• Investigative Magnetic Resonance Imaging
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• v.24 no.2
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• pp.76-84
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• 2020

Background: Determination of inter-method differences between clinically available volumetry methods are essential for the clinical application of brain volumetry in a wider context. Purpose: The purpose of this study was to examine the inter-method reliability and differences between the Siemens morphometry (SM) software and the NeuroQuant (NQ) software. Materials and Methods: MR images of 86 subjects with subjective or objective cognitive impairment were included in this retrospective study. For this study, 3D T1 volume images were obtained in all subjects using a 3T MR scanner (Skyra 3T, Siemens). Volumetric analysis of the 3D T1 volume images was performed using SM and NQ. To analyze the inter-method difference, correlation, and reliability, we used the paired t-test, Bland-Altman plot, Pearson's correlation coefficient, intraclass correlation coefficient (ICC), and effect size (ES) using the MedCalc and SPSS software. Results: SM and NQ showed excellent reliability for cortical gray matter, cerebral white matter, and cerebrospinal fluid; and good reliability for intracranial volume, whole brain volume, both thalami, and both hippocampi. In contrast, poor reliability was observed for both basal ganglia including the caudate nucleus, putamen, and pallidum. Paired comparison revealed that while the mean volume of the right hippocampus was not different between the two software, the mean difference in the left hippocampus volume between the two methods was 0.17 ml (P < 0.001). The other brain regions showed significant differences in terms of measured volumes between the two software. Conclusion: SM and NQ provided good-to-excellent reliability in evaluating most brain structures, except for the basal ganglia in patients with cognitive impairment. Researchers and clinicians should be aware of the potential differences in the measured volumes when using these two different software interchangeably.

• Journal of Chest Surgery
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• v.54 no.6
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• pp.487-493
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• 2021

Background: Predicting postoperative lung function after pneumonectomy is essential. We retrospectively compared postoperative lung function to predicted postoperative lung function based on computed tomography (CT) volumetry and perfusion scintigraphy in patients who underwent pneumonectomy. Methods: Predicted postoperative lung function was calculated based on perfusion scintigraphy and CT volumetry. The predicted function was compared to the postoperative lung function in terms of forced vital capacity (FVC) and forced expiratory volume in 1 second (FEV₁), using 4 parameters: FVC, FVC%, FEV₁, and FEV₁%. Results: The correlations between postoperative function and predicted function based on CT volumetry were r=0.632 (p=0.003) for FVC% and r=0.728 (p<0.001) for FEV₁%. The correlations between postoperative function and predicted postoperative function based on perfusion scintigraphy were r=0.654 (p=0.002) for FVC% and r=0.758 (p<0.001) for FEV₁%. The preoperative Eastern Cooperative Oncology Group (ECOG) scores were significantly higher in the group in which the gap between postoperative FEV₁ and predicted postoperative FEV₁ analyzed by CT was smaller than the gap analyzed by perfusion scintigraphy (1.2±0.62 vs. 0.4±0.52, p=0.006). Conclusion: This study affirms that CT volumetry can replace perfusion scintigraphy for preoperative evaluation of patients needing pneumonectomy. In particular, it was found to be a better predictor of postoperative lung function for poor-performance patients (i.e., those with high ECOG scores).

• Korean Journal of Radiology
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• v.21 no.4
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• pp.450-461
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• 2020

Objective: We performed a meta-analysis to evaluate the agreement of cardiac computed tomography (CT) with cardiac magnetic resonance imaging (CMRI) in the assessment of right ventricle (RV) volume and functional parameters. Materials and Methods: PubMed, EMBASE, and Cochrane library were systematically searched for studies that compared CT with CMRI as the reference standard for measurement of the following RV parameters: end-diastolic volume (EDV), end-systolic volume (ESV), stroke volume (SV), or ejection fraction (EF). Meta-analytic methods were utilized to determine the pooled weighted bias, limits of agreement (LOA), and correlation coefficient (r) between CT and CMRI. Heterogeneity was also assessed. Subgroup analyses were performed based on the probable factors affecting measurement of RV volume: CT contrast protocol, number of CT slices, CT reconstruction interval, CT volumetry, and segmentation methods. Results: A total of 766 patients from 20 studies were included. Pooled bias and LOA were 3.1 mL (-5.7 to 11.8 mL), 3.6 mL (-4.0 to 11.2 mL), -0.4 mL (5.7 to 5.0 mL), and -1.8% (-5.7 to 2.2%) for EDV, ESV, SV, and EF, respectively. Pooled correlation coefficients were very strong for the RV parameters (r = 0.87-0.93). Heterogeneity was observed in the studies (I² > 50%, p < 0.1). In the subgroup analysis, an RV-dedicated contrast protocol, ≥ 64 CT slices, CT volumetry with the Simpson's method, and inclusion of the papillary muscle and trabeculation had a lower pooled bias and narrower LOA. Conclusion: Cardiac CT accurately measures RV volume and function, with an acceptable range of bias and LOA and strong correlation with CMRI findings. The RV-dedicated CT contrast protocol, ≥ 64 CT slices, and use of the same CT volumetry method as CMRI can improve agreement with CMRI.

• Investigative Magnetic Resonance Imaging
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• v.13 no.1
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• pp.63-73
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• 2009

Purpose : To investigate the effects of various intracranial volume (ICV) measurement methods on the sensitivity of hippocampal volumetry and modulated voxel-based morphometry (mVBM) in female patients with major depressive disorder (MDD). Materials and Methods : T1 magnetic resonance imaging (MRI) data for 41 female subjects (21 MDD patients, 20 normal subjects) were analyzed. Hippocampal volumes were measured manually, and ICV was measured manually and automatically using the FreeSurfer package. Gray and white matter volumes were measured separately. Results : Manual ICV normalization provided the greatest sensitivity in hippocampal volumetry and mVBM, followed by FreeSurfer ICV, GWMV, and GMV. Manual and FreeSurfer ICVs were similar in normal subjects (p = 0.696), but distinct in MDD patients (p = 0.000002). Manual ICV-corrected total gray matter volume (p = 0.0015) and Manual ICV-corrected bilateral hippocampal volumes (right, p = 0.014; left, p = 0.004) were decreased significantly in MDD patients, but the differences of hippocampal volumes corrected by FreeSurfer ICV, GWMV, or GMV were not significant between two groups (p > 0.05). Only manual ICV-corrected mVBM analysis was significant after correction for multiple comparisons. Conclusion : The method of ICV measurement greatly affects the sensitivity of hippocampal volumetry and mVBM. Manual ICV normalization showed the ability to detect differences between women with and without MDD for both methods.

• Journal of the Korean Society of Radiology
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• v.82 no.5
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• pp.1124-1139
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• 2021

The objective assessment of atrophy and the measurement of brain volume is important in the early diagnosis of dementia and neurodegenerative diseases. Recently, several MR-based volumetry software have been developed. For their clinical application, several issues arise, including the standardization of image acquisition and their validation of software. Additionally, it is important to highlight the diagnostic performance of the volumetry software based on expert opinions. We instituted a task force within the Korean Society of Neuroradiology to develop guidelines for the clinical use of MR-based brain volumetry software. In this review, we introduce the commercially available software and compare their diagnostic performances. We suggest the need for a standard protocol for image acquisition, the validation of the software, and evaluations of the limitations of the software related to clinical practice. We present recommendations for the clinical applications of commercially available software for volumetry based on the expert opinions of the Korean Society of Neuroradiology.

• Journal of the Korean Society of Radiology
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• v.84 no.5
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• pp.1091-1093
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• 2023

• Radiation Oncology Journal
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• v.30 no.2
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• pp.70-77
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• 2012

Purpose: To evaluate the patterns of tumor shape and to compare tumor volume derived from simple diameter-based ellipsoid measurement with that derived from tracing the entire tumor contour using region of interest (ROI)-based 3D volumetry with respect to the prediction outcome in cervical cancer patients treated with concurrent chemotherapy and radiotherapy. Materials and Methods: Magnetic resonance imaging was performed in 98 patients with cervical cancer (stage IB-IIIB). The tumor shape was classified into two categories: ellipsoid and non-ellipsoid shape. ROI-based volumetry was derived from each magnetic resonance slice on the work station. For the diameter-based surrogate "ellipsoid volume," the three orthogonal diameters were measured to calculate volume as an ellipsoid. Results: The more than half of tumor (55.1%) had a non-ellipsoid configuration. The predictions for outcome were consistent between two volume groups, with overall survival of 93.6% and 87.7% for small tumor (<20 mL), 62.9% and 69.1% for intermediate-size tumor (20-39 mL), and 14.5% and 16.7% for large tumors (${\geq}$40 mL) using ROI and diameter based measurement, respectively. Disease-free survival was 93.8% and 90.6% for small tumor, 54.3% and 62.7% for intermediate-size tumor, and 13.7% and 10.3% for large tumor using ROI and diameter based method, respectively. Differences in outcome between size groups were statistically significant, and the differences in outcome predicted by the tumor volume by two different methods. Conclusion: Our data suggested that large numbers of cervical cancers are not ellipsoid. However, simple diameter-based tumor volume measurement appears to be useful in comparison with ROI-based volumetry for predicting outcome in cervical cancer patients.

• Journal of Chest Surgery
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• v.50 no.2
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• pp.71-77
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• 2017

Background: Cardiac computed tomography (CT) has emerged as an alternative to magnetic resonance imaging (MRI) for ventricular volumetry. However, the clinical use of cardiac CT requires external validation. Methods: Both cardiac CT and MRI were performed prior to pulmonary valve implantation (PVI) in 11 patients (median age, 19 years) who had undergone total correction of tetralogy of Fallot during infancy. The simplified contouring method (MRI) and semiautomatic 3-dimensional region-growing method (CT) were used to measure ventricular volumes. Results: All volumetric indices measured by CT and MRI generally correlated well with each other, except for the left ventricular end-systolic volume index (LV-ESVI), which showed the following correlations with the other indices: the right ventricular end-diastolic volume index (RV-EDVI) (r=0.88, p<0.001), the right ventricular end-systolic volume index (RV-ESVI) (r=0.84, p=0.001), the left ventricular end-diastolic volume index (LV-EDVI) (r=0.90, p=0.001), and the LV-ESVI (r=0.55, p=0.079). While the EDVIs measured by CT were significantly larger than those measured by MRI (median RV-EDVI: $197mL/m^2$ vs. $175mL/m^2$, p=0.008; median LV-EDVI: $94mL/m^2$ vs. $92mL/m^2$, p=0.026), no significant differences were found for the RV-ESVI or LV-ESVI. Conclusion: The EDVIs measured by cardiac CT were greater than those measured by MRI, whereas the ESVIs measured by CT and MRI were comparable. The volumetric characteristics of these 2 diagnostic modalities should be taken into account when indications for late PVI after tetralogy of Fallot repair are assessed.

• Korean Journal of Radiology
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• v.22 no.3
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• pp.405-414
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• 2021

Objective: To compare two clinically available MR volumetry software, NeuroQuant^® (NQ) and Inbrain^® (IB), and examine the inter-method reliabilities and differences between them. Materials and Methods: This study included 172 subjects (age range, 55-88 years; mean age, 71.2 years), comprising 45 normal healthy subjects, 85 patients with mild cognitive impairment, and 42 patients with Alzheimer's disease. Magnetic resonance imaging scans were analyzed with IB and NQ. Mean differences were compared with the paired t test. Inter-method reliability was evaluated with Pearson's correlation coefficients and intraclass correlation coefficients (ICCs). Effect sizes were also obtained to document the standardized mean differences. Results: The paired t test showed significant volume differences in most regions except for the amygdala between the two methods. Nevertheless, inter-method measurements between IB and NQ showed good to excellent reliability (0.72 < r < 0.96, 0.83 < ICC < 0.98) except for the pallidum, which showed poor reliability (left: r = 0.03, ICC = 0.06; right: r = -0.05, ICC = -0.09). For the measurements of effect size, volume differences were large in most regions (0.05 < r < 6.15). The effect size was the largest in the pallidum and smallest in the cerebellum. Conclusion: Comparisons between IB and NQ showed significantly different volume measurements with large effect sizes. However, they showed good to excellent inter-method reliability in volumetric measurements for all brain regions, with the exception of the pallidum. Clinicians using these commercial software should take into consideration that different volume measurements could be obtained depending on the software used.

• Investigative Magnetic Resonance Imaging
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• v.6 no.1
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• pp.47-54
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• 2002

Purpose : Hippocampal atrophy is one of the characteristic pathologic findings of hippocampal sclerosis, for which MR imaging of the hippocampus is essential in the evaluation of hippocampal sclerosis. The purpose of this study is to present the normal MR volumetric data of the hippocampus in normal adult Korean and to compare those with MR volumetric data of hippocampus in patients with hippocampal s-clerosis, providing the diagnostic volume criteria of the hippocampal atrophy. Materials and methods : MR volumetry was performed in 30 normal adults and 28 patients with temporal lobe epilepsy whose final diagnosis was hippocampal sclerosis. The volumetric data were compared between sexes, right and left sides, and normal and abnormal hippocampus, and the volume criteria for the diagnosis of hippocampal atrophy was determined. Results : The mean $volumes({\pm}standard$ deviation) of normal Korean adult were $2.20{\pm}0.73\textrm{cm}^3$ (right) and $2.17{\pm}0.72\textrm{cm}^3$ (left) in male and $2.27{\pm}0.47{\;}\textrm{cm}^3$ (right) and $2.23{\pm}0.48\textrm{cm}^3$ (left) in female. The mean right-left differences were $0.14{\pm}0.11\textrm{cm}^3$ and $0.19{\pm}0.13\textrm{cm}^3$ in male and female, respectively. The MR volumetry showed no significant statistical differences between sexes and between right and left. The mean volume and standard deviation of the hippocampus in hippocampal sclerosis patients was $1.46{\pm}0.60{\;}\textrm{cm}^3$, and the right-left difference was $0.51{\pm}0.41\textrm{cm}^3$, In comparison of two volume distributions between normal adult group and hippocampal sclerosis patients group, the reasonable diagnostic volume criteria was $0.4{\;}\textrm{cm}^3$ as right-left volume difference, in which the sensitivity and specificity are 0.61 and 0.90. In all patients with right-left volume difference more than $0.4{\;}\textrm{cm}^3$, visual determination of unilateral hippocampal atrophy was possible. Conclusion : The MR-based hippocampal volumetry is a useful add-on of visual MR diagnosis, only when visual diagnosis of hippocampal sclerosis is difficult.