Brain White Matter Hyperintensity Lesion Characterization in T2 Fluid-Attenuated Inversion Recovery Magnetic Resonance Images: Shape, Texture, and Potential Growth.

Chih-Ying Gwo,David C. Zhu,Rong Zhang

doi:10.3389/fnins.2019.00353

Abstract

Prior methods in characterizing age-related white matter hyperintensity (WMH) lesions on T2 fluid-attenuated inversion recovery (FLAIR) magnetic resonance images (MRI) have mainly been limited to understanding the sizes of, and occasionally the locations of WMH lesions. Systematic morphological characterization has been missing. In this work, we proposed innovative methods to fill this knowledge gap. We developed an innovative and proof-of-concept method to characterize and quantify the shape (based on Zernike transformation) and texture (based on fuzzy logic) of WMH lesions. We have also developed a multi-dimension feature vector approach to cluster WMH lesions into distinctive groups based on their shape and then texture features. We then developed an approach to calculate the potential growth index (PGI) of WMH lesions based on the image intensity distributions at the edge of the WMH lesions using a region-growing algorithm. High-quality T2 FLAIR images containing clearly identifiable WMH lesions with various sizes from six cognitively normal older adults were used in our method development Analyses of Variance (ANOVAs) showed significant differences in PGI among WMH group clusters in terms of either the shape (P = 1.06 × 10−2) or the texture (P < 1 × 10−20) features. In conclusion, we propose a systematic framework on which the shape and texture features of WMH lesions can be quantified and may be used to predict lesion growth in older adults.

Highlights

The presence of white matter hyperintensities (WMH) on T2 fluid-attenuated inversion recovery (FLAIR) magnetic resonance images (MRI) is common in older adults over 65 years old with a prevalence rate of ∼ 60–80% in the general population (De Leeuw et al, 2001; Wen and Sachdev, 2004)
Full-brain 2D T2 FLAIR images were collected on a Philips Achieva 3T scanner (Philips Healthcare, Best, the Netherlands) with the following parameters: axial, time of echo (TE) = 125 ms, time of repetition (TR) = 11 s, time of inversion (TI) = 2,800 ms, field of view (FOV) = 23 cm × 23 cm, slice thickness = 2.5 mm, number of slices = 64 with no gaps, acquisition matrix size =
We have developed innovative and proof-ofconcept methods to quantitatively characterize the shape and texture of white matter hyperintensity (WMH) lesions

Summary

Introduction

The presence of white matter hyperintensities (WMH) on T2 fluid-attenuated inversion recovery (FLAIR) magnetic resonance images (MRI) is common in older adults over 65 years old with a prevalence rate of ∼ 60–80% in the general population (De Leeuw et al, 2001; Wen and Sachdev, 2004). WMH lesions are even more extensive in those with vascular or Alzheimer’s disease (AD) type of dementia when compared with cognitively normal older adults, suggesting its role in. The pathogenic mechanisms of WMH are not well-understood, and have been attributed to cerebral small vessel disease (CSVD), white matter demyelization, or both, indicating brain white matter lesions (Greenberg, 2006; Wardlaw et al, 2013). Periventricular and subcortical deep WMHs may have different pathogenic mechanisms (Schmidt et al, 2011; Poels et al, 2012; Tseng et al, 2013)

Objectives

Results

Conclusion