Automatic quantification of brain lesion volume from post-trauma MR Images

ObjectivesThe determination of the volume of brain lesions after trauma is challenging. Manual delineation is observer-dependent and time-consuming which inhibits the practice in clinical routine. We propose and evaluate an automated atlas-based quantification procedure (AQP) based on the detection of abnormal mean diffusivity (MD) values computed from diffusion-weighted MR images. MethodsWe measured the performance of AQP versus manual delineation consensus by independent raters in two series of experiments: i) realistic trauma phantoms (n=5) where abnormal MD values were assigned to healthy brain images according to the intensity, form and location of lesion observed in real TBI cases; ii) severe TBI patients (n=12 patients) who underwent MR imaging within 10 days after injury. ResultsIn realistic trauma phantoms, no statistical difference in Dice similarity coefficient, precision and brain lesion volumes was found between AQP, the rater consensus and the ground truth lesion delineations. Similar findings were obtained when comparing AQP and manual annotations for TBI patients. The intra-class correlation coefficient between AQP and manual delineation was 0.70 in realistic phantoms and 0.92 in TBI patients. The volume of brain lesions detected in TBI patients was 59 ml (19-84 ml) (median; 25-75th centiles). Conclusionsour results indicate that an automatic quantification procedure could accurately determine with accuracy the volume of brain lesions after trauma. This presents an opportunity to support the individualized management of severe TBI patients. Key pointsO_LIThe management of patients with severe traumatic brain injury is complex, and access to objective quantitative information lesion volumes can support clinical decision-making. C_LIO_LIAn automated delineation procedure was developed to determine the nature and volume of brain lesions post-trauma. C_LIO_LIThis procedure was based on diffusion weighted MR-imaging to quantify the volume of vasogenic and cellular edema from realistic phantoms and patients with severe traumatic brain injury. C_LIO_LINature and quantification of the brain lesions volume compared favorably with manual delineation of brain lesions by a panel of experts. C_LI