title: Increased sensitivity to pathological brain changes using co-registration of magnetic resonance imaging scans.
abstract: OBJECTIVE
  To compare automatic software-based co-registration of serial magnetic resonance imaging (MRI) scans with conventional visual comparison, by expert neuroradiologists.
  
  
  METHODS
  Sixty-four patients who were referred to our epilepsy MRI unit for cerebral imaging were identified as having potentially, non-, or slow-growing lesions or cerebral atrophy and followed with sequential scans over a period of up to 8 years, resulting in a total of 92 pairs of scans. Scans were categorized as showing either lesions or atrophy. Each pair of scans was reviewed twice for the presence of change, with and without co-registration, performed using automated software.
  
  
  RESULTS
  Co-registration and visual reporting without co-registration were discordant in the lesions group in nine out of 69 datasets (13%), and in 16 out of 23 pairs of scans in the atrophy group (69%). The most common cause of discordance was visual reporting not detecting changes apparent by co-registration. In three cases, changes detected visually were not detected following co-registration.
  
  
  CONCLUSIONS
  In the group of patients studied, co-registration was more sensitive for detecting changes than visual comparison, particularly with respect to atrophic changes of the brain. With the increasing availability of sophisticated independent consoles attached to MRI scanners that may be used for image co-registration, we propose that serial T1-weighted volumetric MRI brain co-registration should be considered for integration into routine clinical practice to assess patients with suspected progressive disease.
authors.affiliation: The MRI Unit, National Society for Epilepsy, Chalfont St Peter, Buckinghamshire, UK.
authors.forename: J
authors.initials: J
authors.lastname: Burdett
authors.forename: J
authors.initials: J
authors.lastname: Stevens
authors.forename: D
authors.initials: D
authors.lastname: Flügel
authors.forename: E
authors.initials: E
authors.lastname: Williams
authors.forename: J S
authors.initials: JS
authors.lastname: Duncan
authors.forename: L
authors.initials: L
authors.lastname: Lemieux
mesh_terms: D001284:Atrophy; D001921:Brain / Q000473:pathology*; D002983:Clinical Competence; D004827:Epilepsy / Q000473:pathology*; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008279:Magnetic Resonance Imaging / Q000379:methods*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity