Contributions
Abstract: P1117
Type: Poster Sessions
Abstract Category: Pathology and pathogenesis of MS - MRI and PET
Background: Accurate reference segmentations of deep grey matter (GM) structures are needed for training and evaluating automated brain segmentation methods to measure GM atrophy in MS. To create reference segmentations, manual outlining is the “gold standard”; however, it is challenging and time consuming. In this study we investigated whether FASTSURF (FAst Segmentation Through SURface Fairing), a surface-fairing technique based on a bi-Laplacian mesh operator to reconstruct structures from sparse delineations, is accurate enough to create reference segmentations of deep GM structures in MS.
Method: Following a standardized outlining protocol, three independent raters outlined the caudate nucleus, putamen, and thalamus bilaterally on 35 multi-center, 3D T1-weighted scans of 12 healthy controls and 23 MS patients. Structures of the left and right hemisphere were grouped together for analysis. Optimal FASTSURF settings were determined from a training set (n=17). Agreement of FASTSURF with manual segmentations was assessed in a test set (n=18) by evaluating mean volumes, intra-class correlation coefficients (ICC), and generalized conformity index (CIgen) between manual and FASTSURF segmentations.
Results: In the test set, mean volumes of caudate nucleus were 3.78±0.63mL for FASTSURF versus 3.85±0.67mL for manual; putamen: 4.63±1.01mL versus 4.65±1.02mL; and thalamus 6.72±1.52mL versus 6.75±1.51mL. Absolute agreement ICCs were excellent: 0.979 (caudate nucleus), 0.999 (putamen), and 0.999 (thalamus). The good inter-rater overlap between manual segmentations, with CIgen values of 0.74±0.05 (caudate nucleus), 0.74±0.06 (putamen) and 0.75±0.06 (thalamus), was well reproduced by FASTSURF (0.74±0.05, 0.73±0.06 and 0.75±0.06, respectively).
Conclusions: FASTSURF reconstructions exhibit excellent volumetric agreement with manual segmentations. Moreover, inter-rater overlap was almost identical for FASTSURF and for manual segmentations. We conclude that accurate reference segmentations could be created at a strongly reduced workload, outlining only 10 slices instead of the whole structure, using this semi-automated method, which generates opportunities for developing improved automated deep GM atrophy measurement methods for MS and other neurological diseases.
Disclosure: A. de Sitter was funded for this study by the “Nauta Fonds” and "VUmc MS Center Amsterdam" and is employed on a project sponsored by a research grant from Teva Pharmaceuticals (grant to H. Vrenken and F. Barkhof).
F. Bartel has nothing to disclose
M. Palotai is currently a recipient of the McDonald Fellowship from the Multiple Sclerosis International Federation.
J. Burggraaff received funding for research from the “Nauta Fonds”.
Y. Liu was a recipient of the ECTRIMS-MAGNIMS fellowship.
J. Simoes has nothing to disclose.
S. Ruggieri has received fee as speaking honoraria from Teva,Merck Serono, Novartis; travel grant from Biogen, Merck Serono; advisory board from Merck Serono and Novartis.
K.Schregel has nothing to disclose .
A. Morales Pinzon has nothing to disclose.
S. Ropele has nothing to disclose.
M.A. Rocca has received speakers honoraria from Biogen Idec, Novartis, Genzyme, Sanofi-Aventis, Teva, Merck Serono, and Roche and receives research support from the Italian Ministry of Health and Fondazione Italiana Sclerosi Multipla.
C. Gasperini has received fee as speaker for Bayer-Schering Pharma, Sanofi-Aventis, Genzyme, Biogen, Teva, Novartis, Merck Serono and has received a grant for research by Teva.
A. Gallo has received compensation for consulting services and/or speaking activities from Biogen Idec, Merck Serono, Novartis, Genzyme, Roche and Teva.
M. Schoonheim serves on the editorial board of Frontiers of Neurology, receives research support from the Dutch MS Research Foundation, grant number 13-820, and has received compensation for consulting services or speaker honoraria from ExceMed, Genzyme and Biogen.
M. Amann has nothing to disclose.
M. Yiannakas has nothing to disclose.
M.P. Wattjes has received consultancy and speaking honoraria from Biogen, Novartis, IXICO, Janssen, Merck-Serono, Roche, Sanofi-Genzyme.
J. Sastre-Garriga Jaume Sastre-Garriga has received compensation for participation in advisory boards and speaker bureaus from TEVA, Genzyme, Biogen, Novartis, Roche, Celgene, Merck and Almirall.
L. Kappos has received no personal compensation. Ludwig Kappos´s institution (University Hospital Basel) has received and used exclusively for research support: Steering committee, advisory board, and consultancy fees from Actelion, Addex, Bayer HealthCare, Biogen Idec, Biotica, Genzyme, Lilly, Merck, Mitsubishi, Novartis, Ono Pharma, Pfizer, Receptos, Sanofi, Santhera, Siemens, Teva, UCB, and Xenoport; speaker fees from Bayer HealthCare, Biogen Idec, Merck, Novartis, Sanofi, and Teva; support of educational activities from Bayer HealthCare, Biogen, CSL Behring, Genzyme, Merck, Novartis, Sanofi, and Teva; license fees for Neurostatus products; and grants from Bayer HealthCare, Biogen Idec, European Union, Merck, Novartis, Roche Research Foundation, Swiss MS Society, and the Swiss National Research Foundation.
M. Filippi is Editor-in-Chief of the Journal of Neurology; received compensation for consulting services and/or speaking activities from Biogen Idec, Merck-Serono, Novartis, Teva Pharmaceutical Industries; and receives research support from Biogen Idec, Merck-Serono, Novartis, Teva Pharmaceutical Industries, Roche, Italian Ministry of Health, Fondazione Italiana Sclerosi Multipla, and ARiSLA (Fondazione Italiana di Ricerca per la SLA).
C. Enzinger declares no conflict of interest.
O. Ciccarelli has receives research grants from the MS Society of Great Britain & Northern Ireland, , National Institute for Health Research (NIHR) University College London Hospitals Biomedical Research Centre, EUH2020, Spinal Cord Research Foundation and Rosetrees Trust. Professor Ciccarelli serves as a consultant for Novartis, Teva & Roche. And has received an honorarium from the AAN as Associate Editor of Neurology and serves on the Editorial Board of Multiple Sclerosis Journal.
J. Frederiksen has recieved no funding to support the presented work. She has served on scientific advisory boards for and received funding for travel related to these activities as well as honoraria from Biogen Idec, Merck Serono, Sanofi-Aventis, Teva, Novartis and Almirall. She has received speaker honoraria from Biogen Idec, Teva and Novartis. She has served as advisor on preclinical development for Takeda.
F. Barkhof has received compensation for consulting services and/or speaking activities from Bayer Schering Pharma, Biogen Idec, Merck Serono, Novartis, Genzyme, Synthon BV, Roche, Teva, Jansen research and IXICO and is is supported by the NIHR Biomedical Research Centre at UCLH.
C.R.G. Guttmann Dr. Guttmann has nothing to disclose that could constitute a conflict of interest for this work. Dr. Guttmann has received research funding from Sanofi, the National Multiple Sclerosis Society, and the International Progressive Multiple Sclerosis Alliance.
J.C. de Munck declares no conflict of interest.
H. Vrenken has received research grants from Pfizer, MerckSerono, Novartis and Teva, speaker honoraria from Novartis, and consulting fees from MerckSerono; all funds were paid directly to his institution.
Abstract: P1117
Type: Poster Sessions
Abstract Category: Pathology and pathogenesis of MS - MRI and PET
Background: Accurate reference segmentations of deep grey matter (GM) structures are needed for training and evaluating automated brain segmentation methods to measure GM atrophy in MS. To create reference segmentations, manual outlining is the “gold standard”; however, it is challenging and time consuming. In this study we investigated whether FASTSURF (FAst Segmentation Through SURface Fairing), a surface-fairing technique based on a bi-Laplacian mesh operator to reconstruct structures from sparse delineations, is accurate enough to create reference segmentations of deep GM structures in MS.
Method: Following a standardized outlining protocol, three independent raters outlined the caudate nucleus, putamen, and thalamus bilaterally on 35 multi-center, 3D T1-weighted scans of 12 healthy controls and 23 MS patients. Structures of the left and right hemisphere were grouped together for analysis. Optimal FASTSURF settings were determined from a training set (n=17). Agreement of FASTSURF with manual segmentations was assessed in a test set (n=18) by evaluating mean volumes, intra-class correlation coefficients (ICC), and generalized conformity index (CIgen) between manual and FASTSURF segmentations.
Results: In the test set, mean volumes of caudate nucleus were 3.78±0.63mL for FASTSURF versus 3.85±0.67mL for manual; putamen: 4.63±1.01mL versus 4.65±1.02mL; and thalamus 6.72±1.52mL versus 6.75±1.51mL. Absolute agreement ICCs were excellent: 0.979 (caudate nucleus), 0.999 (putamen), and 0.999 (thalamus). The good inter-rater overlap between manual segmentations, with CIgen values of 0.74±0.05 (caudate nucleus), 0.74±0.06 (putamen) and 0.75±0.06 (thalamus), was well reproduced by FASTSURF (0.74±0.05, 0.73±0.06 and 0.75±0.06, respectively).
Conclusions: FASTSURF reconstructions exhibit excellent volumetric agreement with manual segmentations. Moreover, inter-rater overlap was almost identical for FASTSURF and for manual segmentations. We conclude that accurate reference segmentations could be created at a strongly reduced workload, outlining only 10 slices instead of the whole structure, using this semi-automated method, which generates opportunities for developing improved automated deep GM atrophy measurement methods for MS and other neurological diseases.
Disclosure: A. de Sitter was funded for this study by the “Nauta Fonds” and "VUmc MS Center Amsterdam" and is employed on a project sponsored by a research grant from Teva Pharmaceuticals (grant to H. Vrenken and F. Barkhof).
F. Bartel has nothing to disclose
M. Palotai is currently a recipient of the McDonald Fellowship from the Multiple Sclerosis International Federation.
J. Burggraaff received funding for research from the “Nauta Fonds”.
Y. Liu was a recipient of the ECTRIMS-MAGNIMS fellowship.
J. Simoes has nothing to disclose.
S. Ruggieri has received fee as speaking honoraria from Teva,Merck Serono, Novartis; travel grant from Biogen, Merck Serono; advisory board from Merck Serono and Novartis.
K.Schregel has nothing to disclose .
A. Morales Pinzon has nothing to disclose.
S. Ropele has nothing to disclose.
M.A. Rocca has received speakers honoraria from Biogen Idec, Novartis, Genzyme, Sanofi-Aventis, Teva, Merck Serono, and Roche and receives research support from the Italian Ministry of Health and Fondazione Italiana Sclerosi Multipla.
C. Gasperini has received fee as speaker for Bayer-Schering Pharma, Sanofi-Aventis, Genzyme, Biogen, Teva, Novartis, Merck Serono and has received a grant for research by Teva.
A. Gallo has received compensation for consulting services and/or speaking activities from Biogen Idec, Merck Serono, Novartis, Genzyme, Roche and Teva.
M. Schoonheim serves on the editorial board of Frontiers of Neurology, receives research support from the Dutch MS Research Foundation, grant number 13-820, and has received compensation for consulting services or speaker honoraria from ExceMed, Genzyme and Biogen.
M. Amann has nothing to disclose.
M. Yiannakas has nothing to disclose.
M.P. Wattjes has received consultancy and speaking honoraria from Biogen, Novartis, IXICO, Janssen, Merck-Serono, Roche, Sanofi-Genzyme.
J. Sastre-Garriga Jaume Sastre-Garriga has received compensation for participation in advisory boards and speaker bureaus from TEVA, Genzyme, Biogen, Novartis, Roche, Celgene, Merck and Almirall.
L. Kappos has received no personal compensation. Ludwig Kappos´s institution (University Hospital Basel) has received and used exclusively for research support: Steering committee, advisory board, and consultancy fees from Actelion, Addex, Bayer HealthCare, Biogen Idec, Biotica, Genzyme, Lilly, Merck, Mitsubishi, Novartis, Ono Pharma, Pfizer, Receptos, Sanofi, Santhera, Siemens, Teva, UCB, and Xenoport; speaker fees from Bayer HealthCare, Biogen Idec, Merck, Novartis, Sanofi, and Teva; support of educational activities from Bayer HealthCare, Biogen, CSL Behring, Genzyme, Merck, Novartis, Sanofi, and Teva; license fees for Neurostatus products; and grants from Bayer HealthCare, Biogen Idec, European Union, Merck, Novartis, Roche Research Foundation, Swiss MS Society, and the Swiss National Research Foundation.
M. Filippi is Editor-in-Chief of the Journal of Neurology; received compensation for consulting services and/or speaking activities from Biogen Idec, Merck-Serono, Novartis, Teva Pharmaceutical Industries; and receives research support from Biogen Idec, Merck-Serono, Novartis, Teva Pharmaceutical Industries, Roche, Italian Ministry of Health, Fondazione Italiana Sclerosi Multipla, and ARiSLA (Fondazione Italiana di Ricerca per la SLA).
C. Enzinger declares no conflict of interest.
O. Ciccarelli has receives research grants from the MS Society of Great Britain & Northern Ireland, , National Institute for Health Research (NIHR) University College London Hospitals Biomedical Research Centre, EUH2020, Spinal Cord Research Foundation and Rosetrees Trust. Professor Ciccarelli serves as a consultant for Novartis, Teva & Roche. And has received an honorarium from the AAN as Associate Editor of Neurology and serves on the Editorial Board of Multiple Sclerosis Journal.
J. Frederiksen has recieved no funding to support the presented work. She has served on scientific advisory boards for and received funding for travel related to these activities as well as honoraria from Biogen Idec, Merck Serono, Sanofi-Aventis, Teva, Novartis and Almirall. She has received speaker honoraria from Biogen Idec, Teva and Novartis. She has served as advisor on preclinical development for Takeda.
F. Barkhof has received compensation for consulting services and/or speaking activities from Bayer Schering Pharma, Biogen Idec, Merck Serono, Novartis, Genzyme, Synthon BV, Roche, Teva, Jansen research and IXICO and is is supported by the NIHR Biomedical Research Centre at UCLH.
C.R.G. Guttmann Dr. Guttmann has nothing to disclose that could constitute a conflict of interest for this work. Dr. Guttmann has received research funding from Sanofi, the National Multiple Sclerosis Society, and the International Progressive Multiple Sclerosis Alliance.
J.C. de Munck declares no conflict of interest.
H. Vrenken has received research grants from Pfizer, MerckSerono, Novartis and Teva, speaker honoraria from Novartis, and consulting fees from MerckSerono; all funds were paid directly to his institution.