Open access series of imaging studies: Longitudinal MRI data in nondemented and demented older adults

The Open Access Series of Imaging Studies (OASIS) is a series of neuroimaging data sets that is publicly available for study and analysis. The present MRI data set consists of a longitudinal collection of 150 subjects aged 60 to 96 all acquired on the same scanner using identical sequences. Each subject was scanned on two or more visits, separated by at least one year for a total of 373 imaging sessions. Subjects were characterized using the Clinical Dementia Rating (CDR) as either nondemented or with very mild to mild Alzheimer‘s disease (AD). 72 of the subjects were characterized as nondemented throughout the study. 64 of the included subjects were characterized as demented at the time of their initial visits and remained so for subsequent scans, including 51 individuals with CDR 0.5 similar level of impairment to individuals elsewhere considered to have ‘mild cognitive impairment’. Another 14 subjects were characterized as nondemented at the time of their initial visit (CDR 0) and were subsequently characterized as demented at a later visit (CDR > 0). The subjects were all right-handed and include both men (n=62) and women (n=88). For each scanning session, 3 or 4 individual T1-weighted MRI scans were obtained. Multiple within-session acquisitions provide extremely high contrast-to-noise making the data amenable to a wide range of analytic approaches including automated computational analysis. Automated calculation of whole brain volume is presented to demonstrate use of the data for measuring differences associated with normal aging and AD

Brain Volume Decline in Aging

Objectives: To assess the relation between socioeconomic status (SES) and structural brain change in nondemented older adults and to ascertain the potential role of preclinical Alzheimer disease (AD). Design: Cross-sectional and longitudinal observation. Setting: Alzheimer's Disease Research Center, St Louis, Missouri. Participants: Volunteer sample of 362 nondemented adults aged 18 to 93 years. The main cohort of 100 was evaluated for dementia and SES; a Clinical Dementia Rating (CDR) of 0 (no dementia) and middle, high-middle, or high SES was required for eligibility. All 362 received magnetic resonance imaging; of the main 100, 91 received follow-up clinical assessment, and 33 received follow-up magnetic resonance imaging over at least a 3-year interval. A separate sample of 58 CDR 0 participants (aged 47 to 86 years) took part in amyloid imaging with Pittsburgh Compound B (PiB) labeled with radioactive carbon (C-11). Main Outcome Measures: Whole-brain volume adjusted for head size (aWBV) and change per year. Results: aWBV declined by 0:22% per year between the ages of 20 and 80 years with accelerated decline in advanced aging. Controlling for effects of age and sex in older adults (> 65 years) with CDR 0, higher SES was associated with smaller aWBV (3.8% difference spanning the sample range from middle to high privilege, P <.01) and more rapid volume loss (0.39% per year to 0.68% per year from middle to high privilege, P <.05). aWBV was reduced by 2.5% in individuals positive for PiB binding (n=9) as compared with individuals negative for PiB binding (n=49, P < .05), supporting an influence of undetected preclinical AD. Follow-up clinical data revealed that brain volume reduction associated with SES was greater in those who later developed very mild dementia (preclinical CDR 0 group, n=19) compared with those who remained nondemented (stable CDR 0 group, n=64; group X SES interaction, P <.05). Conclusions: Privileged nondemented older adults harbor more preclinical brain atrophy, consistent with their having greater reserve against the expression of AD.Psycholog

Unbiased review of digital diagnostic images in practice: informatics prototype and pilot study

RATIONALE AND OBJECTIVES: Clinical and contextual information associated with images may influence how radiologists draw diagnostic inferences, highlighting the need to control multiple sources of bias in the methodological design of investigations involving radiological interpretation. In the past, manual control methods to mask review films presented in practice have been used to reduce potential interpretive bias associated with differences between viewing images for patient care versus reviewing images for purposes of research, education, and quality improvement. These manual precedents from the film era raise the question whether similar methods to reduce bias can be implemented in the modern digital environment. MATERIALS AND METHODS: We built prototype “CreateAPatient” information technology for masking review case presentations within our institution’s production Radiology Information and Picture Archiving and Reporting Systems (RIS and PACS). To test whether CreateAPatient could be used to mask review images presented in practice, six board-certified radiologists participated in a pilot study. During pilot testing, seven digital chest radiographs, known to contain lung nodules and associated with fictitious patient identifiers, were mixed into the routine workload of the participating radiologists while they covered general evening call shifts. We tested whether it was possible to mask the presentation of these review cases, both by probing the interpreting radiologists to report detection and by conducting a forced-choice experiment on a separate cohort of 20 radiologists and information technology professionals. RESULTS: None of the participating radiologists reported awareness of review activity, and forced-choice detection was less than predicted at chance, suggesting radiologists were effectively blinded. In addition, we identified no evidence of review reports unsafely propagating beyond their intended scope or otherwise interfering with patient care, despite integration of these records within production electronic workflow systems. CONCLUSION: Information technology can facilitate the design of unbiased methods involving professional review of digital diagnostic images