Abstract: Accurate Cervical Spinal Cord Area Measurements Can be Extracted from Brain Images (2021 Annual Meeting of the Consortium of Multiple Sclerosis Centers)

IMG05
Accurate Cervical Spinal Cord Area Measurements Can be Extracted from Brain Images

Tuesday, October 26, 2021: 4:05 PM

Sandlake (Rosen Shingle Creek)

Kamyar Taheri, B.Sc. , Medicine, The University of British Columbia, Vancouver, BC, Canada

Irene Vavasour, PhD , University of British Columbia, Vancouver, BC, Canada

Shawana Abel, M.Sc. , The University of British Columbia, Vancouver, BC, Canada

Lisa Lee, M.Sc. , The University of British Columbia, Vancouver, BC, Canada

Poljanka Johnson, B.Sc. , The University of British Columbia, Vancouver, BC, Canada

Stephen Ristow, B.Sc. , The University of British Columbia, Vancouver, BC, Canada

Roger Tam, PhD , Radiology & School of Biomedical Engineering, University of British Columbia, Vancouver, BC, Canada

Cornelia Laule, PhD , Djavad Mowafaghian Centre for Brain Health, Vancouver, BC, Canada

Nathalie Ackermans, MD , The University of British Columbia, Vancouver, BC, Canada

Alice Schabas, MD , The University of British Columbia, Vancouver, BC, Canada

Helen Cross, MD , The University of British Columbia, Vancouver, BC, Canada

Jillian Chan, MD , The University of British Columbia, Vancouver, BC, Canada

Ana-Luiza Sayao, MD , Neurology, University of British Columbia, Vancouver, BC, Canada

Virender Bhan, MD , The University of British Columbia, Vancouver, BC, Canada

Virginia Devonshire, MD , University of British Columbia, Vancouver, BC, Canada

Robert Carruthers, MD , Neurology, University of British Columbia, Vancouver, BC, Canada

David Li, MD, FRCPC , The University of British Columbia, Vancouver, BC, Canada

Anthony Traboulsee, MD, FRCPC , Medicine (Neurology), University of British Columbia, Vancouver, BC, Canada

Adam Dvorak, B.Sc. , The University of British Columbia, Vancouver, BC, Canada

Shannon Kolind, PhD , Medicine (Neurology), University of British Columbia, Vancouver, BC, Canada

Background: Multiple Sclerosis (MS) is an inflammatory, demyelinating disease with neurodegeneration in the central nervous system. Spinal cord atrophy has been associated with disability in MS.The C2/3 segment of the cervical cord is often used to assess atrophy; however, the spinal cord is imaged far less frequently compared to the brain due to additional cost and scanning time including repositioning and coil changes. 3DT1 brain images often capture a few upper cervical spinal cord levels.

Objectives: If C1 cross-sectional areas (CSA) from brain imaging could accurately reflects C2/C3 CSA from cord imaging, spinal cord area measures could be obtained using only a standard T1-weighted brain image.

Methods: We collected data from 28 healthy controls and 73 MS patients. A For brain imaging, a 3D T1- weighted magnetization-prepared rapid gradient-echo sequence was acquired. For spinal cord imaging, a T2*-weighted multi-echo rapid gradient echo scan was collected. Spinal Cord Toolbox (SCT) was used to extract the mean cord CSA. Spearman correlations and Bland-Altman analyses (BA) were assessed between: (1) C1 CSA_cord and C2/3 CSA_cord, (2) C1 CSA_brain and C1 CSA_cord, and (3) C1 CSA_brain and C2/3 CSA_cord.

Results: C1 CSA_cord was correlated with C2/C3 CSA_cord in both controls (r=0.94, p<0.0001) and MS patients (r=0.85, p<0.0001). BA analysis showed a bias of 0.50 and -0.38 mm² for controls and MS patients respectively with no significant non-zero slope (p=0.052; p=0.37). C1 CSA_cord and C1 CSA_brain showed a correlation in both controls (r=0.89, p<0.0001) and MS patients (r=0.91, p<0.0001). BA analysis showed a bias of 2.4 and 0.43mm² for controls and MS patients with no significant non-zero slope (p=0.16; p=0.78). C1 CSA_brain was correlated with C2/3 CSA_cord for both controls (r=0.84, p<0.0001) and MS patients (r=0.81, p<0.0001). BA analysis showed a bias of -1.9 and -0.81mm² for controls and MS patients with no significant non-zero slope (p=0.095; p=0.59).

Conclusions: A significant, positive correlation was seen between C1 and C2/3 CSA using spinal cord scans. The BA further supported the use of C1 as a proxy for C2/3 CSA in cord atrophy analysis. There was a strong correlation between C1 CSA from brain and cord images, supporting acquisition of an accurate C1 CSA using 3DT1 brain images. Direct comparison of C1 CSA_brain to C2/3 CSA_cord displayed a strong relationship in both healthy controls and MS patients.

IMG05 Accurate Cervical Spinal Cord Area Measurements Can be Extracted from Brain Images

IMG05
Accurate Cervical Spinal Cord Area Measurements Can be Extracted from Brain Images