Bringing psychiatrists into the picture: automated measurement of regional MRI brain volume in patients with suspected dementia

Wibawa, Pierre, Matta, Gabriel, Das, Sourav, Eratne, Dhamidu, Farrand, Sarah, Desmond, Patricia, Velakoulis, Dennis, and Gaillard, Frank (2021) Bringing psychiatrists into the picture: automated measurement of regional MRI brain volume in patients with suspected dementia. Australian and New Zealand Journal of Psychiatry, 55 (8). pp. 799-808.

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Objective: The volumes of various brain regions can be rapidly quantified using automated magnetic resonance imaging tools. While these appear to be useful at face value, their formal clinical utility is not yet understood, particularly for non-neuroradiologists and in patients presenting with suspected dementia. This study investigated the utility of an automated normative morphometry tool on determinations of brain atrophy by psychiatrists and radiologists in a tertiary hospital.

Methods: Consecutive magnetic resonance scans (n = 110) of patients referred with suspected neurodegenerative disorders were obtained retrospectively and rated by two neuroradiologists, two general radiologists and four psychiatrists over two sessions. First, conventional magnetic resonance sequences were shown. Then, morphometry colour-coded maps, which segmented T1-weighted magnetisation prepared rapid gradient echo images into brain regions and visualised these regions in colour according to their volumetric standard deviation from a normative population, were added to the second reading which occurred ⩾6 weeks later. Presence and laterality of atrophy in frontal, parietal and temporal lobes and hippocampal regions were measured using a digital checklist. The primary outcome of inter-rater agreement on atrophy was measured with Fleiss’ Kappa (κ). We also evaluated the accuracy of the atrophy ratings for differentiating post hoc diagnosis of subjective cognitive impairment, mild cognitive impairment and dementia.

Results: Agreement among all raters was fair in frontal lobe and moderate in other regions with conventional method (κ = 0.362–0.555). With morphometry, higher agreement was seen in all regions (κ = 0.551–0.654), reaching significant improvement in the frontal and temporal lobes. No significant improvement was seen within the various disciplines, except in frontal lobes rated by psychiatrists. Accuracy of atrophy ratings on determining post hoc diagnosis was significantly improved for distinguishing subjective cognitive impairment versus dementia.

Conclusion: In routine clinical assessment, automated normative morphometry complements the determination of regional atrophy and improves inter-rater agreement regardless of neuroradiology experience.

Item ID: 67526
Item Type: Article (Research - C1)
ISSN: 1440-1614
Copyright Information: © The Royal Australian and New Zealand College of Psychiatrists 2021
Research Data:
Date Deposited: 28 Jun 2021 22:00
FoR Codes: 32 BIOMEDICAL AND CLINICAL SCIENCES > 3202 Clinical sciences > 320221 Psychiatry (incl. psychotherapy) @ 40%
32 BIOMEDICAL AND CLINICAL SCIENCES > 3209 Neurosciences > 320905 Neurology and neuromuscular diseases @ 30%
49 MATHEMATICAL SCIENCES > 4905 Statistics > 490502 Biostatistics @ 30%
SEO Codes: 20 HEALTH > 2005 Specific population health (excl. Indigenous health) > 200502 Health related to ageing @ 100%
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