Deep Learning-based Approach for Brainstem and Ventricular MR Planimetry: Application in Patients with Progressive Supranuclear Palsy.

Journal: Radiology. Artificial intelligence
PMID: 38506619

Abstract

Purpose To develop a fast and fully automated deep learning (DL)-based method for the MRI planimetric segmentation and measurement of the brainstem and ventricular structures most affected in patients with progressive supranuclear palsy (PSP). Materials and Methods In this retrospective study, T1-weighted MR images in healthy controls ( = 84) were used to train DL models for segmenting the midbrain, pons, middle cerebellar peduncle (MCP), superior cerebellar peduncle (SCP), third ventricle, and frontal horns (FHs). Internal, external, and clinical test datasets ( = 305) were used to assess segmentation model reliability. DL masks from test datasets were used to automatically extract midbrain and pons areas and the width of MCP, SCP, third ventricle, and FHs. Automated measurements were compared with those manually performed by an expert radiologist. Finally, these measures were combined to calculate the midbrain to pons area ratio, MR parkinsonism index (MRPI), and MRPI 2.0, which were used to differentiate patients with PSP ( = 71) from those with Parkinson disease (PD) ( = 129). Results Dice coefficients above 0.85 were found for all brain regions when comparing manual and DL-based segmentations. A strong correlation was observed between automated and manual measurements (Spearman ρ > 0.80, < .001). DL-based measurements showed excellent performance in differentiating patients with PSP from those with PD, with an area under the receiver operating characteristic curve above 0.92. Conclusion The automated approach successfully segmented and measured the brainstem and ventricular structures. DL-based models may represent a useful approach to support the diagnosis of PSP and potentially other conditions associated with brainstem and ventricular alterations. MR Imaging, Brain/Brain Stem, Segmentation, Quantification, Diagnosis, Convolutional Neural Network © RSNA, 2024 See also the commentary by Mohajer in this issue.

Authors

  • Salvatore Nigro
    Center for Neurodegenerative Diseases and the Aging Brain, Department of Clinical Research in Neurology, University of Bari 'Aldo Moro', "Pia Fondazione Cardinale G. Panico", Lecce, Italy.
  • Marco Filardi
    From the Center for Neurodegenerative Diseases and the Aging Brain, University of Bari Aldo Moro, Pia Fondazione Cardinale G. Panico, 73039 Tricase, Italy (S.N., M.F., B.T., A.G., V.G., D.U., G.L.); Department of Translational Biomedicine and Neuroscience (DiBraiN), University of Bari Aldo Moro, Bari, Italy (M.F., B.T., G.M., G.L.); Department of Radiology, Pia Fondazione Cardinale G. Panico, Tricase, Italy (M.N., R.D.B.); Department of Neurosciences, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, England (D.U.); and Operative Unit of Neurology, San Paolo Hospital, ASL Bari, Bari, Italy (S.Z.).
  • Benedetta Tafuri
  • Martina Nicolardi
    From the Center for Neurodegenerative Diseases and the Aging Brain, University of Bari Aldo Moro, Pia Fondazione Cardinale G. Panico, 73039 Tricase, Italy (S.N., M.F., B.T., A.G., V.G., D.U., G.L.); Department of Translational Biomedicine and Neuroscience (DiBraiN), University of Bari Aldo Moro, Bari, Italy (M.F., B.T., G.M., G.L.); Department of Radiology, Pia Fondazione Cardinale G. Panico, Tricase, Italy (M.N., R.D.B.); Department of Neurosciences, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, England (D.U.); and Operative Unit of Neurology, San Paolo Hospital, ASL Bari, Bari, Italy (S.Z.).
  • Roberto De Blasi
    From the Center for Neurodegenerative Diseases and the Aging Brain, University of Bari Aldo Moro, Pia Fondazione Cardinale G. Panico, 73039 Tricase, Italy (S.N., M.F., B.T., A.G., V.G., D.U., G.L.); Department of Translational Biomedicine and Neuroscience (DiBraiN), University of Bari Aldo Moro, Bari, Italy (M.F., B.T., G.M., G.L.); Department of Radiology, Pia Fondazione Cardinale G. Panico, Tricase, Italy (M.N., R.D.B.); Department of Neurosciences, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, England (D.U.); and Operative Unit of Neurology, San Paolo Hospital, ASL Bari, Bari, Italy (S.Z.).
  • Alessia Giugno
    From the Center for Neurodegenerative Diseases and the Aging Brain, University of Bari Aldo Moro, Pia Fondazione Cardinale G. Panico, 73039 Tricase, Italy (S.N., M.F., B.T., A.G., V.G., D.U., G.L.); Department of Translational Biomedicine and Neuroscience (DiBraiN), University of Bari Aldo Moro, Bari, Italy (M.F., B.T., G.M., G.L.); Department of Radiology, Pia Fondazione Cardinale G. Panico, Tricase, Italy (M.N., R.D.B.); Department of Neurosciences, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, England (D.U.); and Operative Unit of Neurology, San Paolo Hospital, ASL Bari, Bari, Italy (S.Z.).
  • Valentina Gnoni
    From the Center for Neurodegenerative Diseases and the Aging Brain, University of Bari Aldo Moro, Pia Fondazione Cardinale G. Panico, 73039 Tricase, Italy (S.N., M.F., B.T., A.G., V.G., D.U., G.L.); Department of Translational Biomedicine and Neuroscience (DiBraiN), University of Bari Aldo Moro, Bari, Italy (M.F., B.T., G.M., G.L.); Department of Radiology, Pia Fondazione Cardinale G. Panico, Tricase, Italy (M.N., R.D.B.); Department of Neurosciences, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, England (D.U.); and Operative Unit of Neurology, San Paolo Hospital, ASL Bari, Bari, Italy (S.Z.).
  • Giammarco Milella
    From the Center for Neurodegenerative Diseases and the Aging Brain, University of Bari Aldo Moro, Pia Fondazione Cardinale G. Panico, 73039 Tricase, Italy (S.N., M.F., B.T., A.G., V.G., D.U., G.L.); Department of Translational Biomedicine and Neuroscience (DiBraiN), University of Bari Aldo Moro, Bari, Italy (M.F., B.T., G.M., G.L.); Department of Radiology, Pia Fondazione Cardinale G. Panico, Tricase, Italy (M.N., R.D.B.); Department of Neurosciences, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, England (D.U.); and Operative Unit of Neurology, San Paolo Hospital, ASL Bari, Bari, Italy (S.Z.).
  • Daniele Urso
    From the Center for Neurodegenerative Diseases and the Aging Brain, University of Bari Aldo Moro, Pia Fondazione Cardinale G. Panico, 73039 Tricase, Italy (S.N., M.F., B.T., A.G., V.G., D.U., G.L.); Department of Translational Biomedicine and Neuroscience (DiBraiN), University of Bari Aldo Moro, Bari, Italy (M.F., B.T., G.M., G.L.); Department of Radiology, Pia Fondazione Cardinale G. Panico, Tricase, Italy (M.N., R.D.B.); Department of Neurosciences, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, England (D.U.); and Operative Unit of Neurology, San Paolo Hospital, ASL Bari, Bari, Italy (S.Z.).
  • Stefano Zoccolella
    From the Center for Neurodegenerative Diseases and the Aging Brain, University of Bari Aldo Moro, Pia Fondazione Cardinale G. Panico, 73039 Tricase, Italy (S.N., M.F., B.T., A.G., V.G., D.U., G.L.); Department of Translational Biomedicine and Neuroscience (DiBraiN), University of Bari Aldo Moro, Bari, Italy (M.F., B.T., G.M., G.L.); Department of Radiology, Pia Fondazione Cardinale G. Panico, Tricase, Italy (M.N., R.D.B.); Department of Neurosciences, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, England (D.U.); and Operative Unit of Neurology, San Paolo Hospital, ASL Bari, Bari, Italy (S.Z.).
  • Giancarlo Logroscino
    From the Center for Neurodegenerative Diseases and the Aging Brain, University of Bari Aldo Moro, Pia Fondazione Cardinale G. Panico, 73039 Tricase, Italy (S.N., M.F., B.T., A.G., V.G., D.U., G.L.); Department of Translational Biomedicine and Neuroscience (DiBraiN), University of Bari Aldo Moro, Bari, Italy (M.F., B.T., G.M., G.L.); Department of Radiology, Pia Fondazione Cardinale G. Panico, Tricase, Italy (M.N., R.D.B.); Department of Neurosciences, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, England (D.U.); and Operative Unit of Neurology, San Paolo Hospital, ASL Bari, Bari, Italy (S.Z.).

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