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Evaluation of a new approach for semi-automatic segmentation of the cerebellum in patients with multiple sclerosis

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Abstract

Cerebellar dysfunction is an important contributor to disability in patients with multiple sclerosis (MS), however, few in vivo studies focused on cerebellar volume loss so far. This relates to technical challenges regarding the segmentation of the cerebellum. In this study, we evaluated the semi-automatic ECCET software for performing cerebellar volumetry using high-resolution 3D T1-MR scans in patients with MS and healthy volunteers. We performed test–retest as well as inter-observer reliability testing of cerebellar segmentation and compared the ECCET results with a fully automatic cerebellar segmentation using the FreeSurfer software pipeline in 15 MS patients. In a pilot matched-pair analysis with another data set from 15 relapsing–remitting MS patients and 15 age- and sex-matched healthy controls (HC), we assessed the feasibility of the ECCET approach to detect MS-related cerebellar volume differences. For total normalized cerebellar volume as well as grey and white matter volumes, intrarater (intraclass correlation coefficient (ICC) = 0.99, 95 % CI = 0.98–0.99) and interobserver agreement (ICC = 0.98, 95 % CI = 0.74–0.99) were strong. Comparison between ECCET and FreeSurfer results likewise yielded a good intraclass correlation (ICC = 0.86, 95 % CI = 0.58–0.95). Compared to HC, MS patients had significantly reduced normalized total brain, total cerebellar, and grey matter volumes (p ≤ 0.05). ECCET is a suitable tool for cerebellar segmentation showing excellent test–retest and inter-observer reliability. Our matched-pair analysis between MS patients and healthy volunteers suggests that the method is sensitive and reliable in detecting cerebellar atrophy in MS.

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Conflicts of interest

A. Beck has developed the ECCET Toolkit, which is currently provided free of charge for research purposes by his company ‘Beck Datentechnik’. T. Derfuss served on advisory boards for Novartis, Merck-Serono, Bayer Schering, Biogen Idec, and TEVA. He received travel support from Biogen Idec, Bayer Schering, and Merck Serono. He received research and/or unrestricted grants from Novartis, Biogen Idec, Merck Serono, the German Research Foundation, the Swiss MS Society, and the European Union. L. Kappos has participated in the last 24 months as principal investigator, member or chair of planning and steering committees or advisory boards in corporate-sponsored clinical trials in multiple sclerosis and other neurological diseases. The sponsoring pharmaceutical companies for these trials include: Abbott, Actelion, Advancell, Allozyne, BaroFold, Bayer HealthCare Pharmaceuticals, Bayer Schering, Bayhill, Biogen Idec, BioMarin, CSL Behring, Elan, Genmab, Glenmark, GeNeuro SA, GlaxoSmithKline, Lilly, Merck Serono, Novartis, Novonordisk, Peptimmune, Sanofiaventis, Santhera, Roche, TEVA, UCB and Wyeth. D. Timmann received research support from the German Research Foundation (DFG), grants DFG Ti 239/9-1 and DFG TI 239/10-1, the European Union (Partner in one of the Marie Curie Initial Training Networks), the Bernd Fink Foundation and the German Heredoataxia Foundation. T. Sprenger served on advisory boards for Mitsubishi Pharma, Eli Lilly, Biogen and Allergan. He received travel support from Pfizer, Bayer Schering, Eli Lilly and Allergan. All remaining authors report no conflicts of interest.

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Authors and Affiliations

  1. Department of Neurology, University Hospital Basel, Petersgraben 4, 4031, Basel, Switzerland

    Katrin Weier, Stefano Magon, Michael Amann, Yvonne Naegelin, Tobias Derfuss, Ludwig Kappos & Till Sprenger

  2. Division of Neuroradiology, Department of Radiology and Nuclear Medicine, University Hospital Basel, 4031, Basel, Switzerland

    Michael Amann, Christoph Stippich & Till Sprenger

  3. Beck Datentechnik, 40764, Langenfeld, Germany

    Andreas Beck

  4. Department of Cognitive Psychology and Methodology, University of Basel, 4055, Basel, Switzerland

    Iris K. Penner

  5. Medical Image Analysis Center, University Hospital Basel, 4031, Basel, Switzerland

    Ernst-Wilhelm Radue

  6. Department of Neurology, University of Duisburg-Essen, 45122, Essen, Germany

    Markus Thürling & Dagmar Timmann

  7. Erwin L. Hahn Institute for Magnetic Resonance Imaging, University of Duisburg-Essen, Essen, Germany

    Markus Thürling

  8. Department of Computer Sciences, University of Düsseldorf, Düsseldorf, Germany

    Volker Aurich

Authors
  1. Katrin Weier
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  2. Andreas Beck
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  3. Stefano Magon
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  4. Michael Amann
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  5. Yvonne Naegelin
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  7. Markus Thürling
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  8. Volker Aurich
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  9. Tobias Derfuss
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  10. Ernst-Wilhelm Radue
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  11. Christoph Stippich
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  12. Ludwig Kappos
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  13. Dagmar Timmann
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  14. Till Sprenger
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Correspondence to Katrin Weier.

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Weier, K., Beck, A., Magon, S. et al. Evaluation of a new approach for semi-automatic segmentation of the cerebellum in patients with multiple sclerosis. J Neurol 259, 2673–2680 (2012). https://doi.org/10.1007/s00415-012-6569-4

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  • DOI: https://doi.org/10.1007/s00415-012-6569-4

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