Publications

Evidence-based validation that demonstrates how we continue to advance the field of neuroimaging

Examine detailed studies published in top medical journals that outline how physicians, radiologists, and researchers are using Cortechs.ai’s groundbreaking AI image analysis software to elevate diagnosis and treatment of neurodegenerative diseases and cancer.

Estimates of Age-Dependent Cutoffs for Pathological Brain Volume Loss Using SIENA/FSLda Longitudinal Brain Volumetry Study in Healthy Adults

Brain volume loss (BVL) has gained increasing interest for monitoring tissue damage in neurodegenerative diseases including multiple sclerosis (MS). In this longitudinal study, 117 healthy participants (age range 37.3 82.6 years) received at least 2 magnetic resonance imaging examinations. BVL (in %) was determined with the Structural Image Evaluation using Normalisation of Atrophy/FMRIB Software Library and annualized. 2017.

Prediction of Amyloid Positivity in Mild Cognitive Impairment Using Fully Automated Brain Segmentation Software

The objective of this study was to assess the predictive ability of regional volume information provided by fully automated brain segmentation software for cerebral amyloid positivity in mild cognitive impairment (MCI). (2020).

Diagnostic Efficacy of Structural MRI in Patients With Mild-to-Moderate Alzheimer Disease: Automated Volumetric Assessment Versus Visual Assessment

The automated volumetric assessment tool had moderate sensitivity (63.3%) and high specificity (100%) in differentiating patients with mild-to-moderate AD from control subjects. Visual inspection showed sensitivity of 63.3% and specificity of 92.0%. The diagnostic performance was not significantly different between the two methods (p =0.536–0.906). Intraobserver reliability for visual inspection was 0.858 and 0.902 for the two reviewers, and interobserver reliability was 0.692–0.780. (2016).

STRUCTURAL, FUNCTIONAL, AND MOLECULAR NEUROIMAGING BIOMARKERS FOR ALZHEIMER DISEASE

Magnetic resonance spectroscopy (MRS) has long showed promise for detection of regional chemical changes associated with neurodegeneration, infl ammation, or gliosis, and so it has been a technique of interest for detecting such changes in AD. It provides information about relative concentrations of key chemicals, such as N acetylaspartate, creatinine, and myoinositol, and there is strong evidence that the regional concentration of these chemicals varies with the neurodegeneration seen in AD. (2013).

volBrain: An Online MRI Brain Volumetry System

The amount of medical image data produced in clinical and research settings is rapidly growing resulting in vast amount of data to analyze. Automatic and reliable quantitative analysis tools, including segmentation, allow to analyze brain development and to understand specific patterns of many neurological diseases. 2016.

High-throughput, Fully Automated Volumetry for Prediction of MMSE and CDR Decline in Mild Cognitive Impairment

This study examined whether measures of hippocampus, amygdala, and temporal horn volume predict clinical decline over the following 6-month period in patients with mild cognitive impairment (MCI). Fully automated volume measurements were performed in 269 MCI patients. Baseline volumes of the hippocampus, amygdala, and temporal horn were evaluated as predictors of change in Mini-mental State Examination and Clinical Dementia Rating Sum of Boxes over a 6-month interval. Fully automated measurements of baseline hippocampus and amygdala volumes correlated with baseline delayed recall scores. (2009).

Translating Research Findings into Clinical Practice: A Systematic and Critical Review of Neuroimaging-based Clinical Tools for Brain Disorders

This systematic review describes and compares the technical characteristics of the available tools, with the aim to assess their translational potential into real-world clinical settings. The results reveal that a total of eight tools. All of these were specifically developed for neurological disorders, and as such are not suitable for application to psychiatric disorders. 2020.

LesionQuant for Assessment of MRI in Multiple Sclerosis—A Promising Supplement to the Visual Scan Inspection

Quantitative measurements of lesion volume, lesion count, distribution of lesions, and brain atrophy have a potentially significant value for evaluating disease progression. We hypothesize that utilizing software designed for evaluating MRI data in MS will provide more accurate and detailed analyses compared to the visual neuro-radiological evaluation. 2020.

MAGNIMS Consensus Recommendations On the Use of Brain and Spinal Cord Atrophy Measures in Clinical Practice

Based on the evidence reviewed, the idea that brain volume changes and, to a lesser extent, spinal cord atrophy are helpful predictors of the evolution of MS before initiation of therapy is undisputed, so these measures could be valid treatment-decision tools. The evidence reviewed also supports the idea that brain volume measures have value in monitoring the effects of MS drugs as part of the no evidence of disease activity outcome measure or minimal evidence of disease activity outcome measure. However, several potential sources of substantial error remain, including, but not limited to, differential effects of drugs on brain volume measures, confounding physiological and technical factors and the performance and value of volumetric tools. To make implementation of volume measurements in clinical practice feasible, these potential sources of error need to be accounted for and appropriately managed, and further research is needed to ensure the accuracy and reliability of the measurements. (2020).

Clinical Relevance of Brain Volume Measures in Multiple Sclerosis

Findings from a number of recent studies have prompted debates on the clinical relevance of brain volume change as a measure of neurological and neuropsychological disability. This article reviews the current understanding of the implications of brain volume changes in MS, including the effects of disease-modifying treatments (DMTs). Additionally, the pathophysiology and clinical relevance of measuring brain volume in patients with MS is discussed. 2014.

MRI-Based Brain Volumetry at a Single Time Point Complements Clinical Evaluation of Patients with Multiple Sclerosis in an Outpatient Setting

Thalamic atrophy and whole brain atrophy in multiple sclerosis (MS) are associated with disease progression. The motivation of this study was to propose and evaluate a new grouping scheme which is based on MS patients’ whole brain and thalamus volumes measured on MRI at a single time point. 2018.

Volumetric MRI Markers and Predictors of Disease Activity in Early Multiple Sclerosis: A Longitudinal Cohort Study

This study compares clinical and MRI parameters between patients with clinically isolated syndrome and those converting to clinically definite multiple sclerosis within 2 years, to identify volumetric MRI predictors of this conversion and to assess effect of early relapses. 2012.

The Contribution of MRI in Assessing Cognitive Impairment in Multiple Sclerosis

Due to their ability to detect MS-related abnormalities, MRI techniques are a valuable tool to achieve these goals. Following an updated overview of the assessment methods and profile of cognitive impairment in patients with MS, this review provides a state-of-the-art summary of the main results obtained from the application of conventional and modern magnetic resonance–based techniques to quantify MS-related damage, in terms of macroscopic lesions, as well as involvement of the normal-appearing white matter and gray matter and their association with cognitive impairment. 2010.

Mild Cognitive Impairment: Baseline and Longitudinal Structural MR Imaging Measures Improve Predictive Prognosis

To assess whether single-time-point and longitudinal volumetric magnetic resonance (MR) imaging measures provide predictive prognostic information in patients with amnestic mild cognitive impairment (MCI). Radiology, June 2011.

Predicting MCI Outcome With Clinically Available MRI And CSF Biomarkers

Study to determine the ability of clinically available volumetric MRI (vMRI) and CSF biomarkers, alone or in combination with a quantitative learning measure, to predict conversion to Alzheimer’s disease (AD) in patients with mild cognitive impairment (MCI). 2011 October 12.

An Expanded Role For Neuroimaging In the Evaluation Of Memory Impairment

Authors Rahul Desikan et al from UCSD and UCSF describe a strategy to incorporate newly available imaging markers in the workup of memory problems, emphasizing that evidence of neurodegeneration can be an important piece of the puzzle to guide further management and testing, while helping to avoid overuse of more expensive biomarker tests. The paper highlights the way in which advanced neuroimaging tools such as Cortechs.ai’ NeuroQuant® volumetric MRI analysis system can provide information key to an improved understanding of the patient’s clinical status. (AJNR Am J Neuroradiology originally published online on June 13, 2013, 10.3174/ajnr.A3644)

Biomarkers For The Clinical Evaluation Of The Cognitively Impaired Elderly, Amyloid Is Not Enough

Recently published in the journal Imaging in Medicine (June, 2012), Linda K. McEvoy and James B. Brewer argue that while incorporating biomarkers for assessing Alzheimer’s disease risk (including volumetric MRI done with NeuroQuant®) can help in patient prognosis, tests for amyloid, if used in isolation, have potential for harm, as amyloid tests are clinically useful only when evidence suggests progressive cognitive decline or neurodegeneration. (Imaging in Medicine, June 2012, Vol. 4, No. 3 , Pages 343-357).

Structural Functional And Molecular Neuroimaging Biomarkers For Alzheimer’s Disease

Neuroimaging biomarkers are now routinely incorporated into AD clinical trials and are increasingly used in clinical practice. This paper broadly describes the development and use of these biomarkers as they relate to AD.

High-Throughput, Fully Automated Volumetry For Prediction Of MMSE And CDR Decline In Mild Cognitive Impairment

Scientists at the University of California, San Diego School of Medicine have shown that NeuroQuant®’s fully-automated volumetric MRI scanning is effective in predicting the progression from mild cognitive impairment (MCI) to Alzheimer’s disease. The procedure can be readily used in clinics to measure brain atrophy, and may help physicians to predict decline in MCI patients.

Fully-Automated Quantification Of Regional Brain Volumes For Improved Detection Of Focal Atrophy In Alzheimer’s Disease

NeuroQuant® Results Published in the American Journal of Neuroradiology.

Mesial Temporal Sclerosis: Accuracy Of NeuroQuant Versus Neuroradiologist

A study to compare the accuracy of a volumetric fully automated computer assessment of hippocampal volume asymmetry versus neuroradiologists’ interpretations of the temporal lobes for mesial temporal sclerosis (MTS), which is important for patients with temporal lobe epilepsy. American Journal of Neuroradiology, 2015 April 23.

Neuroradiology: Quantitative MR Volumetry In Temporal Lobe Epilepsy

Quantitative MR imaging using NeuroQuant® can enhance standard visual analysis, providing a viable means for translating volumetric analysis into clinical practice and increasing the detection of hippocampal atrophy in temporal lobe epilepsy in both community and tertiary care settings. Radiology August 2012 264:542-550; Published online June 21, 2012.

Amygdala Volume Changes In Posttraumatic Stress Disorder In A Large Case-Controlled Veterans Group

Assessment of military veterans with PTSD and trauma-exposed control subjects, with sufficient power to perform a definitive assessment of the effect of PTSD on volumetric changes in the amygdala and hippocampus and of the contribution of illness duration, trauma load, and depressive symptoms. November 2012.

Prospective Longitudinal MRI Study Of Brain Volumes And Diffusion Changes During The First Year After Moderate To Severe TBI

Prospective study of Traumatic Brain Injury (TBI) patients to investigate volume change in cortical grey matter (GM), hippocampus, lenticular nucleus, lobar white matter (WM), brainstem and ventricles.

Automated CT registration tool improves sensitivity to change in ventricular volume in patients with shunts and drains

A retrospective evaluation of ventricular shunt or EVD patients who underwent sequential head CT scans with an automated CT registration tool (CT CoPilot), assessing reader ability to discern change in ventricular volume between scans using standard axial CT images versus reformats and subtraction images generated by the registration tool. 2020.

Restriction Spectrum Imaging: An Evolving Imaging Biomarker in Prostate MRI

Restriction spectrum imaging (RSI) is a novel diffusion-weighted MRI technique that uses the mathematically distinct behavior of water diffusion in separable microscopic tissue compartments to highlight key aspects of the tissue micro architecture with high conspicuity. 2017.

Restriction Spectrum Imaging Improves MRI-based Prostate Cancer Detection

Compares the diagnostic performance of restriction spectrum imaging (RSI), with that of conventional multi-parametric (MP) magnetic resonance imaging (MRI) for prostate cancer (PCa) detection in a blinded reader-based format. 2016.

In Vivo Prostate Cancer Detection and Grading Using Restriction Spectrum Imaging-MRI

Magnetic resonance imaging (MRI) is emerging as a robust, noninvasive method for detecting and characterizing prostate cancer (PCa), but limitations remain in its ability to distinguish cancerous from non-cancerous tissue. We evaluated the performance of a novel MRI technique, restriction spectrum imaging (RSI-MRI), to quantitatively detect and grade PCa compared with current standard-of-care MRI. 2016.

Diffusion-Weighted Imaging in Cancer: Physical Foundations and Applications of Restriction Spectrum Imaging

In this review, we provide a detailed explanation of the biophysical basis of diffusion contrast, emphasizing the difference between hindered and restricted diffusion, and elucidating how diffusion parameters in tissue are derived from the measurements via the diffusion model. We describe one advanced DWI modeling technique, called restriction spectrum imaging (RSI). 2014.
Volumetric MR Imaging

Estimates of Age-Dependent Cutoffs for Pathological Brain Volume Loss Using SIENA/FSLda Longitudinal Brain Volumetry Study in Healthy Adults

Brain volume loss (BVL) has gained increasing interest for monitoring tissue damage in neurodegenerative diseases including multiple sclerosis (MS). In this longitudinal study, 117 healthy participants (age range 37.3 82.6 years) received at least 2 magnetic resonance imaging examinations. BVL (in %) was determined with the Structural Image Evaluation using Normalisation of Atrophy/FMRIB Software Library and annualized. 2017.

Prediction of Amyloid Positivity in Mild Cognitive Impairment Using Fully Automated Brain Segmentation Software

The objective of this study was to assess the predictive ability of regional volume information provided by fully automated brain segmentation software for cerebral amyloid positivity in mild cognitive impairment (MCI). (2020).

Diagnostic Efficacy of Structural MRI in Patients With Mild-to-Moderate Alzheimer Disease: Automated Volumetric Assessment Versus Visual Assessment

The automated volumetric assessment tool had moderate sensitivity (63.3%) and high specificity (100%) in differentiating patients with mild-to-moderate AD from control subjects. Visual inspection showed sensitivity of 63.3% and specificity of 92.0%. The diagnostic performance was not significantly different between the two methods (p =0.536–0.906). Intraobserver reliability for visual inspection was 0.858 and 0.902 for the two reviewers, and interobserver reliability was 0.692–0.780. (2016).

STRUCTURAL, FUNCTIONAL, AND MOLECULAR NEUROIMAGING BIOMARKERS FOR ALZHEIMER DISEASE

Magnetic resonance spectroscopy (MRS) has long showed promise for detection of regional chemical changes associated with neurodegeneration, infl ammation, or gliosis, and so it has been a technique of interest for detecting such changes in AD. It provides information about relative concentrations of key chemicals, such as N acetylaspartate, creatinine, and myoinositol, and there is strong evidence that the regional concentration of these chemicals varies with the neurodegeneration seen in AD. (2013).

volBrain: An Online MRI Brain Volumetry System

The amount of medical image data produced in clinical and research settings is rapidly growing resulting in vast amount of data to analyze. Automatic and reliable quantitative analysis tools, including segmentation, allow to analyze brain development and to understand specific patterns of many neurological diseases. 2016.

High-throughput, Fully Automated Volumetry for Prediction of MMSE and CDR Decline in Mild Cognitive Impairment

This study examined whether measures of hippocampus, amygdala, and temporal horn volume predict clinical decline over the following 6-month period in patients with mild cognitive impairment (MCI). Fully automated volume measurements were performed in 269 MCI patients. Baseline volumes of the hippocampus, amygdala, and temporal horn were evaluated as predictors of change in Mini-mental State Examination and Clinical Dementia Rating Sum of Boxes over a 6-month interval. Fully automated measurements of baseline hippocampus and amygdala volumes correlated with baseline delayed recall scores. (2009).

Translating Research Findings into Clinical Practice: A Systematic and Critical Review of Neuroimaging-based Clinical Tools for Brain Disorders

This systematic review describes and compares the technical characteristics of the available tools, with the aim to assess their translational potential into real-world clinical settings. The results reveal that a total of eight tools. All of these were specifically developed for neurological disorders, and as such are not suitable for application to psychiatric disorders. 2020.
Multiple Sclerosis

LesionQuant for Assessment of MRI in Multiple Sclerosis—A Promising Supplement to the Visual Scan Inspection

Quantitative measurements of lesion volume, lesion count, distribution of lesions, and brain atrophy have a potentially significant value for evaluating disease progression. We hypothesize that utilizing software designed for evaluating MRI data in MS will provide more accurate and detailed analyses compared to the visual neuro-radiological evaluation. 2020.

MAGNIMS Consensus Recommendations On the Use of Brain and Spinal Cord Atrophy Measures in Clinical Practice

Based on the evidence reviewed, the idea that brain volume changes and, to a lesser extent, spinal cord atrophy are helpful predictors of the evolution of MS before initiation of therapy is undisputed, so these measures could be valid treatment-decision tools. The evidence reviewed also supports the idea that brain volume measures have value in monitoring the effects of MS drugs as part of the no evidence of disease activity outcome measure or minimal evidence of disease activity outcome measure. However, several potential sources of substantial error remain, including, but not limited to, differential effects of drugs on brain volume measures, confounding physiological and technical factors and the performance and value of volumetric tools. To make implementation of volume measurements in clinical practice feasible, these potential sources of error need to be accounted for and appropriately managed, and further research is needed to ensure the accuracy and reliability of the measurements. (2020).

Clinical Relevance of Brain Volume Measures in Multiple Sclerosis

Findings from a number of recent studies have prompted debates on the clinical relevance of brain volume change as a measure of neurological and neuropsychological disability. This article reviews the current understanding of the implications of brain volume changes in MS, including the effects of disease-modifying treatments (DMTs). Additionally, the pathophysiology and clinical relevance of measuring brain volume in patients with MS is discussed. 2014.

MRI-Based Brain Volumetry at a Single Time Point Complements Clinical Evaluation of Patients with Multiple Sclerosis in an Outpatient Setting

Thalamic atrophy and whole brain atrophy in multiple sclerosis (MS) are associated with disease progression. The motivation of this study was to propose and evaluate a new grouping scheme which is based on MS patients’ whole brain and thalamus volumes measured on MRI at a single time point. 2018.

Volumetric MRI Markers and Predictors of Disease Activity in Early Multiple Sclerosis: A Longitudinal Cohort Study

This study compares clinical and MRI parameters between patients with clinically isolated syndrome and those converting to clinically definite multiple sclerosis within 2 years, to identify volumetric MRI predictors of this conversion and to assess effect of early relapses. 2012.

The Contribution of MRI in Assessing Cognitive Impairment in Multiple Sclerosis

Due to their ability to detect MS-related abnormalities, MRI techniques are a valuable tool to achieve these goals. Following an updated overview of the assessment methods and profile of cognitive impairment in patients with MS, this review provides a state-of-the-art summary of the main results obtained from the application of conventional and modern magnetic resonance–based techniques to quantify MS-related damage, in terms of macroscopic lesions, as well as involvement of the normal-appearing white matter and gray matter and their association with cognitive impairment. 2010.
Neurodementias

Mild Cognitive Impairment: Baseline and Longitudinal Structural MR Imaging Measures Improve Predictive Prognosis

To assess whether single-time-point and longitudinal volumetric magnetic resonance (MR) imaging measures provide predictive prognostic information in patients with amnestic mild cognitive impairment (MCI). Radiology, June 2011.

Predicting MCI Outcome With Clinically Available MRI And CSF Biomarkers

Study to determine the ability of clinically available volumetric MRI (vMRI) and CSF biomarkers, alone or in combination with a quantitative learning measure, to predict conversion to Alzheimer’s disease (AD) in patients with mild cognitive impairment (MCI). 2011 October 12.

An Expanded Role For Neuroimaging In the Evaluation Of Memory Impairment

Authors Rahul Desikan et al from UCSD and UCSF describe a strategy to incorporate newly available imaging markers in the workup of memory problems, emphasizing that evidence of neurodegeneration can be an important piece of the puzzle to guide further management and testing, while helping to avoid overuse of more expensive biomarker tests. The paper highlights the way in which advanced neuroimaging tools such as Cortechs.ai’ NeuroQuant® volumetric MRI analysis system can provide information key to an improved understanding of the patient’s clinical status. (AJNR Am J Neuroradiology originally published online on June 13, 2013, 10.3174/ajnr.A3644)

Biomarkers For The Clinical Evaluation Of The Cognitively Impaired Elderly, Amyloid Is Not Enough

Recently published in the journal Imaging in Medicine (June, 2012), Linda K. McEvoy and James B. Brewer argue that while incorporating biomarkers for assessing Alzheimer’s disease risk (including volumetric MRI done with NeuroQuant®) can help in patient prognosis, tests for amyloid, if used in isolation, have potential for harm, as amyloid tests are clinically useful only when evidence suggests progressive cognitive decline or neurodegeneration. (Imaging in Medicine, June 2012, Vol. 4, No. 3 , Pages 343-357).

Structural Functional And Molecular Neuroimaging Biomarkers For Alzheimer’s Disease

Neuroimaging biomarkers are now routinely incorporated into AD clinical trials and are increasingly used in clinical practice. This paper broadly describes the development and use of these biomarkers as they relate to AD.

High-Throughput, Fully Automated Volumetry For Prediction Of MMSE And CDR Decline In Mild Cognitive Impairment

Scientists at the University of California, San Diego School of Medicine have shown that NeuroQuant®’s fully-automated volumetric MRI scanning is effective in predicting the progression from mild cognitive impairment (MCI) to Alzheimer’s disease. The procedure can be readily used in clinics to measure brain atrophy, and may help physicians to predict decline in MCI patients.

Fully-Automated Quantification Of Regional Brain Volumes For Improved Detection Of Focal Atrophy In Alzheimer’s Disease

NeuroQuant® Results Published in the American Journal of Neuroradiology.

Epilepsy

Mesial Temporal Sclerosis: Accuracy Of NeuroQuant Versus Neuroradiologist

A study to compare the accuracy of a volumetric fully automated computer assessment of hippocampal volume asymmetry versus neuroradiologists’ interpretations of the temporal lobes for mesial temporal sclerosis (MTS), which is important for patients with temporal lobe epilepsy. American Journal of Neuroradiology, 2015 April 23.

Neuroradiology: Quantitative MR Volumetry In Temporal Lobe Epilepsy

Quantitative MR imaging using NeuroQuant® can enhance standard visual analysis, providing a viable means for translating volumetric analysis into clinical practice and increasing the detection of hippocampal atrophy in temporal lobe epilepsy in both community and tertiary care settings. Radiology August 2012 264:542-550; Published online June 21, 2012.

Traumatic Brain Injury

Amygdala Volume Changes In Posttraumatic Stress Disorder In A Large Case-Controlled Veterans Group

Assessment of military veterans with PTSD and trauma-exposed control subjects, with sufficient power to perform a definitive assessment of the effect of PTSD on volumetric changes in the amygdala and hippocampus and of the contribution of illness duration, trauma load, and depressive symptoms. November 2012.

Prospective Longitudinal MRI Study Of Brain Volumes And Diffusion Changes During The First Year After Moderate To Severe TBI

Prospective study of Traumatic Brain Injury (TBI) patients to investigate volume change in cortical grey matter (GM), hippocampus, lenticular nucleus, lobar white matter (WM), brainstem and ventricles.

Automated CT registration tool improves sensitivity to change in ventricular volume in patients with shunts and drains

A retrospective evaluation of ventricular shunt or EVD patients who underwent sequential head CT scans with an automated CT registration tool (CT CoPilot), assessing reader ability to discern change in ventricular volume between scans using standard axial CT images versus reformats and subtraction images generated by the registration tool. 2020.

Prostate Cancer

Restriction Spectrum Imaging: An Evolving Imaging Biomarker in Prostate MRI

Restriction spectrum imaging (RSI) is a novel diffusion-weighted MRI technique that uses the mathematically distinct behavior of water diffusion in separable microscopic tissue compartments to highlight key aspects of the tissue micro architecture with high conspicuity. 2017.

Restriction Spectrum Imaging Improves MRI-based Prostate Cancer Detection

Compares the diagnostic performance of restriction spectrum imaging (RSI), with that of conventional multi-parametric (MP) magnetic resonance imaging (MRI) for prostate cancer (PCa) detection in a blinded reader-based format. 2016.

In Vivo Prostate Cancer Detection and Grading Using Restriction Spectrum Imaging-MRI

Magnetic resonance imaging (MRI) is emerging as a robust, noninvasive method for detecting and characterizing prostate cancer (PCa), but limitations remain in its ability to distinguish cancerous from non-cancerous tissue. We evaluated the performance of a novel MRI technique, restriction spectrum imaging (RSI-MRI), to quantitatively detect and grade PCa compared with current standard-of-care MRI. 2016.

Diffusion-Weighted Imaging in Cancer: Physical Foundations and Applications of Restriction Spectrum Imaging

In this review, we provide a detailed explanation of the biophysical basis of diffusion contrast, emphasizing the difference between hindered and restricted diffusion, and elucidating how diffusion parameters in tissue are derived from the measurements via the diffusion model. We describe one advanced DWI modeling technique, called restriction spectrum imaging (RSI). 2014.