The identification of cerebral volume changes in treated growth
hormone-deficient adults using serial 3D MR image processing.
J Comput Assist Tomogr 24(1) pp. 139-145 (January-February, 2000)
E. R. Denton¹,
Derek L.G. Hill,
J. M. Jarosz¹,
Tim C. S. Cox³,
David J. Hawkes
Radiological Sciences, GKT, Guy's Hospital,
London, SE1 9RT, UK.
¹ Radiology Dept., King's College Hospital, London SE5 9RS, UK
² Endocrinology Dept., Guy's Hospital, London, SE1 9RT, UK.
³ Institute of Neurology, UCL, Queen's Square, London WC1N 3BG, UK
PURPOSE: A pilot study to detect volume changes of cerebral structures in growth
hormone GH-deficient adults treated with GH using serial 3D MR image processing and
to assess need for segmentation prior to registration was conducted.
METHOD: Volume MR scans of the brain were obtained in five patients
and six control subjects.
Patients were scanned before and after 3 and 6 months of therapy. Control subjects were scanned
at the same intervals. A phantom was used to quantify scaling errors. Second and third
volumes were aligned with the baseline by maximizing normalized mutual information
and transformed using sinc interpolation. Registration was performed with and without
brain segmentation and correction of scaling errors. Each registered, transformed image
had the original subtracted, generating a difference image. Structural change and effects
of segmentation and scaling error correction were assessed on original and difference
images. The radiologists' ability to detect volume change was also assessed.
RESULTS: Compared with control subjects, GH-treated subjects had an increase in cerebral volume
and reduction in ventricular volume (p = 0.91x10^-3). Scale correction and
segmentation made no difference (p = 1 and p = 0.873). Structural changes were
identified in the difference images but not in the original (p = 0.136). The radiologists
detected changes > 200 micron.
CONCLUSION: GH treatment in deficient patients results
in cerebral volume changes detectable by registration and subtraction of serial MR
studies but not by standard assessment of images. This registration method did not
require prior segmentation.
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Mark Holden |
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