Reduced accuracy of MRI deep grey matter segmentation in multiple sclerosis: an evaluation of four automated methods against manual reference segmentations in a multi-center cohort

Alexandra de Sitter, Tom Verhoeven, Jessica Burggraaff, Yaou Liu, Jorge Simoes, Serena Ruggieri, Miklos Palotai, Iman Brouwer, Adriaan Versteeg, Viktor Wottschel, Stefan Ropele, Mara A Rocca, Claudio Gasperini, Antonio Gallo, Marios C Yiannakas, Alex Rovira, Christian Enzinger, Massimo Filippi, Nicola De Stefano, Ludwig KapposJette L Frederiksen, Bernard M J Uitdehaag, Frederik Barkhof, Charles R G Guttmann, Hugo Vrenken, MAGNIMS Study Group

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BACKGROUND: Deep grey matter (DGM) atrophy in multiple sclerosis (MS) and its relation to cognitive and clinical decline requires accurate measurements. MS pathology may deteriorate the performance of automated segmentation methods. Accuracy of DGM segmentation methods is compared between MS and controls, and the relation of performance with lesions and atrophy is studied.

METHODS: On images of 21 MS subjects and 11 controls, three raters manually outlined caudate nucleus, putamen and thalamus; outlines were combined by majority voting. FSL-FIRST, FreeSurfer, Geodesic Information Flow and volBrain were evaluated. Performance was evaluated volumetrically (intra-class correlation coefficient (ICC)) and spatially (Dice similarity coefficient (DSC)). Spearman's correlations of DSC with global and local lesion volume, structure of interest volume (ROIV), and normalized brain volume (NBV) were assessed.

RESULTS: ICC with manual volumes was mostly good and spatial agreement was high. MS exhibited significantly lower DSC than controls for thalamus and putamen. For some combinations of structure and method, DSC correlated negatively with lesion volume or positively with NBV or ROIV. Lesion-filling did not substantially change segmentations.

CONCLUSIONS: Automated methods have impaired performance in patients. Performance generally deteriorated with higher lesion volume and lower NBV and ROIV, suggesting that these may contribute to the impaired performance.

Original languageEnglish
JournalJournal of Neurology
Publication statusE-pub ahead of print - 3 Jul 2020

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