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20 March 2015 Highly accurate volumetry of the spinal cord
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Quantitative analysis of the spinal cord from MR images is of significant clinical interest when studying certain neurologic diseases. Especially for multiple sclerosis, a number of studies have analyzed the relation between spinal cord atrophy and clinically monitored progression of the disease. A commonly analyzed parameter in this field is the mean cross-sectional area of the cord, which can also be expressed as the average volume per cm. In this paper, we present a novel approach for precise measurement of the volume, length, and cross-sectional area of the spinal cord from T1-weighted MR images. It is computationally fast, with a low effort of required user interaction. It is based on a semi-automated pre-segmentation of a sub-section of the spinal cord, followed by an automated Gaussian mixture-model fit for volume calculation. Additionally, the centerline of the cord is extracted, which allows for calculation of the mean cross-sectional area of the measured section. We evaluate the accuracy of our method with respect to scan/re-scan reproducibility as well as intra- and inter-rater agreement. We achieved a mean coefficient of variation of 0.62% over repeated MR acquisitions, mean CoV of 0.39% for intra-rater comparison, and a mean CoV of 0.28% for inter-rater comparison by five different observers. These results prove a high sensitivity to detect even small changes in atrophy, as it could typically be observed over the temporal progression of MS
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Florian Weiler, Marita Daams, Carsten Lukas, Frederik Barkhof, and Horst K. Hahn "Highly accurate volumetry of the spinal cord", Proc. SPIE 9413, Medical Imaging 2015: Image Processing, 941302 (20 March 2015);

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