Comparison of acute and chronic traumatic brain injury using semi-automatic multimodal segmentation of MR volumes.

Although neuroimaging is essential for prompt and proper management of traumatic brain injury (TBI), there is a regrettable and acute lack of robust methods for the visualization and assessment of TBI pathophysiology, especially for of the purpose of improving clinical outcome metrics. Until now, the application of automatic segmentation algorithms to TBI in a clinical setting has remained an elusive goal because existing methods have, for the most part, been insufficiently robust to faithfully capture TBI-related changes in brain anatomy. This article introduces and illustrates the combined use of multimodal TBI segmentation and time point comparison using 3D Slicer, a widely-used software environment whose TBI data processing solutions are openly available. For three representative TBI cases, semi-automatic tissue classification and 3D model generation are performed to perform intra-patient time point comparison of TBI using multimodal volumetrics and clinical atrophy measures. Identification and quantitative assessment of extra- and intra-cortical bleeding, lesions, edema, and diffuse axonal injury are demonstrated. The proposed tools allow cross-correlation of multimodal metrics from structural imaging (e.g., structural volume, atrophy measurements) with clinical outcome variables and other potential factors predictive of recovery. In addition, the workflows described are suitable for TBI clinical practice and patient monitoring, particularly for assessing damage extent and for the measurement of neuroanatomical change over time. With knowledge of general location, extent, and degree of change, such metrics can be associated with clinical measures and subsequently used to suggest viable treatment options.

[1]  M. Huckman,et al.  The validity of criteria for the evaluation of cerebral atrophy by computed tomography. , 1975, Radiology.

[2]  G. du Boulay,et al.  Comparing Evans' index and computerized axial tomography in assessing relationship of ventricular size to brain size , 1976, Neurology.

[3]  W E Wilkinson,et al.  Cortical atrophy, ventricular enlargement and intellectual impairment in the aged , 1979, Neurology.

[4]  Grace Scott,et al.  Diffuse axonal injury due to nonmissile head injury in humans: An analysis of 45 cases , 1982, Annals of neurology.

[5]  R A Robb,et al.  Analyze: a comprehensive, operator-interactive software package for multidimensional medical image display and analysis. , 1989, Computerized medical imaging and graphics : the official journal of the Computerized Medical Imaging Society.

[6]  J. Mugler,et al.  Three‐dimensional magnetization‐prepared rapid gradient‐echo imaging (3D MP RAGE) , 1990, Magnetic resonance in medicine.

[7]  F A Jolesz,et al.  Fast spin-echo MR imaging of the brain and spine: current concepts. , 1992, AJR. American journal of roentgenology.

[8]  J V Hajnal,et al.  MR of the brain using fluid-attenuated inversion recovery (FLAIR) pulse sequences. , 1992, AJNR. American journal of neuroradiology.

[9]  G. Hotz,et al.  Risk factors predicting operable intracranial hematomas in head injury. , 1992, Journal of neurosurgery.

[10]  B. Siewert,et al.  Acute human stroke studied by whole brain echo planar diffusion‐weighted magnetic resonance imaging , 1995, Annals of neurology.

[11]  Guy Marchal,et al.  Multimodality image registration by maximization of mutual information , 1997, IEEE Transactions on Medical Imaging.

[12]  E. Bigler,et al.  MR-based brain and cerebrospinal fluid measurement after traumatic brain injury: correlation with neuropsychological outcome. , 1997, AJNR. American journal of neuroradiology.

[13]  J Grimaud,et al.  Effect of training and different measurement strategies on the reproducibility of brain MRI lesion load measurements in multiple sclerosis , 1998, Neurology.

[14]  R. Chesnut,et al.  Implications of the guidelines for the management of severe head injury for the practicing neurosurgeon. , 1998, Surgical neurology.

[15]  National Center for Injury Prevention and Control: statistics and activities. , 1998, International journal of trauma nursing.

[16]  Anders M. Dale,et al.  Cortical Surface-Based Analysis I. Segmentation and Surface Reconstruction , 1999, NeuroImage.

[17]  Koenraad Van Leemput,et al.  Automated model-based tissue classification of MR images of the brain , 1999, IEEE Transactions on Medical Imaging.

[18]  A. Karantanas,et al.  Outcome of patients with diffuse axonal injury: the significance and prognostic value of MRI in the acute phase. , 2000, The Journal of trauma.

[19]  R. Vichi,et al.  Correlation between MRI findings and long-term outcome in patients with severe brain trauma , 2000, Neuroradiology.

[20]  L. Itti,et al.  Segmentation of Progressive Multifocal Leukoencephalopathy Lesions in Fluid‐Attenuated Inversion Recovery Magnetic Resonance Imaging , 2001, Journal of neuroimaging : official journal of the American Society of Neuroimaging.

[21]  A. Dale,et al.  Whole Brain Segmentation Automated Labeling of Neuroanatomical Structures in the Human Brain , 2002, Neuron.

[22]  James S Babb,et al.  Brain atrophy in mild or moderate traumatic brain injury: a longitudinal quantitative analysis. , 2002, AJNR. American journal of neuroradiology.

[23]  Guido Gerig,et al.  Automatic brain tumor segmentation by subject specific modification of atlas priors. , 2003, Academic radiology.

[24]  D Yves von Cramon,et al.  Diffuse axonal injury associated with chronic traumatic brain injury: evidence from T2*-weighted gradient-echo imaging at 3 T. , 2003, AJNR. American journal of neuroradiology.

[25]  A Gregory Sorensen,et al.  Diffusion-Weighted Imaging for the Evaluation of Diffuse Axonal Injury in Closed Head Injury , 2003, Journal of computer assisted tomography.

[26]  F. Dick,et al.  Voxel-based lesion–symptom mapping , 2003, Nature Neuroscience.

[27]  T. Huisman Diffusion-weighted imaging: basic concepts and application in cerebral stroke and head trauma , 2003, European Radiology.

[28]  E Mark Haacke,et al.  Hemorrhagic shearing lesions in children and adolescents with posttraumatic diffuse axonal injury: improved detection and initial results. , 2003, Radiology.

[29]  K. Kiening,et al.  Edema and brain trauma , 2004, Neuroscience.

[30]  Guido Gerig,et al.  A brain tumor segmentation framework based on outlier detection , 2004, Medical Image Anal..

[31]  C. Gyldensted Measurements of the normal ventricular system and hemispheric sulci of 100 adults with computed tomography , 1977, Neuroradiology.

[32]  Nikos Makris,et al.  Automatically parcellating the human cerebral cortex. , 2004, Cerebral cortex.

[33]  Dan Hanfling,et al.  An evaluation of the use of guidelines in prehospital management of brain injury. , 2004, Prehospital emergency care : official journal of the National Association of EMS Physicians and the National Association of State EMS Directors.

[34]  F. Hahn,et al.  The excessively small ventricle on computed axial tomography of the brain , 2004, Neuroradiology.

[35]  Jaladhar Neelavalli,et al.  Clinical applications of neuroimaging with susceptibility‐weighted imaging , 2005, Journal of magnetic resonance imaging : JMRI.

[36]  A. Buki,et al.  All roads lead to disconnection? – Traumatic axonal injury revisited , 2006, Acta Neurochirurgica.

[37]  K. Taber,et al.  Blast-related traumatic brain injury: what is known? , 2006, The Journal of neuropsychiatry and clinical neurosciences.

[38]  J. Langlois,et al.  Traumatic brain injury in the United States; emergency department visits, hospitalizations, and deaths , 2006 .

[39]  W. Eric L. Grimson,et al.  A Hierarchical Algorithm for MR Brain Image Parcellation , 2007, IEEE Transactions on Medical Imaging.

[40]  Sterling C. Johnson,et al.  Longitudinal changes in global brain volume between 79 and 409 days after traumatic brain injury: relationship with duration of coma. , 2007, Journal of neurotrauma.

[41]  Kilian M. Pohl,et al.  The Impact of Atlas Formation Methods on Atlas-Guided Brain Segmentation , 2007 .

[42]  E. Haacke,et al.  Susceptibility-Weighted MR Imaging: A Review of Clinical Applications in Children , 2008, American Journal of Neuroradiology.

[43]  Elena I. Nica,et al.  The Toronto traumatic brain injury study , 2008, Neurology.

[44]  Andrew Newberg,et al.  Neuroimaging of traumatic brain injury. , 2008, Seminars in neurology.

[45]  Guido Gerig,et al.  Brain Lesion Segmentation through Physical Model Estimation , 2008, ISVC.

[46]  R. Mccoll,et al.  Cerebral atrophy after traumatic white matter injury: correlation with acute neuroimaging and outcome. , 2008, Journal of neurotrauma.

[47]  Steven Warach,et al.  Cerebral Microbleeds : A Field Guide to their Detection and Interpretation , 2012 .

[48]  Sébastien Tremblay,et al.  Brain Function Decline in Healthy Retired Athletes who Sustained their Last Sports Concussion in Early Adulthood , 2009, NeuroImage.

[49]  Guido Gerig,et al.  Simulation of brain tumors in MR images for evaluation of segmentation efficacy , 2009, Medical Image Anal..

[50]  Egill Rostrup,et al.  Long-term global and regional brain volume changes following severe traumatic brain injury: A longitudinal study with clinical correlates , 2009, NeuroImage.

[51]  Xiaoqi Li,et al.  Diffuse damage in pediatric traumatic brain injury: A comparison of automated versus operator-controlled quantification methods , 2010, NeuroImage.

[52]  M. Wald,et al.  Traumatic brain injury in the United States; emergency department visits, hospitalizations, and deaths, 2002-2006 , 2010 .

[53]  Richard Goldstein,et al.  Human Neuroscience , 2010 .

[54]  Jeffrey S. Spence,et al.  Assessing spatial relationships between axonal integrity, regional brain volumes, and neuropsychological outcomes after traumatic axonal injury. , 2010, Journal of neurotrauma.

[55]  Mark D'Esposito,et al.  Traumatic Brain Injury: From Bench to Bedside to Society , 2010, Neuron.

[56]  Marc Modat,et al.  Atrophy patterns in Alzheimer's disease and semantic dementia: A comparison of FreeSurfer and manual volumetric measurements , 2010, NeuroImage.

[57]  A. Newberg,et al.  Neuroimaging in traumatic brain imaging , 2005, NeuroRX.