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3D Quantitative MRI : A Fast and Reliable Method for Ventricular Volumetry

Holmgren, Rafael T. ; Tisell, Anders ; Warntjes, Marcel J.B. and Georgiopoulos, Charalampos LU orcid (2025) In World Neurosurgery 195.
Abstract

Purpose: Volumetry of cerebral ventricles is a far more sensitive measure for shunt-induced reduction of ventricular size than traditional 2-dimensional (2D) measures, such as Evans index. However, available ventricle segmentation methods are time-consuming, resulting in limited use in clinical practice. Quantitative MRI (qMRI) obtains objective measurements of physical tissue properties, enabling automatic segmentation of white and gray matter and intracranial cerebrospinal fluid. The aim of this study was to evaluate the reliability and processing time of both manual and manually corrected automatic ventricular volumetry through the application of 3D qMRI. Methods: An independent examiner performed manual ventricular volumetry... (More)

Purpose: Volumetry of cerebral ventricles is a far more sensitive measure for shunt-induced reduction of ventricular size than traditional 2-dimensional (2D) measures, such as Evans index. However, available ventricle segmentation methods are time-consuming, resulting in limited use in clinical practice. Quantitative MRI (qMRI) obtains objective measurements of physical tissue properties, enabling automatic segmentation of white and gray matter and intracranial cerebrospinal fluid. The aim of this study was to evaluate the reliability and processing time of both manual and manually corrected automatic ventricular volumetry through the application of 3D qMRI. Methods: An independent examiner performed manual ventricular volumetry segmentations on 45 3D qMRI acquisitions (15 healthy individuals, 15 idiopathic normal pressure hydrocephalus (iNPH) patients, 15 shunted iNPH patients) twice. Another independent examiner manually segmented 15 of these acquisitions once. An automatic ventricle segmentation algorithm generated a third set of ventricular segmentations for all 45 data sets. The automatic segmentations were then corrected by both examiners to obtain a fourth set of data. All segmentations were assessed for intra- and interobserver reliability. Results: Intra- and interobserver reliability for all segmentations, manual, corrected, and automatic, was excellent (intra-class correlation coefficient 1.000, 1.000 and 0.999 respectively). Ventricular volumes were on average 42 ± 18 mL (mean ± SD) in healthy individuals, 140 ± 34 mL in iNPH patients, and 113 ± 35 mL in shunted iNPH patients. Conclusions: 3D qMRI is a reliable and time-efficient method to obtain relevant volumetric measures of intracranial cerebrospinal fluid spaces for both clinical and research purposes. The corrected automatic segmentations provide a feasible time expenditure for clinicians caring for patients with iNPH.

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author
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organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Evan's index, Idiopathic normal pressure hydrocephalus, Neuroimaging, Quantitative MRI, Ventricular volumetry, Volumetry
in
World Neurosurgery
volume
195
article number
123661
publisher
Elsevier
external identifiers
  • scopus:85216566609
  • pmid:39788420
ISSN
1878-8750
DOI
10.1016/j.wneu.2025.123661
language
English
LU publication?
yes
id
34be0185-bf7c-48c4-8a8c-bb0413c4415a
date added to LUP
2025-03-21 16:14:49
date last changed
2025-07-12 01:04:02
@article{34be0185-bf7c-48c4-8a8c-bb0413c4415a,
  abstract     = {{<p>Purpose: Volumetry of cerebral ventricles is a far more sensitive measure for shunt-induced reduction of ventricular size than traditional 2-dimensional (2D) measures, such as Evans index. However, available ventricle segmentation methods are time-consuming, resulting in limited use in clinical practice. Quantitative MRI (qMRI) obtains objective measurements of physical tissue properties, enabling automatic segmentation of white and gray matter and intracranial cerebrospinal fluid. The aim of this study was to evaluate the reliability and processing time of both manual and manually corrected automatic ventricular volumetry through the application of 3D qMRI. Methods: An independent examiner performed manual ventricular volumetry segmentations on 45 3D qMRI acquisitions (15 healthy individuals, 15 idiopathic normal pressure hydrocephalus (iNPH) patients, 15 shunted iNPH patients) twice. Another independent examiner manually segmented 15 of these acquisitions once. An automatic ventricle segmentation algorithm generated a third set of ventricular segmentations for all 45 data sets. The automatic segmentations were then corrected by both examiners to obtain a fourth set of data. All segmentations were assessed for intra- and interobserver reliability. Results: Intra- and interobserver reliability for all segmentations, manual, corrected, and automatic, was excellent (intra-class correlation coefficient 1.000, 1.000 and 0.999 respectively). Ventricular volumes were on average 42 ± 18 mL (mean ± SD) in healthy individuals, 140 ± 34 mL in iNPH patients, and 113 ± 35 mL in shunted iNPH patients. Conclusions: 3D qMRI is a reliable and time-efficient method to obtain relevant volumetric measures of intracranial cerebrospinal fluid spaces for both clinical and research purposes. The corrected automatic segmentations provide a feasible time expenditure for clinicians caring for patients with iNPH.</p>}},
  author       = {{Holmgren, Rafael T. and Tisell, Anders and Warntjes, Marcel J.B. and Georgiopoulos, Charalampos}},
  issn         = {{1878-8750}},
  keywords     = {{Evan's index; Idiopathic normal pressure hydrocephalus; Neuroimaging; Quantitative MRI; Ventricular volumetry; Volumetry}},
  language     = {{eng}},
  publisher    = {{Elsevier}},
  series       = {{World Neurosurgery}},
  title        = {{3D Quantitative MRI : A Fast and Reliable Method for Ventricular Volumetry}},
  url          = {{http://dx.doi.org/10.1016/j.wneu.2025.123661}},
  doi          = {{10.1016/j.wneu.2025.123661}},
  volume       = {{195}},
  year         = {{2025}},
}