TY - JOUR
T1 - In vitro evaluation of cerebrospinal fluid velocity measurement in type I Chiari malformation
T2 - repeatability, reproducibility, and agreement using 2D phase contrast and 4D flow MRI
AU - Williams, Gwendolyn
AU - Thyagaraj, Suraj
AU - Fu, Audrey
AU - Oshinski, John
AU - Giese, Daniel
AU - Bunck, Alexander C.
AU - Fornari, Eleonora
AU - Santini, Francesco
AU - Luciano, Mark
AU - Loth, Francis
AU - Martin, Bryn A.
N1 - Funding Information:
This research was funded by the American Syringomyelia and Chiari Alliance Project, NIH National Institute of Neurological Disorders and Stroke under Grant #R01NS111283 (Martin), an Institutional Development Award (IDeA) from the National Institute of General Medical Sciences (NIGMS) of the National Institutes of health (NIH) under Grant #P20GM1033408 (Martin & Schiele), #4U54GM104944-04TBD (Martin), and the National Center for Advancing Translational Sciences of the National Institutes of Health under Award Number UL1TR002378 (Oshinski/Emory).
Funding Information:
BAM is a full-time employee at Alcyone Therapeutics and has received grant support from Genentech, Minnetronix Neuro, Biogen, Voyager Therapeutics, and Alcyone Therapeutics. BAM is scientific advisory board member for Anuncia Inc., Alcyone Therapeutics Inc., International Society for Hydrocephalus and CSF Disorders, and the Chiari and Syringomyelia Foundation and has served as a consultant to Roche, InviCRO, Praxis Medicines, SwanBio Therapeutics, Cerebral Therapeutics, Minnetronix Medical, Genentech and CereVasc. DG is a full-time employee of Siemens Healthcare since December 2018. All of the work related to the current study was performed prior and / or outside of his duties at Siemens.
Publisher Copyright:
© 2021, The Author(s).
PY - 2021/12
Y1 - 2021/12
N2 - Background: Phase contrast magnetic resonance imaging, PC MRI, is a valuable tool allowing for non-invasive quantification of CSF dynamics, but has lacked adoption in clinical practice for Chiari malformation diagnostics. To improve these diagnostic practices, a better understanding of PC MRI based measurement agreement, repeatability, and reproducibility of CSF dynamics is needed. Methods: An anatomically realistic in vitro subject specific model of a Chiari malformation patient was scanned three times at five different scanning centers using 2D PC MRI and 4D Flow techniques to quantify intra-scanner repeatability, inter-scanner reproducibility, and agreement between imaging modalities. Peak systolic CSF velocities were measured at nine axial planes using 2D PC MRI, which were then compared to 4D Flow peak systolic velocity measurements extracted at those exact axial positions along the model. Results: Comparison of measurement results showed good overall agreement of CSF velocity detection between 2D PC MRI and 4D Flow (p = 0.86), fair intra-scanner repeatability (confidence intervals ± 1.5 cm/s), and poor inter-scanner reproducibility. On average, 4D Flow measurements had a larger variability than 2D PC MRI measurements (standard deviations 1.83 and 1.04 cm/s, respectively). Conclusion: Agreement, repeatability, and reproducibility of 2D PC MRI and 4D Flow detection of peak CSF velocities was quantified using a patient-specific in vitro model of Chiari malformation. In combination, the greatest factor leading to measurement inconsistency was determined to be a lack of reproducibility between different MRI centers. Overall, these findings may help lead to better understanding for application of 2D PC MRI and 4D Flow techniques as diagnostic tools for CSF dynamics quantification in Chiari malformation and related diseases.
AB - Background: Phase contrast magnetic resonance imaging, PC MRI, is a valuable tool allowing for non-invasive quantification of CSF dynamics, but has lacked adoption in clinical practice for Chiari malformation diagnostics. To improve these diagnostic practices, a better understanding of PC MRI based measurement agreement, repeatability, and reproducibility of CSF dynamics is needed. Methods: An anatomically realistic in vitro subject specific model of a Chiari malformation patient was scanned three times at five different scanning centers using 2D PC MRI and 4D Flow techniques to quantify intra-scanner repeatability, inter-scanner reproducibility, and agreement between imaging modalities. Peak systolic CSF velocities were measured at nine axial planes using 2D PC MRI, which were then compared to 4D Flow peak systolic velocity measurements extracted at those exact axial positions along the model. Results: Comparison of measurement results showed good overall agreement of CSF velocity detection between 2D PC MRI and 4D Flow (p = 0.86), fair intra-scanner repeatability (confidence intervals ± 1.5 cm/s), and poor inter-scanner reproducibility. On average, 4D Flow measurements had a larger variability than 2D PC MRI measurements (standard deviations 1.83 and 1.04 cm/s, respectively). Conclusion: Agreement, repeatability, and reproducibility of 2D PC MRI and 4D Flow detection of peak CSF velocities was quantified using a patient-specific in vitro model of Chiari malformation. In combination, the greatest factor leading to measurement inconsistency was determined to be a lack of reproducibility between different MRI centers. Overall, these findings may help lead to better understanding for application of 2D PC MRI and 4D Flow techniques as diagnostic tools for CSF dynamics quantification in Chiari malformation and related diseases.
KW - Cerebrospinal fluid
KW - Chiari malformation
KW - Magnetic resonance imaging
KW - Phase contrast
KW - Spinal cord
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U2 - 10.1186/s12987-021-00246-3
DO - 10.1186/s12987-021-00246-3
M3 - Article
C2 - 33736664
AN - SCOPUS:85102825136
VL - 18
JO - Fluids and Barriers of the CNS
JF - Fluids and Barriers of the CNS
SN - 2045-8118
IS - 1
M1 - 12
ER -