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Intersubject Variability and Normalization Strategies for Spinal Cord Total Cross‐Sectional and Gray Matter Areas
Author(s) -
Papinutto Nico,
Asteggiano Carlo,
Bischof Antje,
Gundel Tristan J.,
Caverzasi Eduardo,
Stern William A.,
Bastianello Stefano,
Hauser Stephen L.,
Henry Roland G.
Publication year - 2019
Publication title -
journal of neuroimaging
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.822
H-Index - 64
eISSN - 1552-6569
pISSN - 1051-2284
DOI - 10.1111/jon.12666
Subject(s) - medicine , spinal cord , white matter , sagittal plane , grey matter , nuclear medicine , radiology , magnetic resonance imaging , psychiatry
BACKGROUND AND PURPOSE The quantification of spinal cord (SC) atrophy by MRI has assumed an important role in assessment of neuroinflammatory/neurodegenerative diseases and traumatic SC injury. Recent technical advances make possible the quantification of gray matter (GM) and white matter tissues in clinical settings. However, the goal of a reliable diagnostic, prognostic or predictive marker is still elusive, in part due to large intersubject variability of SC areas. Here, we investigated the sources of this variability and explored effective strategies to reduce it. METHODS One hundred twenty‐nine healthy subjects (mean age: 41.0 ± 15.9) underwent MRI on a Siemens 3T Skyra scanner. Two‐dimensional PSIR at the C2‐C3 vertebral level and a sagittal 1 mm 3 3D T1‐weighted brain acquisition extended to the upper cervical cord were acquired. Total cross‐sectional area and GM area were measured at C2‐C3, as well as measures of the vertebra, spinal canal and the skull. Correlations between the different metrics were explored using Pearson product‐moment coefficients. The most promising metrics were used to normalize cord areas using multiple regression analyses. RESULTS The most effective normalization metrics were the V‐scale (from SienaX) and the product of the C2‐C3 spinal canal diameters. Normalization methods based on these metrics reduced the intersubject variability of cord areas of up to 17.74%. The measured cord areas had a statistically significant sex difference, while the effect of age was moderate. CONCLUSIONS The present work explored in a large cohort of healthy subjects the source of intersubject variability of SC areas and proposes effective normalization methods for its reduction.