CC, and a simulation analysis.

RESULTS: Overall, DARTEL + LI yielded the most accurate GM maps among the 4 methods (highest NMI and CC, P &lt; .001). DARTEL + LI showed significant GM loss in the bilateral thalami and caudate nuclei in patients with RRMS versus NC. The other 3 methods overestimated the number of regions of GM loss in RRMS versus NC. LI improved the accuracy of both VBM methods. Simulated data suggested the accuracy of the results provided from patient MR imaging analysis.

CONCLUSIONS: We introduce a pipeline that shows promise in limiting segmentation and registration errors in VBM analysis in MS.

CC
:   cross-correlation
DARTEL
:   diffeomorphic anatomical registration through exponentiated lie algebra
EDSS
:   Expanded Disability Status Scale
FP
:   false-positive
GM
:   gray matter
LI
:   lesion in-painting
MDEFT
:   Modified Driven Equilibrium Fourier Transform
NC
:   normal controls
NMI
:   normalized mutual information
RRMS
:   relapsing-remitting MS
USM
:   unified segmentation model
VBM
:   voxel-based morphometry" />
<meta name="DC.Contributor" content="A. Ceccarelli" />
<meta name="DC.Contributor" content="J.S. Jackson" />
<meta name="DC.Contributor" content="S. Tauhid" />
<meta name="DC.Contributor" content="A. Arora" />
<meta name="DC.Contributor" content="J. Gorky" />
<meta name="DC.Contributor" content="E. Dell'Oglio" />
<meta name="DC.Contributor" content="A. Bakshi" />
<meta name="DC.Contributor" content="T. Chitnis" />
<meta name="DC.Contributor" content="S.J. Khoury" />
<meta name="DC.Contributor" content="H.L. Weiner" />
<meta name="DC.Contributor" content="C.R.G. Guttmann" />
<meta name="DC.Contributor" content="R. Bakshi" />
<meta name="DC.Contributor" content="M. Neema" />
<meta name="article:published_time" content="2012-09-01" />
<meta name="article:section" content="Brain" />
<meta name="citation_title" content="The Impact of Lesion In-Painting and Registration Methods on Voxel-Based Morphometry in Detecting Regional Cerebral Gray Matter Atrophy in Multiple Sclerosis" />
<meta name="citation_abstract" lang="en" content="&lt;h3&gt;BACKGROUND AND PURPOSE:&lt;/h3&gt;
&lt;p&gt;VBM has been widely used to study GM atrophy in MS. MS lesions lead to segmentation and registration errors that may affect the reliability of VBM results. Improved segmentation and registration have been demonstrated by WM LI before segmentation. DARTEL appears to improve registration versus the USM. Our aim was to compare the performance of VBM-DARTEL versus VBM-USM and the effect of LI in the regional analysis of GM atrophy in MS.&lt;/p&gt;&lt;h3&gt;MATERIALS AND METHODS:&lt;/h3&gt;
&lt;p&gt;3T T1 MR imaging scans were acquired from 26 patients with RRMS and 28 age-matched NC. LI replaced WM lesions with normal-appearing WM intensities before image segmentation. VBM analysis was performed in SPM8 by using DARTEL and USM with and without LI, allowing the comparison of 4 VBM methods (DARTEL + LI, DARTEL − LI, USM + LI, and USM − LI). Accuracy of VBM was assessed by using NMI, CC, and a simulation analysis.&lt;/p&gt;&lt;h3&gt;RESULTS:&lt;/h3&gt;
&lt;p&gt;Overall, DARTEL + LI yielded the most accurate GM maps among the 4 methods (highest NMI and CC, &lt;i&gt;P&lt;/i&gt; &amp;lt; .001). DARTEL + LI showed significant GM loss in the bilateral thalami and caudate nuclei in patients with RRMS versus NC. The other 3 methods overestimated the number of regions of GM loss in RRMS versus NC. LI improved the accuracy of both VBM methods. Simulated data suggested the accuracy of the results provided from patient MR imaging analysis.&lt;/p&gt;&lt;h3&gt;CONCLUSIONS:&lt;/h3&gt;
&lt;p&gt;We introduce a pipeline that shows promise in limiting segmentation and registration errors in VBM analysis in MS.&lt;/p&gt;" />
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<meta name="citation_author" content="R. Bakshi" />
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<meta name="twitter:title" content="The Impact of Lesion In-Painting and Registration Methods on Voxel-Based Morphometry in Detecting Regional Cerebral Gray Matter Atrophy in Multiple Sclerosis" />
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<meta name="twitter:description" content="BACKGROUND AND PURPOSE: VBM has been widely used to study GM atrophy in MS. MS lesions lead to segmentation and registration errors that may affect the reliability of VBM results. Improved segmentation and registration have been demonstrated by WM LI before segmentation. DARTEL appears to improve registration versus the USM. Our aim was to compare the performance of VBM-DARTEL versus VBM-USM and the effect of LI in the regional analysis of GM atrophy in MS.

MATERIALS AND METHODS: 3T T1 MR imaging scans were acquired from 26 patients with RRMS and 28 age-matched NC. LI replaced WM lesions with normal-appearing WM intensities before image segmentation. VBM analysis was performed in SPM8 by using DARTEL and USM with and without LI, allowing the comparison of 4 VBM methods (DARTEL + LI, DARTEL − LI, USM + LI, and USM − LI). Accuracy of VBM was assessed by using NMI, CC, and a simulation analysis.

RESULTS: Overall, DARTEL + LI yielded the most accurate GM maps among the 4 methods (highest NMI and CC, P &lt; .001). DARTEL + LI showed significant GM loss in the bilateral thalami and caudate nuclei in patients with RRMS versus NC. The other 3 methods overestimated the number of regions of GM loss in RRMS versus NC. LI improved the accuracy of both VBM methods. Simulated data suggested the accuracy of the results provided from patient MR imaging analysis.

CONCLUSIONS: We introduce a pipeline that shows promise in limiting segmentation and registration errors in VBM analysis in MS.

CC
:   cross-correlation
DARTEL
:   diffeomorphic anatomical registration through exponentiated lie algebra
EDSS
:   Expanded Disability Status Scale
FP
:   false-positive
GM
:   gray matter
LI
:   lesion in-painting
MDEFT
:   Modified Driven Equilibrium Fourier Transform
NC
:   normal controls
NMI
:   normalized mutual information
RRMS
:   relapsing-remitting MS
USM
:   unified segmentation model
VBM
:   voxel-based morphometry" />
<meta name="og-title" property="og:title" content="The Impact of Lesion In-Painting and Registration Methods on Voxel-Based Morphometry in Detecting Regional Cerebral Gray Matter Atrophy in Multiple Sclerosis" />
<meta name="og-url" property="og:url" content="http://ajnr-stage2.stage.highwire.org/content/33/8/1579" />
<meta name="og-site-name" property="og:site_name" content="American Journal of Neuroradiology" />
<meta name="og-description" property="og:description" content="BACKGROUND AND PURPOSE: VBM has been widely used to study GM atrophy in MS. MS lesions lead to segmentation and registration errors that may affect the reliability of VBM results. Improved segmentation and registration have been demonstrated by WM LI before segmentation. DARTEL appears to improve registration versus the USM. Our aim was to compare the performance of VBM-DARTEL versus VBM-USM and the effect of LI in the regional analysis of GM atrophy in MS.

MATERIALS AND METHODS: 3T T1 MR imaging scans were acquired from 26 patients with RRMS and 28 age-matched NC. LI replaced WM lesions with normal-appearing WM intensities before image segmentation. VBM analysis was performed in SPM8 by using DARTEL and USM with and without LI, allowing the comparison of 4 VBM methods (DARTEL + LI, DARTEL − LI, USM + LI, and USM − LI). Accuracy of VBM was assessed by using NMI, CC, and a simulation analysis.

RESULTS: Overall, DARTEL + LI yielded the most accurate GM maps among the 4 methods (highest NMI and CC, P &lt; .001). DARTEL + LI showed significant GM loss in the bilateral thalami and caudate nuclei in patients with RRMS versus NC. The other 3 methods overestimated the number of regions of GM loss in RRMS versus NC. LI improved the accuracy of both VBM methods. Simulated data suggested the accuracy of the results provided from patient MR imaging analysis.

CONCLUSIONS: We introduce a pipeline that shows promise in limiting segmentation and registration errors in VBM analysis in MS.

CC
:   cross-correlation
DARTEL
:   diffeomorphic anatomical registration through exponentiated lie algebra
EDSS
:   Expanded Disability Status Scale
FP
:   false-positive
GM
:   gray matter
LI
:   lesion in-painting
MDEFT
:   Modified Driven Equilibrium Fourier Transform
NC
:   normal controls
NMI
:   normalized mutual information
RRMS
:   relapsing-remitting MS
USM
:   unified segmentation model
VBM
:   voxel-based morphometry" />
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    <div class="highwire-article-citation highwire-citation-type-highwire-article node12050--5" data-node-nid="12050" id="top-node-12050--6620718346" data-pisa="ajnr;33/8/1579" data-pisa-master="ajnr;ajnr.A3083" data-apath="/ajnr/33/8/1579.atom" data-hw-author-tooltip-instance="highwire_author_tooltip"><div class="highwire-cite highwire-cite-highwire-article highwire-citation-jcore-article-title-complete clearfix has-author-tooltip highwire-citation-highwire-article-top-a">
  
  
      <div class="highwire-cite-overline"><span  class="highwire-cite-metadata-article-type highwire-cite-metadata">Research Article</span><span class="separator-pipe"></span><span  class="highwire-cite-metadata-art-cat highwire-cite-metadata"><span class="wrapper">Brain</span></span></div>
  
      <div class="highwire-cite-access"><span class="highwire-citation-access"><i class="highwire-access-icon highwire-access-icon-open-access open-access hw-icon-open-access" title="Open Access" aria-hidden="true"></i><span  class="element-invisible highwire-access-icon highwire-access-icon-open-access" style="">Open Access</span></span></div>
  
      <h1 class="highwire-cite-title" id="page-title">The Impact of Lesion In-Painting and Registration Methods on Voxel-Based Morphometry in Detecting Regional Cerebral Gray Matter Atrophy in Multiple Sclerosis</h1>  
    	<div class="highwire-cite-authors"><span  class="highwire-citation-authors"><span class="highwire-citation-author first" data-delta="0">A. Ceccarelli</span>, <span class="highwire-citation-author" data-delta="1">J.S. Jackson</span>, <span class="highwire-citation-author" data-delta="2">S. Tauhid</span>, <span class="highwire-citation-author" data-delta="3">A. Arora</span>, <span class="highwire-citation-author" data-delta="4">J. Gorky</span>, <span class="highwire-citation-author" data-delta="5">E. Dell'Oglio</span>, <span class="highwire-citation-author" data-delta="6">A. Bakshi</span>, <span class="highwire-citation-author" data-delta="7">T. Chitnis</span>, <span class="highwire-citation-author" data-delta="8">S.J. Khoury</span>, <span class="highwire-citation-author" data-delta="9">H.L. Weiner</span>, <span class="highwire-citation-author" data-delta="10">C.R.G. Guttmann</span>, <span class="highwire-citation-author" data-delta="11">R. Bakshi</span> and <span class="highwire-citation-author" data-delta="12">M. Neema</span></span></div>
  
    	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-journal highwire-cite-metadata">American Journal of Neuroradiology </span><span  class="highwire-cite-metadata-date highwire-cite-metadata">September 2012,  </span><span  class="highwire-cite-metadata-volume highwire-cite-metadata">33 </span><span  class="highwire-cite-metadata-issue highwire-cite-metadata">(8) </span><span  class="highwire-cite-metadata-pages highwire-cite-metadata">1579-1585; </span><span  class="highwire-cite-metadata-doi highwire-cite-metadata">DOI: https://doi.org/10.3174/ajnr.A3083 </span></div>
  
  
  
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<div id="hw-article-author-popups-top-node-12050--6620718346" style="display: none;"><div class="author-tooltip-0"><div class="author-tooltip-name">A. Ceccarelli </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'>aFrom the Departments of Neurology (A.C., J.S.J., S.T., A.A., J.G., E.D., A.B., T.C., S.J.K., H.L.W., R.B., M.N.)</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=A.%2BCeccarelli%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Ceccarelli%20A&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link last"><a href="/search/author1%3AA.%2BCeccarelli%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li></ul></div><div class="author-tooltip-1"><div class="author-tooltip-name">J.S. Jackson </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'>aFrom the Departments of Neurology (A.C., J.S.J., S.T., A.A., J.G., E.D., A.B., T.C., S.J.K., H.L.W., R.B., M.N.)</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=J.S.%2BJackson%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Jackson%20J&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link last"><a href="/search/author1%3AJ.S.%2BJackson%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li></ul></div><div class="author-tooltip-2"><div class="author-tooltip-name">S. Tauhid </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'>aFrom the Departments of Neurology (A.C., J.S.J., S.T., A.A., J.G., E.D., A.B., T.C., S.J.K., H.L.W., R.B., M.N.)</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=S.%2BTauhid%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Tauhid%20S&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link last"><a href="/search/author1%3AS.%2BTauhid%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li></ul></div><div class="author-tooltip-3"><div class="author-tooltip-name">A. Arora </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'>aFrom the Departments of Neurology (A.C., J.S.J., S.T., A.A., J.G., E.D., A.B., T.C., S.J.K., H.L.W., R.B., M.N.)</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=A.%2BArora%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Arora%20A&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link last"><a href="/search/author1%3AA.%2BArora%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li></ul></div><div class="author-tooltip-4"><div class="author-tooltip-name">J. Gorky </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'>aFrom the Departments of Neurology (A.C., J.S.J., S.T., A.A., J.G., E.D., A.B., T.C., S.J.K., H.L.W., R.B., M.N.)</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=J.%2BGorky%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Gorky%20J&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link last"><a href="/search/author1%3AJ.%2BGorky%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li></ul></div><div class="author-tooltip-5"><div class="author-tooltip-name">E. Dell'Oglio </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'>aFrom the Departments of Neurology (A.C., J.S.J., S.T., A.A., J.G., E.D., A.B., T.C., S.J.K., H.L.W., R.B., M.N.)</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=E.%2BDell%27Oglio%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Dell%27Oglio%20E&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link last"><a href="/search/author1%3AE.%2BDell%2527Oglio%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li></ul></div><div class="author-tooltip-6"><div class="author-tooltip-name">A. Bakshi </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'>aFrom the Departments of Neurology (A.C., J.S.J., S.T., A.A., J.G., E.D., A.B., T.C., S.J.K., H.L.W., R.B., M.N.)</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=A.%2BBakshi%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Bakshi%20A&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link last"><a href="/search/author1%3AA.%2BBakshi%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li></ul></div><div class="author-tooltip-7"><div class="author-tooltip-name">T. Chitnis </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'>aFrom the Departments of Neurology (A.C., J.S.J., S.T., A.A., J.G., E.D., A.B., T.C., S.J.K., H.L.W., R.B., M.N.)</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=T.%2BChitnis%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Chitnis%20T&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link last"><a href="/search/author1%3AT.%2BChitnis%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li></ul></div><div class="author-tooltip-8"><div class="author-tooltip-name">S.J. Khoury </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'>aFrom the Departments of Neurology (A.C., J.S.J., S.T., A.A., J.G., E.D., A.B., T.C., S.J.K., H.L.W., R.B., M.N.)</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=S.J.%2BKhoury%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Khoury%20S&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link last"><a href="/search/author1%3AS.J.%2BKhoury%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li></ul></div><div class="author-tooltip-9"><div class="author-tooltip-name">H.L. Weiner </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'>aFrom the Departments of Neurology (A.C., J.S.J., S.T., A.A., J.G., E.D., A.B., T.C., S.J.K., H.L.W., R.B., M.N.)</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=H.L.%2BWeiner%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Weiner%20H&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link last"><a href="/search/author1%3AH.L.%2BWeiner%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li></ul></div><div class="author-tooltip-10"><div class="author-tooltip-name">C.R.G. Guttmann </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'>bRadiology (C.R.G.G.), Brigham and Women's Hospital, Laboratory for Neuroimaging Research, Partners MS Center, Harvard Medical School, Boston, Massachusetts.</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=C.R.G.%2BGuttmann%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Guttmann%20C&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link last"><a href="/search/author1%3AC.R.G.%2BGuttmann%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li></ul></div><div class="author-tooltip-11"><div class="author-tooltip-name">R. Bakshi </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'>aFrom the Departments of Neurology (A.C., J.S.J., S.T., A.A., J.G., E.D., A.B., T.C., S.J.K., H.L.W., R.B., M.N.)</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=R.%2BBakshi%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Bakshi%20R&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link last"><a href="/search/author1%3AR.%2BBakshi%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li></ul></div><div class="author-tooltip-12"><div class="author-tooltip-name">M. Neema </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'>aFrom the Departments of Neurology (A.C., J.S.J., S.T., A.A., J.G., E.D., A.B., T.C., S.J.K., H.L.W., R.B., M.N.)</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=M.%2BNeema%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Neema%20M&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link last"><a href="/search/author1%3AM.%2BNeema%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li></ul></div></div></div>  </div>

  
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    <div class="highwire-markup"><div xmlns="http://www.w3.org/1999/xhtml" data-highwire-cite-ref-tooltip-instance="highwire_reflinks_tooltip" class="content-block-markup" xmlns:xhtml="http://www.w3.org/1999/xhtml"><div class="article abstract-view"><span class="highwire-journal-article-marker-start"></span><div class="section abstract" id="abstract-1"><h2>Abstract</h2>
<div id="sec-1" class="subsection"> 
<p id="p-2"><strong>BACKGROUND AND PURPOSE:</strong> VBM has been widely used to study GM atrophy in MS. MS lesions lead to segmentation and registration errors that may affect the reliability of VBM results. Improved segmentation and registration have been demonstrated by WM LI before segmentation. DARTEL appears to improve registration versus the USM. Our aim was to compare the performance of VBM-DARTEL versus VBM-USM and the effect of LI in the regional analysis of GM atrophy in MS.</p>
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<p id="p-3"><strong>MATERIALS AND METHODS:</strong> 3T T1 MR imaging scans were acquired from 26 patients with RRMS and 28 age-matched NC. LI replaced WM lesions with normal-appearing WM intensities before image segmentation. VBM analysis was performed in SPM8 by using DARTEL and USM with and without LI, allowing the comparison of 4 VBM methods (DARTEL + LI, DARTEL − LI, USM + LI, and USM − LI). Accuracy of VBM was assessed by using NMI, CC, and a simulation analysis.</p>
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<p id="p-4"><strong>RESULTS:</strong> Overall, DARTEL + LI yielded the most accurate GM maps among the 4 methods (highest NMI and CC, <em>P</em> &lt; .001). DARTEL + LI showed significant GM loss in the bilateral thalami and caudate nuclei in patients with RRMS versus NC. The other 3 methods overestimated the number of regions of GM loss in RRMS versus NC. LI improved the accuracy of both VBM methods. Simulated data suggested the accuracy of the results provided from patient MR imaging analysis.</p>
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<p id="p-5"><strong>CONCLUSIONS:</strong> We introduce a pipeline that shows promise in limiting segmentation and registration errors in VBM analysis in MS.</p>
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</div><div class="section glossary" id="glossary-1"><h2>ABBREVIATIONS:</h2>
<dl id="def-list-1"><dt id="def-item-1">CC<span class="def-item-dt-sep"></span></dt><dd>cross-correlation<span class="def-item-dd-sep"></span></dd><dt id="def-item-2">DARTEL<span class="def-item-dt-sep"></span></dt><dd>diffeomorphic anatomical registration through exponentiated lie algebra<span class="def-item-dd-sep"></span></dd><dt id="def-item-3">EDSS<span class="def-item-dt-sep"></span></dt><dd>Expanded Disability Status Scale<span class="def-item-dd-sep"></span></dd><dt id="def-item-4">FP<span class="def-item-dt-sep"></span></dt><dd>false-positive<span class="def-item-dd-sep"></span></dd><dt id="def-item-5">GM<span class="def-item-dt-sep"></span></dt><dd>gray matter<span class="def-item-dd-sep"></span></dd><dt id="def-item-6">LI<span class="def-item-dt-sep"></span></dt><dd>lesion in-painting<span class="def-item-dd-sep"></span></dd><dt id="def-item-7">MDEFT<span class="def-item-dt-sep"></span></dt><dd>Modified Driven Equilibrium Fourier Transform<span class="def-item-dd-sep"></span></dd><dt id="def-item-8">NC<span class="def-item-dt-sep"></span></dt><dd>normal controls<span class="def-item-dd-sep"></span></dd><dt id="def-item-9">NMI<span class="def-item-dt-sep"></span></dt><dd>normalized mutual information<span class="def-item-dd-sep"></span></dd><dt id="def-item-10">RRMS<span class="def-item-dt-sep"></span></dt><dd>relapsing-remitting MS<span class="def-item-dd-sep"></span></dd><dt id="def-item-11">USM<span class="def-item-dt-sep"></span></dt><dd>unified segmentation model<span class="def-item-dd-sep"></span></dd><dt id="def-item-12">VBM<span class="def-item-dt-sep"></span></dt><dd>voxel-based morphometry</dd></dl></div><ul class="copyright-statement"><li class="fn" id="copyright-statement-1">© 2012 by American Journal of Neuroradiology</li></ul><div class="license" id="license-1"><p id="p-1">Indicates open access to non-subscribers at <a href="http://www.ajnr.org">www.ajnr.org</a></p></div><span class="highwire-journal-article-marker-end"></span></div><span class="related-urls"></span></div><a href="http://ajnr-stage2.stage.highwire.org/content/33/8/1579.full" class="hw-link hw-link-article-full-text" data-icon-position="" data-hide-link-title="0">View Full Text</a></div>  </div>

  
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    	<div class="highwire-cite-authors"><span  class="highwire-citation-authors"><span class="highwire-citation-author first" data-delta="0"><span class="nlm-given-names">A.</span> <span class="nlm-surname">Ceccarelli</span></span>, <span class="highwire-citation-author" data-delta="1"><span class="nlm-given-names">J.S.</span> <span class="nlm-surname">Jackson</span></span>, <span class="highwire-citation-author" data-delta="2"><span class="nlm-given-names">S.</span> <span class="nlm-surname">Tauhid</span></span>, <span class="highwire-citation-author" data-delta="3"><span class="nlm-given-names">A.</span> <span class="nlm-surname">Arora</span></span>, <span class="highwire-citation-author" data-delta="4"><span class="nlm-given-names">J.</span> <span class="nlm-surname">Gorky</span></span>, <span class="highwire-citation-author" data-delta="5"><span class="nlm-given-names">E.</span> <span class="nlm-surname">Dell'Oglio</span></span>, <span class="highwire-citation-author" data-delta="6"><span class="nlm-given-names">A.</span> <span class="nlm-surname">Bakshi</span></span>, <span class="highwire-citation-author" data-delta="7"><span class="nlm-given-names">T.</span> <span class="nlm-surname">Chitnis</span></span>, <span class="highwire-citation-author" data-delta="8"><span class="nlm-given-names">S.J.</span> <span class="nlm-surname">Khoury</span></span>, <span class="highwire-citation-author" data-delta="9"><span class="nlm-given-names">H.L.</span> <span class="nlm-surname">Weiner</span></span>, <span class="highwire-citation-author" data-delta="10"><span class="nlm-given-names">C.R.G.</span> <span class="nlm-surname">Guttmann</span></span>, <span class="highwire-citation-author" data-delta="11"><span class="nlm-given-names">R.</span> <span class="nlm-surname">Bakshi</span></span>, <span class="highwire-citation-author" data-delta="12"><span class="nlm-given-names">M.</span> <span class="nlm-surname">Neema</span></span></span></div>
  
    	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-oa-ind highwire-cite-metadata"><i class="highwire-oa-indicator"></i> </span><span  class="highwire-cite-metadata-journal highwire-cite-metadata">American Journal of Neuroradiology </span><span  class="highwire-cite-metadata-date highwire-cite-metadata">Sep 2012, </span><span  class="highwire-cite-metadata-volume highwire-cite-metadata">33 </span><span  class="highwire-cite-metadata-issue highwire-cite-metadata">(8) </span><span  class="highwire-cite-metadata-pages highwire-cite-metadata">1579-1585; </span><span  class="highwire-cite-metadata-doi highwire-cite-metadata"><span class="label">DOI:</span> 10.3174/ajnr.A3083 </span></div>
  
  
  
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