Skeletal Radiology

, Volume 46, Issue 1, pp 93–99 | Cite as

Tumor segmentation of whole-body magnetic resonance imaging in neurofibromatosis type 1 patients: tumor burden correlates

  • Michael A. Heffler
  • Lu Q. Le
  • Yin Xi
  • Avneesh Chhabra
Scientific Article



Segmentation of whole-body MRI (WBMRI) to assess the feasibility, quantitate the total tumor volume (tumor burden) in patients with neurofibromatosis type 1 (NF1) and examine associations with demographic, disease-related and anthropomorphic features.


A consecutive series of patients with NF1 underwent WBMRI and were reviewed for tumors. Tumors were segmented using a semiautomated software-based tool. Tumors were classified as superficial or deep and discrete or plexiform. Segmentation times were recorded. Segmentation yielded the quantity and tumor burden of superficial, internal and plexiform tumors. Correlations between segmentation data and demographic, disease-related and anthropomorphic features were examined.


Fifteen patients were evaluated (42.3 ± 13.6 years, 10 female, 5 male). Segmentation times were a median of 30 min and yielded 2,328 tumors (1,582 superficial, 746 internal and 23 plexiform). One tumor was malignant. Tumor counts ranged from 14 to 397. Tumor burden ranged from 6.95 cm3 to 571 cm3. Individual tumor volume ranged from 0.0120 cm3 to 298 cm3. Significant correlation was found between the total volume of superficial tumors and height (ρ = 0.5966, p < 0.02). Male patients had higher overall tumor burdens (p < 0.05) and higher superficial tumor burden (p < 0.03). Patients with negative family history had more tumors (p < 0.05).


Segmentation of WBMRI in patients with NF1 is feasible and elucidates meaningful relationships among disease phenotype, anthropomorphic and demographic features.


Neurofibromatosis type 1 Whole-body MRI Segmentation Tumor burden Magnetic resonance imaging 



Body mass index \( \left(\frac{mass\kern0.5em in\kern0.5em kg}{{\left( height\kern0.5em in\kern0.5em m\right)}^2}\right) \)


Malignant peripheral nerve sheath tumor


Neurofibromatosis type 1 (also known as von Recklinghausen disease)


Short tau inversion recovery


Whole-body magnetic resonance imaging


Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Supplementary material

256_2016_2522_MOESM1_ESM.jpg (122 kb)
Figure 1 A 45-year-old female with known NF1 and right neck swelling. (A) Coronal composed STIR image, (B) maximum intensity projection image, and (C, D) reconstructed sagittal STIR images from the same contiguous data set (3.5-mm-thick slices and 0 mm interslice gap) confirm the plexiform neurofibroma (arrows). (JPG 121 kb)


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Copyright information

© ISS 2016

Authors and Affiliations

  • Michael A. Heffler
    • 1
  • Lu Q. Le
    • 2
  • Yin Xi
    • 1
  • Avneesh Chhabra
    • 1
  1. 1.Department of RadiologyUniversity of Texas Southwestern Medical CenterDallasUSA
  2. 2.Department of DermatologyUniversity of Texas Southwestern Medical CenterDallasUSA

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