Abstract

The aim of this study was to assess whether the use of accelerated MRI scans in place of non-accelerated scans influenced brain volume and atrophy rate measures in controls and subjects with mild cognitive impairment and Alzheimer’s disease. We used data from 861 subjects at baseline, 573 subjects at 6 months and 384 subjects at 12 months from the Alzheimer’s Disease Neuroimaging Initiative (ADNI). We calculated whole-brain, ventricular and hippocampal atrophy rates using the k-means boundary shift integral (BSI). Scan quality was visually assessed and the proportion of good quality accelerated and non-accelerated scans compared. We also compared MMSE scores, vascular burden and age between subjects with poor quality scans with those with good quality scans. Finally, we estimated sample size requirements for a hypothetical clinical trial when using atrophy rates from accelerated scans and non-accelerated scans. No significant differences in whole-brain, ventricular and hippocampal volumes and atrophy rates were found between accelerated and non-accelerated scans. Twice as many non-accelerated scan pairs suffered from at least some motion artefacts compared with accelerated scan pairs (p ≤ 0.001), which may influence the BSI. Subjects whose accelerated scans had significant motion had a higher mean vascular burden and age (p ≤ 0.05) whilst subjects whose non-accelerated scans had significant motion had poorer MMSE scores (p ≤ 0.05). No difference in estimated sample size requirements was found when using accelerated vs. non-accelerated scans. Accelerated scans reduce scan time and are better tolerated. Therefore it may be advantageous to use accelerated over non-accelerated scans in clinical trials that use ADNI-type protocols, especially in more cognitively impaired subjects.

Highlights

  • Volumetric magnetic resonance imaging (MRI) plays a key role in diagnosis, research and clinical trials in dementia

  • The primary goal of Alzheimer’s Disease Neuroimaging Initiative (ADNI) has been to test whether serial magnetic resonance imaging (MRI), positron emission tomography (PET), other biological markers, and clinical and neuropsychological assessment can be combined to measure the progression of mild cognitive impairment (MCI) and early Alzheimer’s disease (AD)

  • Of the 573 subjects who had scans available at 6 months, scan pairs from 29 subjects were rated as unusable due to geometrical distortions due to positioning differencing in the scanner being detected on either or both of the accelerated and non-accelerated scans

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Summary

Introduction

Volumetric magnetic resonance imaging (MRI) plays a key role in diagnosis, research and clinical trials in dementia. Single time-point structural MRI of the brain allows for the visualisation of atrophy patterns and quantification of brain volumes, which can aid diagnosis in neurodegenerative diseases. Neuroinform (2017) 15:215–226 changes in volume can be visualised and measured Such longitudinal measures have less variability and can be used to track progression allowing objective assessment of the effects of potentially disease-modifying therapies. This necessitates coregistration of the image series and for quantification, the application of techniques such as the boundary shift integral (BSI) to pairs of images (Fox and Freeborough 1997; Leung et al 2010). Poor quality scans can be caused by patient-related factors such as movement during the scanning process

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