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AJNR Awards, New Junior Editors, and more. Read the latest AJNR updates

Research ArticlePediatric Neuroimaging

Synthetic MRI of Preterm Infants at Term-Equivalent Age: Evaluation of Diagnostic Image Quality and Automated Brain Volume Segmentation

T. Vanderhasselt, M. Naeyaert, N. Watté, G.-J. Allemeersch, S. Raeymaeckers, J. Dudink, J. de Mey and H. Raeymaekers
American Journal of Neuroradiology May 2020, 41 (5) 882-888; DOI: https://doi.org/10.3174/ajnr.A6533
T. Vanderhasselt
aFrom the Department of Radiology (T.V., M.N., N.W., G.-J.A., S.R., J.d.M., H.R.), Vrije Universiteit Brussels, Universitair Ziekenhuis Brussels, Brussels, Belgium
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M. Naeyaert
aFrom the Department of Radiology (T.V., M.N., N.W., G.-J.A., S.R., J.d.M., H.R.), Vrije Universiteit Brussels, Universitair Ziekenhuis Brussels, Brussels, Belgium
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N. Watté
aFrom the Department of Radiology (T.V., M.N., N.W., G.-J.A., S.R., J.d.M., H.R.), Vrije Universiteit Brussels, Universitair Ziekenhuis Brussels, Brussels, Belgium
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G.-J. Allemeersch
aFrom the Department of Radiology (T.V., M.N., N.W., G.-J.A., S.R., J.d.M., H.R.), Vrije Universiteit Brussels, Universitair Ziekenhuis Brussels, Brussels, Belgium
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S. Raeymaeckers
aFrom the Department of Radiology (T.V., M.N., N.W., G.-J.A., S.R., J.d.M., H.R.), Vrije Universiteit Brussels, Universitair Ziekenhuis Brussels, Brussels, Belgium
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J. Dudink
bDepartment of Neonatology (J.D.), Wilhelmina Children’s Hospital/Utrecht University Medical Center, Utrecht, the Netherlands
cRudolf Magnus Brain Center (J.D.), Utrecht University Medical Center, Utrecht, the Netherlands.
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J. de Mey
aFrom the Department of Radiology (T.V., M.N., N.W., G.-J.A., S.R., J.d.M., H.R.), Vrije Universiteit Brussels, Universitair Ziekenhuis Brussels, Brussels, Belgium
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H. Raeymaekers
aFrom the Department of Radiology (T.V., M.N., N.W., G.-J.A., S.R., J.d.M., H.R.), Vrije Universiteit Brussels, Universitair Ziekenhuis Brussels, Brussels, Belgium
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    Fig 1.

    Qualitative comparison of T1WI and T2WI quality (A) and image artifacts (B). Horizontal lines within colored portions indicate scoring per rater. PSIR indicates phase-sensitive inversion recovery.

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    Fig 2.

    Upper row, Conventional T1WI (A) and T2WI (B and C). Lower row, Synthetic T1WI (D) and T2WIs (E and F). Focal WM lesions (small arrows) are clearly visible on both T1WIs. Cystic periventricular leukomalacia (arrows) is seen around the ventricles in both T2WIs.

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    Fig 3.

    Bland-Altman plots comparing different volumetric metrics calculated with Synthetic MR imaging (labeled SyMRI) and MANTiS. The red line indicates the average relative difference, and the blue dashed lines indicate the average ±1.96.

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    Fig 4.

    Synthetic CSF segmentation maps: SyMRI algorithm without optimization for the immature neonatal brain and CSF haze in the WM (blue) (A); improved SyMRI (Version 11.1) at the same level (B). Example of CSF overlap to calculate the Dice similarity coefficients (C). The synthetic CSF segment is red, and the MANTiS segment is blue. Regions where the segments overlap are purple. Voxels of the SyMRI CSF segment containing <20% CSF are not shown.

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    Table 1:

    Image quality

    CategoryAssessment Scale
    Overall image qualityPoor, sufficient, good, excellent
    ArtifactsSevere, moderate, minor, none
    Visualization of anatomic  structuresLegible, illegible
     Posterior cross-roads  (T2/T2 STIR only)
     Central sulcus
     Lentiform nucleus
     Ventrolateral thalamus
     Dorsal pons
    Diagnostic performancePresent, absent
     Focal WM lesions
     Cystic degeneration
    • View popup
    Table 2:

    Lesion conspicuity

    SensitivitySpecificityAccuracyP Value
    WM lesions (n = 23/76)
     Conventional91%86%89%1.00
     Synthetic89%77%86%
    Cysts (n = 7/76)
     Conventional96%57%92%.29
     Synthetic100%64%95%
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American Journal of Neuroradiology: 41 (5)
American Journal of Neuroradiology
Vol. 41, Issue 5
1 May 2020
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Cite this article
T. Vanderhasselt, M. Naeyaert, N. Watté, G.-J. Allemeersch, S. Raeymaeckers, J. Dudink, J. de Mey, H. Raeymaekers
Synthetic MRI of Preterm Infants at Term-Equivalent Age: Evaluation of Diagnostic Image Quality and Automated Brain Volume Segmentation
American Journal of Neuroradiology May 2020, 41 (5) 882-888; DOI: 10.3174/ajnr.A6533

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Synthetic MRI of Preterm Infants at Term-Equivalent Age: Evaluation of Diagnostic Image Quality and Automated Brain Volume Segmentation
T. Vanderhasselt, M. Naeyaert, N. Watté, G.-J. Allemeersch, S. Raeymaeckers, J. Dudink, J. de Mey, H. Raeymaekers
American Journal of Neuroradiology May 2020, 41 (5) 882-888; DOI: 10.3174/ajnr.A6533
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