MRI-Based Brain Volume Scoring in Cerebral Malaria is Externally Valid and Applicable to Lower-Resolution Images

Authors

Manu S. Goyal, From the Mallinckrodt Institute of Radiology (M.S.G.), Washington University School of Medicine, St. Louis, Missouri goyalm@wustl.edu.
Lorenna Vidal, Children's Hospital of Philadelphia (L.V.), Philadelphia, Pennsylvania.
Karen Chetcuti, Department of Radiology (K.C.), Kamuzu University of Health Sciences, Blantyre, Malawi.
Cowles Chilingulo, Department of Radiology (K.C., C.C.), Queen Elizabeth Central Hospital, Blantyre, Malawi.
Khalid Ibrahim, Department of Radiology (K.C., C.C.), Queen Elizabeth Central Hospital, Blantyre, Malawi.
Jeffrey Zhang, Department of Statistics and Data Science (J.Z., D.S.S.), The Wharton School, University of Pennsylvania, Philadelphia, Pennsylvania.
Dylan S. Small, Department of Statistics and Data Science (J.Z., D.S.S.), The Wharton School, University of Pennsylvania, Philadelphia, Pennsylvania.
Karl B. Seydel, College of Osteopathic Medicine (K.B.S., T.E.T.), MI State University, East Lansing, Michigan.
Nicole O'Brien, Blantyre Malaria Project, (K.B.S., N.O., T.E.T., D.G.P.) Kamuzu University of Health Sciences, Blantyre, Malawi.
Terrie E. Taylor, College of Osteopathic Medicine (K.B.S., T.E.T.), MI State University, East Lansing, Michigan.
Douglas G. Postels, Blantyre Malaria Project, (K.B.S., N.O., T.E.T., D.G.P.) Kamuzu University of Health Sciences, Blantyre, Malawi.

Document Type

Journal Article

Publication Date

1-12-2024

Journal

AJNR. American journal of neuroradiology

DOI

10.3174/ajnr.A8098

Abstract

BACKGROUND AND PURPOSE: Children with cerebral malaria have an elevated risk of mortality and neurologic morbidity. Both mortality and morbidity are associated with initially increased brain volume on MR imaging, as graded by the Brain Volume Score, a subjective ordinal rating scale created specifically for brain MRIs in children with cerebral malaria. For the Brain Volume Score to be more widely clinically useful, we aimed to determine its independent reproducibility and whether it can be applicable to lower-resolution MRIs. MATERIALS AND METHODS: To assess the independent reproducibility of the Brain Volume Score, radiologists not associated with the initial study were trained to score MRIs from a new cohort of patients with cerebral malaria. These scores were then compared with survival and neurologic outcomes. To assess the applicability to lower-resolution MRI, we assigned Brain Volume Scores to brain MRIs degraded to simulate a very-low-field (64 mT) portable scanner and compared these with the original scores assigned to the original nondegraded MRIs. RESULTS: Brain Volume Scores on the new cohort of patients with cerebral malaria were highly associated with outcomes (OR for mortality = 16, < .001). Scoring of the simulated degraded images remained consistent with the Brain Volume Scores assigned to the original higher-quality (0.35 T) images (intraclass coefficients > 0.86). CONCLUSIONS: Our findings demonstrate that the Brain Volume Score is externally valid in reproducibly predicting outcomes and can be reliably assigned to lower-resolution images.

APA Citation

Goyal, Manu S.; Vidal, Lorenna; Chetcuti, Karen; Chilingulo, Cowles; Ibrahim, Khalid; Zhang, Jeffrey; Small, Dylan S.; Seydel, Karl B.; O'Brien, Nicole; Taylor, Terrie E.; and Postels, Douglas G., "MRI-Based Brain Volume Scoring in Cerebral Malaria is Externally Valid and Applicable to Lower-Resolution Images" (2024). GW Authored Works. Paper 4184.
https://hsrc.himmelfarb.gwu.edu/gwhpubs/4184

Department

Neurology