Performance of five research-domain automated WM lesion segmentation methods in a multi-center MS study.
de Sitter ADepartment of Radiology and Nuclear Medicine, VUmc, Amsterdam, The Netherlands. Electronic address: a.desitter@vumc.nl.
Steenwijk MDDepartment of Anatomy and Neuroscience, VUmc, Amsterdam, The Netherlands.
Ruet ADepartment of Neurology, CHU-Bordeaux, Bordeaux, France; University of Bordeaux, Bordeaux, France; Inserm U-1215 Magendie Neurocenter-Pathophysiology of Neural Plasticity, CHU-Bordeaux, Bordeaux, France.
Versteeg ADepartment of Radiology and Nuclear Medicine, VUmc, Amsterdam, The Netherlands.
Liu YDepartment of Radiology and Nuclear Medicine, VUmc, Amsterdam, The Netherlands.
van Schijndel RADepartment of Radiology and Nuclear Medicine, VUmc, Amsterdam, The Netherlands.
Pouwels PJWDepartment of Radiology and Nuclear Medicine, VUmc, Amsterdam, The Netherlands.
Kilsdonk IDDepartment of Radiology and Nuclear Medicine, VUmc, Amsterdam, The Netherlands.
Cover KSDepartment of Radiology and Nuclear Medicine, VUmc, Amsterdam, The Netherlands.
van Dijk BWDepartment of Anatomy and Neuroscience, VUmc, Amsterdam, The Netherlands.
Ropele SDepartment of Neurology, Medical University of Graz, Graz, Austria.
Rocca MANeuroimaging Research Unit, Institute of Experimental Neurology, Division of Neuroscience, San Raffaele Scientific Institute, UniSR, Milan, Italy.
Yiannakas MDepartment of Neuroinflammation, Institute of Neurology, UCL, London, UK.
Wattjes MPDepartment of Radiology and Nuclear Medicine, VUmc, Amsterdam, The Netherlands.
Damangir SDepartment of Neurobiology, Care Sciences and Society, Karolinska Institute, Stockholm, Sweden.
Frisoni GBLaboratory of Epidemiology, Neuroimaging and Telemedicine, IRCCS Centro "S. Giovanni di Dio-F.B.F.", Brescia, Italy; Memory Clinic and LANVIE - Laboratory of Neuroimaging of Aging, HUG, Geneva, Switzerland.
Sastre-Garriga JCentre d'Esclerosi Múltiple de Catalunya (Cemcat), Department of Neurology/Neuroimmunology, VHIR, Barcelona, Spain.
Rovira AMagnetic Resonance Unit, Department of Radiology (IDI), VHIR, Barcelona, Spain.
Enzinger CDepartment of Neurology, Medical University of Graz, Graz, Austria; Division of Neuroradiology, Vascular and Interventional Radiology, Department of Radiology, Medical University of Graz, Graz, Austria.
Filippi MNeuroimaging Research Unit, Institute of Experimental Neurology, Division of Neuroscience, San Raffaele Scientific Institute, UniSR, Milan, Italy.
Frederiksen JDepartment of Neurology, Glostrup University Hospital, Copenhagen, Denmark.
Ciccarelli OUK/NIHR UCL-UCLH Biomedical Research Centre, Institute of Neurology, UCL, London, UK.
Kappos LNeurologic Clinic and Policlinic, University Hospital, University of Basel, Switzerland.
Barkhof FDepartment of Radiology and Nuclear Medicine, VUmc, Amsterdam, The Netherlands; Institutes of Neurology & Healthcare Engineering, UCL, London, UK.
Vrenken HDepartment of Radiology and Nuclear Medicine, VUmc, Amsterdam, The Netherlands; Department of Anatomy and Neuroscience, VUmc, Amsterdam, The Netherlands.
English
BACKGROUND AND PURPOSE In vivoidentification of white matter lesions plays a key-role in evaluation of patients with multiple sclerosis (MS). Automated lesion segmentation methods have been developed to substitute manual outlining, but evidence of their performance in multi-center investigations is lacking. In this work, five research-domain automated segmentation methods were evaluated using a multi-center MS dataset.
METHODS 70 MS patients (median EDSS of 2.0 [range 0.0-6.5]) were included from a six-center dataset of the MAGNIMS Study Group (www.magnims.eu) which included 2D FLAIR and 3D T1 images with manual lesion segmentation as a reference. Automated lesion segmentations were produced using five algorithms: Cascade; Lesion Segmentation Toolbox (LST) with both the Lesion growth algorithm (LGA) and the Lesion prediction algorithm (LPA); Lesion-Topology preserving Anatomical Segmentation (Lesion-TOADS); and k-Nearest Neighbor with Tissue Type Priors (kNN-TTP). Main software parameters were optimized using a training set (N = 18), and formal testing was performed on the remaining patients (N = 52). To evaluate volumetric agreement with the reference segmentations, intraclass correlation coefficient (ICC) as well as mean difference in lesion volumes between the automated and reference segmentations were calculated. The Similarity Index (SI), False Positive (FP) volumes and False Negative (FN) volumes were used to examine spatial agreement. All analyses were repeated using a leave-one-center-out design to exclude the center of interest from the training phase to evaluate the performance of the method on 'unseen' center.
RESULTS Compared to the reference mean lesion volume (4.85 ± 7.29 mL), the methods displayed a mean difference of 1.60 ± 4.83 (Cascade), 2.31 ± 7.66 (LGA), 0.44 ± 4.68 (LPA), 1.76 ± 4.17 (Lesion-TOADS) and -1.39 ± 4.10 mL (kNN-TTP). The ICCs were 0.755, 0.713, 0.851, 0.806 and 0.723, respectively. Spatial agreement with reference segmentations was higher for LPA (SI = 0.37 ± 0.23), Lesion-TOADS (SI = 0.35 ± 0.18) and kNN-TTP (SI = 0.44 ± 0.14) than for Cascade (SI = 0.26 ± 0.17) or LGA (SI = 0.31 ± 0.23). All methods showed highly similar results when used on data from a center not used in software parameter optimization.
CONCLUSION The performance of the methods in this multi-center MS dataset was moderate, but appeared to be robust even with new datasets from centers not included in training the automated methods.