scholarly journals Optimal Diagnostic Indices for Idiopathic Normal Pressure Hydrocephalus Based on the 3D Quantitative Volumetric Analysis for the Cerebral Ventricle and Subarachnoid Space

2015 ◽  
Vol 36 (12) ◽  
pp. 2262-2269 ◽  
Author(s):  
S. Yamada ◽  
M. Ishikawa ◽  
K. Yamamoto
Keyword(s):  
Normal Pressure Hydrocephalus ◽  
Subarachnoid Space ◽  
Normal Pressure ◽  
Volumetric Analysis ◽  
Idiopathic Normal Pressure Hydrocephalus ◽  
Cerebral Ventricle ◽  
Diagnostic Indices

scholarly journals Changes in the Subarachnoid Space Precede Ventriculomegaly in Idiopathic Normal Pressure Hydrocephalus (iNPH)

2012 ◽  
Vol 51 (13) ◽  
pp. 1751-1753 ◽  
Author(s):  
Chifumi Iseki ◽  
Yoshimi Takahashi ◽  
Manabu Wada ◽  
Shigeki Arawaka ◽  
Toru Kawanami ◽  
...  
Keyword(s):  
Normal Pressure Hydrocephalus ◽  
Subarachnoid Space ◽  
Normal Pressure ◽  
Idiopathic Normal Pressure Hydrocephalus

scholarly journals Systematic volumetric analysis predicts response to CSF drainage and outcome to shunt surgery in idiopathic normal pressure hydrocephalus

2021 ◽  
Author(s):  
Dan Wu ◽  
Abhay Moghekar ◽  
Wen Shi ◽  
Ari M. Blitz ◽  
Susumu Mori
Keyword(s):  
White Matter ◽  
Normal Pressure Hydrocephalus ◽  
Neurodegenerative Disorder ◽  
Brain Mri ◽  
Area Under The Curve ◽  
Normal Pressure ◽  
Volumetric Analysis ◽  
Idiopathic Normal Pressure Hydrocephalus ◽  
Shunt Placement ◽  
Csf Drainage

Abstract Objectives Idiopathic normal pressure hydrocephalus (INPH) is a neurodegenerative disorder characterized by excess cerebrospinal fluid (CSF) in the ventricles, which can be diagnosed by invasive CSF drainage test and treated by shunt placement. Here, we aim to investigate the diagnostic and prognostic power of systematic volumetric analysis based on brain structural MRI for INPH. Methods We performed a retrospective study with a cohort of 104 probable INPH patients who underwent CSF drainage tests and another cohort of 41 INPH patients who had shunt placement. High-resolution T1-weighted images of the patients were segmented using an automated pipeline into 283 structures that are grouped into different granularity levels for volumetric analysis. Volumes at multi-granularity levels were used in a recursive feature elimination model to classify CSF drainage responders and non-responders. We then used pre-surgical brain volumes to predict Tinetti and MMSE scores after shunting, based on the least absolute shrinkage and selection operator. Results The classification accuracy of differentiating the CSF drainage responders and non-responders increased as the granularity increased. The highest diagnostic accuracy was achieved at the finest segmentation with a sensitivity/specificity/precision/accuracy of 0.89/0.91/0.84/0.90 and an area under the curve of 0.94. The predicted post-surgical neurological scores showed high correlations with the ground truth, with r = 0.80 for Tinetti and r = 0.88 for MMSE. The anatomical features that played important roles in the diagnostic and prognostic tasks were also illustrated. Conclusions We demonstrated that volumetric analysis with fine segmentation could reliably differentiate CSF drainage responders from other INPH-like patients, and it could accurately predict the neurological outcomes after shunting. Key Points • We performed a fully automated segmentation of brain MRI at multiple granularity levels for systematic volumetric analysis of idiopathic normal pressure hydrocephalus (INPH) patients. • We were able to differentiate patients that responded to CSF drainage test with an accuracy of 0.90 and area under the curve of 0.94 in a cohort of 104 probable INPH patients, as well as to predict the post-shunt gait and cognitive scores with a coefficient of 0.80 for Tinetti and 0.88 for MMSE. • Feature analysis showed the inferior lateral ventricle, bilateral hippocampus, and orbital cortex are positive indicators of CSF drainage responders, whereas the posterior deep white matter and parietal subcortical white matter were negative predictors.

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