Bullseye's representation of cerebral white matter hyperintensities

Altres ajuts: Carole H. Sudre is funded by the Wolfson Foundation , UCL Faculty of EngineeringMRC (MR/M023664/1), EPSRC (EP/M020533/1), the NIHR Biomedical Research Centre (BRC345/NS/SB/101410) and Alzheimer's Society(AS-JF-17-011). Sebastien Ourselin receives funding from the EPSRC (EP/H046410/1, EP/J020990/1, EP/K005278), the MRC (MR/J01107X/1), the EU-FP7 project VPH-DARE@IT (FP7-ICT-2011-9-601055), the NIHR Biomedical Research Unit (Dementia) at UCL and the National Institute for Health Research University College London Hospitals Biomedical Research Centre (NIHR BRC UCLH/UCL High Impact Initiative-BW.mn.BRC10269). Ferran Prados is funded by the National Institute for Health Research College London Hospitals Biomedical Research Centre (NIHR BRC UCLH/UCL High Impact Initiative) and is a Guarantors of Brain fellow. Indran Davagnanam receives support from the NIHR UCLH/UCL BRC. The Dementia Research Centre is supported by Alzheimer's Research UK, Brain Research Trust, and The Wolfson Foundation. M. Jorge Cardoso receives funding from EPSRC (EP/H046410/1). The SABRE study was funded at baseline by the UK Medical Research Council, Diabetes UK and the British Heart Foundation, and at follow-up by the Wellcome Trust (WT082464), British Heart Foundation (SP/07/001/23603 and CS/13/1/30327) and Diabetes UK (13/0004774).Visual rating scales have limited capacities to depict the regional distribution of cerebral white matter hyperintensities (WMH). We present a regional-zonal volumetric analysis alongside a visualization tool to compare and deconstruct visual rating scales. 3D T1-weighted, T2-weighted spin-echo and FLAIR images were acquired on a 3 T system, from 82 elderly participants in a population-based study. Images were automatically segmented for WMH. Lobar boundaries and distance to ventricular surface were used to define white matter regions. Regional-zonal WMH loads were displayed using bullseye plots. Four raters assessed all images applying three scales. Correlations between visual scales and regional WMH as well as inter and intra-rater variability were assessed. A multinomial ordinal regression model was used to predict scores based on regional volumes and global WMH burdens. On average, the bullseye plot depicted a right-left symmetry in the distribution and concentration of damage in the periventricular zone, especially in frontal regions. WMH loads correlated well with the average visual rating scores (e.g. Kendall's tau [Volume, Scheltens] = 0.59 CI = [0.53 0.62]). Local correlations allowed comparison of loading patterns between scales and between raters. Regional measurements had more predictive power than global WMH burden (e.g. frontal caps prediction with local features: ICC = 0.67 CI = [0.53 0.77], global volume = 0.50 CI = [0.32 0.65], intra-rater = 0.44 CI = [0.23 0.60]). Regional-zonal representation of WMH burden highlights similarities and differences between visual rating scales and raters. The bullseye infographic tool provides a simple visual representation of regional lesion load that can be used for rater calibration and training