Evaluation of cervical spinal cord atrophy using a modified SIENA approach.

Spinal cord (SC) atrophy obtained from structural magnetic resonance imaging has gained relevance as an indicator of neurodegeneration in various neurological disorders. The common method to assess SC atrophy is by comparing numerical differences of the cross-sectional spinal cord area (CSA) between time points. However, this indirect approach leads to considerable variability in the obtained results. Studies showed that this limitation can be overcome by using a registration-based technique. The present study introduces the Structural Image Evaluation using Normalization of Atrophy on the Spinal Cord (SIENA-SC), which is an adapted version of the original SIENA method, designed to directly calculate the percentage of SC volume change over time from clinical brain MRI acquired with an extended field of view to cover the superior part of the cervical SC. In this work, we compared SIENA-SC with the Generalized Boundary Shift Integral (GBSI) and the CSA change. On a scan-rescan dataset, SIENA-SC was shown to have the lowest measurement error than the other two methods. When comparing a group of 190 Healthy Controls with a group of 65 Multiple Sclerosis patients, SIENA-SC provided significantly higher yearly rates of atrophy in patients than in controls and a lower sample size when measured for treatment effect sizes of 50%, 30% and 10%. Our findings indicate that SIENA-SC is a robust, reproducible, and sensitive approach for assessing longitudinal changes in spinal cord volume, providing neuroscientists with an accessible and automated tool able to reduce the need for manual intervention and minimize variability in measurements.
Competing Interests: Declaration of competing interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Nicola De Stefano reports financial support was provided by National Recovery and Resilience Plan (PNRR), and also relationship with Biogen, Merck, Novartis, Sanofi, Roche, Teva, FISM that includes: consulting or advisory, funding grants, speaking and lecture fees, and travel reimbursement. Rosa Cortese reports a relationship with Roche, Merck Serono, Janssen, Novartis, Sanofi that includes: speaking and lecture fees and travel reimbursement. Ferran Prados reports a relationship with National Institute for Health and Care Research (NIHR) Biomedical Research Centres (BRC) at University College London (UCL) that includes: employment, funding grants, speaking and lecture fees, and travel reimbursement. Massimiliano Calabrese reports a relationship with Roche, Sanofi Genzyme, Merck Serono, Biogen Idec, Teva, and Novartis Pharma that includes: consulting or advisory, funding grants, speaking and lecture fees, and travel reimbursement. If there are other authors, they declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. If there are other authors, they declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
(Copyright © 2024. Published by Elsevier Inc.)