RT Journal Article
SR Electronic
T1 Prediction of Surgical Outcomes in Normal Pressure Hydrocephalus by MR Elastography
JF American Journal of Neuroradiology
JO Am. J. Neuroradiol.
FD American Society of Neuroradiology
SP 328
OP 334
DO 10.3174/ajnr.A8108
VO 45
IS 3
A1 Pragalv Karki
A1 Matthew C. Murphy
A1 Petrice M. Cogswell
A1 Matthew L. Senjem
A1 Jonathan Graff-Radford
A1 Benjamin D. Elder
A1 Avital Perry
A1 Christopher S. Graffeo
A1 Fredric B Meyer
A1 Clifford R. Jack, Jr.
A1 Richard L. Ehman
A1 John Huston III
YR 2024
UL http://www.ajnr.org/content/45/3/328.abstract
AB BACKGROUND AND PURPOSE: Normal pressure hydrocephalus is a treatable cause of dementia associated with distinct mechanical property signatures in the brain as measured by MR elastography. In this study, we tested the hypothesis that specific anatomic features of normal pressure hydrocephalus are associated with unique mechanical property alterations. Then, we tested the hypothesis that summary measures of these mechanical signatures can be used to predict clinical outcomes.MATERIALS AND METHODS: MR elastography and structural imaging were performed in 128 patients with suspected normal pressure hydrocephalus and 44 control participants. Patients were categorized into 4 subgroups based on their anatomic features. Surgery outcome was acquired for 68 patients. Voxelwise modeling was performed to detect regions with significantly different mechanical properties between each group. Mechanical signatures were summarized using pattern analysis and were used as features to train classification models and predict shunt outcomes for 2 sets of feature spaces: a limited 2D feature space that included the most common features found in normal pressure hydrocephalus and an expanded 20-dimensional (20D) feature space that included features from all 4 morphologic subgroups.RESULTS: Both the 2D and 20D classifiers performed significantly better than chance for predicting clinical outcomes with estimated areas under the receiver operating characteristic curve of 0.66 and 0.77, respectively (P < .05, permutation test). The 20D classifier significantly improved the diagnostic OR and positive predictive value compared with the 2D classifier (P < .05, permutation test).CONCLUSIONS: MR elastography provides further insight into mechanical alterations in the normal pressure hydrocephalus brain and is a promising, noninvasive method for predicting surgical outcomes in patients with normal pressure hydrocephalus.AUROCarea under the receiver operating curveDESHdisproportionately enlarged subarachnoid hydrocephalusDORdiagnostic ORFDRfalse discovery rateHCTShigh-convexity tight sulciMREMR elastographyNPHnormal pressure hydrocephalusNPVnegative predictive valuePPVpositive predictive valueSVMsupport vector machine