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@ARTICLE{Bendella:270639,
author = {Bendella, Zeynep and Purrer, Veronika and Haase, Robert and
Zülow, Stefan and Kindler, Christine and Borger, Valerie
and Banat, Mohammed and Dorn, Franziska and Wüllner,
Ullrich and Radbruch, Alexander and Schmeel, Frederic
Carsten},
title = {{B}rain and {V}entricle {V}olume {A}lterations in
{I}diopathic {N}ormal {P}ressure {H}ydrocephalus
{D}etermined by {A}rtificial {I}ntelligence-{B}ased {MRI}
{V}olumetry.},
journal = {Diagnostics},
volume = {14},
number = {13},
issn = {2075-4418},
address = {Basel},
publisher = {MDPI},
reportid = {DZNE-2024-00811},
pages = {1422},
year = {2024},
abstract = {The aim of this study was to employ artificial intelligence
(AI)-based magnetic resonance imaging (MRI) brain volumetry
to potentially distinguish between idiopathic normal
pressure hydrocephalus (iNPH), Alzheimer's disease (AD), and
age- and sex-matched healthy controls (CG) by evaluating
cortical, subcortical, and ventricular volumes.
Additionally, correlations between the measured brain and
ventricle volumes and two established semi-quantitative
radiologic markers for iNPH were examined. An IRB-approved
retrospective analysis was conducted on 123 age- and
sex-matched subjects (41 iNPH, 41 AD, and 41 controls), with
all of the iNPH patients undergoing routine clinical brain
MRI prior to ventriculoperitoneal shunt implantation.
Automated AI-based determination of different cortical and
subcortical brain and ventricular volumes in mL, as well as
calculation of population-based normalized percentiles
according to an embedded database, was performed; the
CE-certified software mdbrain v4.4.1 or above was used with
a standardized T1-weighted 3D magnetization-prepared rapid
gradient echo (MPRAGE) sequence. Measured brain volumes and
percentiles were analyzed for between-group differences and
correlated with semi-quantitative measurements of the Evans'
index and corpus callosal angle: iNPH patients exhibited
ventricular enlargement and changes in gray and white matter
compared to AD patients and controls, with the most
significant differences observed in total ventricular volume
$(+67\%)$ and the lateral $(+68\%),$ third $(+38\%),$ and
fourth $(+31\%)$ ventricles compared to controls. Global
ventriculomegaly and marked white matter reduction with
concomitant preservation of gray matter compared to AD and
CG were characteristic of iNPH, whereas global and
frontoparietally accentuated gray matter reductions were
characteristic of AD. Evans' index and corpus callosal angle
differed significantly between the three groups and
moderately correlated with the lateral ventricular volumes
in iNPH patients [Evans' index (r > 0.83, p ≤ 0.001),
corpus callosal angle (r < -0.74, p ≤ 0.001)]. AI-based
MRI volumetry in iNPH patients revealed global ventricular
enlargement and focal brain atrophy, which, in contrast to
healthy controls and AD patients, primarily involved the
supratentorial white matter and was marked temporomesially
and in the midbrain, while largely preserving gray matter.
Integrating AI volumetry in conjunction with traditional
radiologic measures could enhance iNPH identification and
differentiation, potentially improving patient management
and therapy response assessment.},
keywords = {automated volumetrization (Other) / brain atrophy (Other) /
normal pressure hydrocephalus (Other) / quantitative
neuroimaging (Other)},
cin = {AG Radbruch / AG Klockgether / Patient Studies Bonn / AG
Wüllner},
ddc = {610},
cid = {I:(DE-2719)5000075 / I:(DE-2719)1011001 /
I:(DE-2719)1011101 / I:(DE-2719)1011302},
pnm = {353 - Clinical and Health Care Research (POF4-353)},
pid = {G:(DE-HGF)POF4-353},
typ = {PUB:(DE-HGF)16},
pubmed = {pmid:39001312},
pmc = {pmc:PMC11241572},
doi = {10.3390/diagnostics14131422},
url = {https://pub.dzne.de/record/270639},
}