NeuroQuant® Methods

NeuroQuant® is a commercially available, FDA-cleared method for measuring brain volume using MRI data (http://www.cortechs.net/products/neuroquant.php), (Brewer 2009; Brewer, Magda et al. 2009; Kovacevic, Rafii et al. 2009; Huppertza, Kröll-Segera et al. 2010). The NeuroQuant® “Standard Analysis” provides measures of 11 brain regions, with 3 of those regions compared to a normal control group, leaving 8 regions not compared with a normal control group. Our methods have been described previously (Ross 2011; Ross, Ochs et al. 2012; Ross, Ochs et al. 2012; Ross, Ochs et al. in press) and summarized below.

VIN uses results from the NeuroQuant Standard Analysis to perform an “Extended Analysis.” The purpose of the Extended Analysis is to test for atrophy of brain parenchymal regions and enlargement of ventricular regions. The patient’s data are compared to data from 20 normal control subjects (10 men, 10 women) previously studied as part of the Alzheimer’s Disease Neuroimaging Initiative (Jack_Jr, Bernstein et al. 2008).

Methods for NeuroQuant Longitudinal Analysis

Results from two NeuroQuant Extended Analyses are used to perform a “Longitudinal Analysis.” Whereas the purpose of the Extended Analysis is to test for atrophy of brain parenchymal regions and enlargement of ventricular regions at one point in time, the purpose of the Longitudinal Analysis is to test for progressive atrophy of brain parenchymal regions and enlargement of ventricular regions by examining and comparing two points in time.

  • The Longitudinal Analysis used comparisons with the 20 normal control subjects described above. Each normal control had 2 MRI scans done.
  • The normal changes in brain volume for the 15 brain regions were calculated.
  • For the Longitudinal Analysis, the patient will have MRI scans done at two points in time and a NeuroQuant Standard Analysis will be done for each. The changes in brain volume for each of the 15 brain regions will be calculated using the same methods that were used for the normal controls. For each brain region, the patient’s annualized percentage change in brain volume will be compared to the normal mean and standard deviation and a Z score will be calculated. Finally, each Z score will be converted to a percentile rank.

References:
Brewer, J. B. (2009). “Fully-automated volumetric MRI with normative ranges: translation to clinical practice.” Behav Neurol 21(1): 21-28.

Brewer, J. B., S. Magda, et al. (2009). “Fully-automated quantification of regional brain volumes for improved detection of focal atrophy in Alzheimer disease.” Am J Neuroradiol 30(3): 578-580.

Huppertza, H., J. Kröll-Segera, et al. (2010). “Intra- and interscanner variability of automated voxel-based volumetry based on a 3D probabilistic atlas of human cerebral structures.” NeuroImage 49: 2216-2224.

Jack_Jr, C. R., M. A. Bernstein, et al. (2008). “The Alzheimer’s Disease Neuroimaging Initiative (ADNI): MRI methods.” J Magn Reson Imaging 27(4): 685-691.

Kovacevic, S., M. S. Rafii, et al. (2009). “High-throughput, Fully Automated Volumetry for Prediction of MMSE and CDR Decline in Mild Cognitive Impairment.” Alzheimer Dis Assoc Disord 23(2): 139–145.

Ross, D. E. (2011). “Review of longitudinal studies of MRI brain volumetry in patients with traumatic brain injury.” Brain Injury 25(13-14): 1271-1278.

Ross, D. E., A. L. Ochs, et al. (2012). “NeuroQuant® revealed hippocampal atrophy in a patient with traumatic brain injury.” Journal of Neuropsychiatry and Clinical Neurosciences 24: E33.

Ross, D. E., A. L. Ochs, et al. (2012). Progressive brain atrophy in patients with chronic neuropsychiatric symptoms after mild traumatic brain injury: A preliminary study. Brain Injury 26:1500-9.

Ross, D. E., A. L. Ochs, et al. (2013). “Man vs. Machine: Comparison of Radiologists’ Interpretations and NeuroQuant® Volumetric Analyses of Brain MRIs in Patients with Traumatic Brain Injury.” Journal of Neuropsychiatry and Clinical Neurosciences 25(1): 32-9.