Biology subjects

Warfield, S. K.

Publications and source records attributed to Warfield, S. K..

4 recordsLinked to original sources

bioRxiv2018

Objective Evaluation of Multiple Sclerosis Lesion Segmentation using a Data Management and Processing Infrastructure

We present a study of multiple sclerosis segmentation algorithms conducted at the international MICCAI 2016 challenge. This challenge was operated using a new open-science computing infrastructure. This allowed for the automatic and independent evaluation of a large range of algorithms in a fair and completely automatic manner. This computing infrastructure was used to evaluate thirteen methods of MS lesions segmentation, exploring a broad range of state-of-the-art algorithms, against a high-quality database of 53 MS cases coming from four centers following a common definition of the acquisition protocol. Each case was annotated manually by an unprecedented number of seven different experts. Results of the challenge highlighted that automatic algorithms, including the recent machine learning methods (random forests, deep learning, ...), are still trailing human expertise on both detection and delineation criteria. In addition, we demonstrate that computing a statistically robust consensus of the algorithms performs closer to human expertise on one score (segmentation) although still trailing on detection scores.

neuroscience↗

bioRxiv2018

A three year follow-up study of gadolinium enhanced and non-enhanced regions in multiple sclerosis lesions using a multi-compartment T2 relaxometry model

Demyelination, axonal damage and inflammation are critical indicators of the onset and progress of neurodegenerative diseases such as multiple sclerosis (MS) in patients. Due to physical limitations of imaging such as acquisition time and imaging resolution, a voxel in a MR image is heterogeneous in terms of tissue microstructure such as myelin, axons, intra and extra cellular fluids and free water. We present a multi-compartment tissue model which estimates the water fraction (WF) of tissues with short, medium and high T2 relaxation times in a T2 relaxometry MRI voxel. The proposed method is validated on test-retest data of healthy controls. This model was then used to study longitudinal trends of the tissue microstructures for two sub-regions of the lesions: gadolinium enhanced (E+) and non-enhanced (L-) regions of MS lesions in 10 MS patients over a period of three years. The water fraction values in E+ and L- regions were found to be significantly different (p < 0.05) over the period of first three months. The results of this study also showed that the estimates of the proposed T2 relaxometry model on brain tissue microstructures have potential to distinguish between regions undergoing active blood brain barrier breakdown from the other regions of the lesion.

neuroscience↗

bioRxiv2018

Presurgical language fMRI: Current technical practices in epilepsy surgical planning

Little is known about how language functional MRI (fMRI) is executed in clinical practice in spite of its widespread use. Here we comprehensively documented its execution in surgical planning in epilepsy. A questionnaire focusing on cognitive design, imaging acquisition, analysis and interpretation and practical considerations was developed. Individuals responsible for collecting, analyzing, and interpreting clinical language fMRI data at 63 epilepsy surgical programs responded. The central finding was of marked heterogeneity in all aspects of fMRI. Most programs use multiple tasks, with a fifth routinely using 2, 3, 4 or 5 tasks with a modal run duration of five minutes. Variants of over fifteen protocols are in routine use with forms of noun-verb generation, verbal fluency, and semantic decision-making used most often. Nearly all aspects of data acquisition and analysis vary markedly. Neither of the two best-validated protocols were used by more than 10% of respondents. Preprocessing steps are broadly consistent across sites, language-related blood flow is most often identified using general linear modeling (76% of respondents), and statistical thresholding typically varies by patient (79%). The software SPM is most often used. fMRI programs inconsistently include input from experts with all required skills (imaging, cognitive assessment, MR physics, statistical analysis, brain-behavior relationships). These data highlight marked gaps between the evidence supporting fMRI and its clinical application. Teams performing language fMRI may benefit from evaluating practice with reference to the best-validated protocols to date and ensuring individuals trained in all aspects of fMRI are involved to optimize patient care.

neuroscience↗

bioRxiv2017

Presurgical language fMRI: Current practices and patient outcomes in epilepsy surgical planning

The goal of this study was to document current clinical practice and report patient outcomes in presurgical language functional MRI (fMRI) for epilepsy surgery. Epilepsy surgical programs worldwide were surveyed as to the utility, implementation, and efficacy of language fMRI in the clinic; 82 programs responded between July 2015 and January 2016. Respondents were predominantly from the US (61%), were academic programs (85%), and predominantly evaluated adults (44%), both adults and children (40%), or children only (16%). Nearly all (96%) respondents reported using language fMRI. fMRI is used for language lateralization (100%) and for localizing (44%) language cortex to guide surgical margins. While typically considered useful, programs often reported at least one instance of disagreement with other measures (56%). When used to localize language cortex, direct brain stimulation typically confirmed fMRI findings (74%) but instances of unpredicted decline were reported by 17% of programs and unexpected preservation of function were reported by 54%. Programs reporting unexpected decline did not clearly differ from those which did not. Clinicians using fMRI to guide surgical margins typically map Brocas and Wernickes areas but not other known language areas. Language fMRI is widely used for lateralizing language cortex in patients with medically intractable epilepsy. It is also frequently used to localize language cortex though it is not yet well validated for this purpose. Many centers report cases of unexpected language preservation when fMRI activation is resected, and cases of language decline when it is not. Care will almost certainly be improved by standardizing protocols and accurately detailing the relationship between fMRI-positive areas and post-surgical language decline.

neuroscience↗