Comparison of acute and chronic traumatic brain injury using semi-automatic multimodal segmentation of MR volumes

Andrei Irimia, Micah C. Chambers, Jeffry R. Alger, Maria Filippou, Marcel W. Prastawa, Bo Wang, David A. Hovda, Guido Gerig, Arthur W. Toga, Ron Kikinis, Paul M. Vespa, John D. Van Horn

    Research output: Contribution to journalArticle

    Abstract

    Although neuroimaging is essential for prompt and proper management of traumatic brain injury (TBI), there is a regrettable and acute lack of robust methods for the visualization and assessment of TBI pathophysiology, especially for of the purpose of improving clinical outcome metrics. Until now, the application of automatic segmentation algorithms to TBI in a clinical setting has remained an elusive goal because existing methods have, for the most part, been insufficiently robust to faithfully capture TBI-related changes in brain anatomy. This article introduces and illustrates the combined use of multimodal TBI segmentation and time point comparison using 3D Slicer, a widely-used software environment whose TBI data processing solutions are openly available. For three representative TBI cases, semi-automatic tissue classification and 3D model generation are performed to perform intra-patient time point comparison of TBI using multimodal volumetrics and clinical atrophy measures. Identification and quantitative assessment of extra- and intra-cortical bleeding, lesions, edema, and diffuse axonal injury are demonstrated. The proposed tools allow cross-correlation of multimodal metrics from structural imaging (e.g., structural volume, atrophy measurements) with clinical outcome variables and other potential factors predictive of recovery. In addition, the workflows described are suitable for TBI clinical practice and patient monitoring, particularly for assessing damage extent and for the measurement of neuroanatomical change over time. With knowledge of general location, extent, and degree of change, such metrics can be associated with clinical measures and subsequently used to suggest viable treatment options.

    Original languageEnglish (US)
    Pages (from-to)2287-2306
    Number of pages20
    JournalJournal of Neurotrauma
    Volume28
    Issue number11
    DOIs
    StatePublished - Nov 1 2011

    Keywords

    • TBI
    • magnetic resonance imaging
    • segmentation
    • visualization

    ASJC Scopus subject areas

    • Clinical Neurology

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  • Cite this

    Irimia, A., Chambers, M. C., Alger, J. R., Filippou, M., Prastawa, M. W., Wang, B., Hovda, D. A., Gerig, G., Toga, A. W., Kikinis, R., Vespa, P. M., & Van Horn, J. D. (2011). Comparison of acute and chronic traumatic brain injury using semi-automatic multimodal segmentation of MR volumes. Journal of Neurotrauma, 28(11), 2287-2306. https://doi.org/10.1089/neu.2011.1920