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Know your tools—concordance of different methods for measuring brain volume change after ischemic stroke

  • Diagnostic Neuroradiology
  • Published:
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Abstract

Introduction

Longitudinal brain volume changes have been investigated in a number of cerebral disorders as a surrogate marker of clinical outcome. In stroke, unique methodological challenges are posed by dynamic structural changes occurring after onset, particularly those relating to the infarct lesion. We aimed to evaluate agreement between different analysis methods for the measurement of post-stroke brain volume change, and to explore technical challenges inherent to these methods.

Methods

Fifteen patients with anterior circulation stroke underwent magnetic resonance imaging within 1 week of onset and at 1 and 3 months. Whole-brain as well as grey- and white-matter volume were estimated separately using both an intensity-based and a surface watershed-based algorithm. In the case of the intensity-based algorithm, the analysis was also performed with and without exclusion of the infarct lesion. Due to the effects of peri-infarct edema at the baseline scan, longitudinal volume change was measured as percentage change between the 1 and 3-month scans. Intra-class and concordance correlation coefficients were used to assess agreement between the different analysis methods. Reduced major axis regression was used to inspect the nature of bias between measurements.

Results

Overall agreement between methods was modest with strong disagreement between some techniques. Measurements were variably impacted by procedures performed to account for infarct lesions.

Conclusions

Improvements in volumetric methods and consensus between methodologies employed in different studies are necessary in order to increase the validity of conclusions derived from post-stroke cerebral volumetric studies. Readers should be aware of the potential impact of different methods on study conclusions.

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Ethical Standards and Patient Consent

We declare that all human and animal studies have been approved by the Melbourne Health Research Ethics Committee and have therefore been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments. We declare that all patients gave informed consent prior to inclusion in this study.

Conflict of Interest

We declare that we have no conflict of interest.

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Authors and Affiliations

  1. Departments of Medicine and Neurology, Melbourne Brain Centre @ The Royal Melbourne Hospital, The University of Melbourne, Grattan St, Parkville, Victoria, 3050, Australia

    Nawaf Yassi, Bruce C. V. Campbell, Stephen M. Davis & Andrew Bivard

  2. Department of Radiology, The Royal Melbourne Hospital, The University of Melbourne, Parkville, Australia

    Bradford A. Moffat, Christopher Steward & Patricia M. Desmond

  3. The Florey Institute of Neurosciences and Mental Health, The University of Melbourne, Parkville, Australia

    Leonid Churilov

  4. Priority Research Centre for Translational Neuroscience and Mental Health, University of Newcastle and Hunter Medical Research Institute, Newcastle, Australia

    Mark W. Parsons

Authors
  1. Nawaf Yassi
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  2. Bruce C. V. Campbell
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Correspondence to Nawaf Yassi.

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Yassi, N., Campbell, B.C.V., Moffat, B.A. et al. Know your tools—concordance of different methods for measuring brain volume change after ischemic stroke. Neuroradiology 57, 685–695 (2015). https://doi.org/10.1007/s00234-015-1522-8

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  • DOI: https://doi.org/10.1007/s00234-015-1522-8

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