RT Journal Article SR Electronic T1 Multicenter Validation of Mean Upper Cervical Cord Area Measurements from Head 3D T1-Weighted MR Imaging in Patients with Multiple Sclerosis JF American Journal of Neuroradiology JO Am. J. Neuroradiol. FD American Society of Neuroradiology SP 749 OP 754 DO 10.3174/ajnr.A4635 VO 37 IS 4 A1 Y. Liu A1 C. Lukas A1 M.D. Steenwijk A1 M. Daams A1 A. Versteeg A1 Y. Duan A1 K. Li A1 F. Weiler A1 H.K. Hahn A1 M.P. Wattjes A1 F. Barkhof A1 H. Vrenken YR 2016 UL http://www.ajnr.org/content/37/4/749.abstract AB BACKGROUND AND PURPOSE: Spinal cord atrophy is a common and clinically relevant characteristic in multiple sclerosis. We aimed to perform a multicenter validation study of mean upper cervical cord area measurements in patients with multiple sclerosis and healthy controls from head MR images and to explore the effect of gadolinium administration on mean upper cervical cord area measurements.MATERIALS AND METHODS: We recruited 97 subjects from 3 centers, including 60 patients with multiple sclerosis of different disease types and 37 healthy controls. Both cervical cord and head 3D T1-weighted images were acquired. In 11 additional patients from 1 center, head images before and after gadolinium administration and cervical cord images after gadolinium administration were acquired. The mean upper cervical cord area was compared between cervical cord and head images by using intraclass correlation coefficients (ICC) for both consistency (ICCconsist) and absolute (ICCabs) agreement.RESULTS: There was excellent agreement of mean upper cervical cord area measurements from head and cervical cord images in the entire group (ICCabs = 0.987) and across centers and disease subtypes. The mean absolute difference between the mean upper cervical cord area measured from head and cervical cord images was 2 mm2 (2.3%). Additionally, excellent agreement was found between the mean upper cervical cord area measured from head images with and without gadolinium administration (ICCabs = 0.991) and between the cervical cord and head images with gadolinium administration (ICCabs = 0.992).CONCLUSIONS: Excellent agreement between mean upper cervical cord area measurements on head and cervical cord images was observed in this multicenter study, implying that upper cervical cord atrophy can be reliably measured from head images. Postgadolinium head or cervical cord images may also be suitable for measuring mean upper cervical cord area.EDSSExpanded Disability Status ScaleGdgadoliniumHChealthy controlICCintraclass correlation coefficientICCabsICC absolute agreementICCconsistICC consistencyMUCCAmean upper cervical cord areaPPMSprimary-progressive MSRRMSrelapsing-remitting MSSPMSsecondary-progressive MS