title: Automatic Segmentation of the Corpus Callosum Using a Cell-Competition Algorithm: Diffusion Tensor Imaging-Based Evaluation of Callosal Atrophy and Tissue Alterations in Patients With Systemic Lupus Erythematosus.
abstract: OBJECTIVE
  Patients with neuropsychiatric systemic lupus erythematosus (NPSLE) may exhibit corpus callosal atrophy and tissue alterations. Measuring the callosal volume and tissue integrity using diffusion tensor imaging (DTI) could help to differentiate patients with NPSLE from patients without NPSLE. Hence, this study aimed to use an automatic cell-competition algorithm to segment the corpus callosum and to investigate the effects of central nervous system (CNS) involvement on the callosal volume and tissue integrity in patients with SLE.
  
  
  METHODS
  Twenty-two SLE patients with (N = 10, NPSLE) and without (N = 12, non-NPSLE) CNS involvement and 22 control subjects were enrolled in this study. For volumetric measurement, a cell-competition algorithm was used to automatically delineate corpus callosal boundaries based on a midsagittal fractional anisotropy (FA) map. After obtaining corpus callosal boundaries for all subjects, the volume, FA, and mean diffusivity (MD) of the corpus callosum were calculated. A post hoc Tamhane's T2 analysis was performed to statistically compare differences among NPSLE, non-NPSLE, and control subjects. A receiver operating characteristic curve analysis was also performed to compare the performance of the volume, FA, and MD of the corpus callosum in differentiating NPSLE from other subjects.
  
  
  RESULTS
  Patients with NPSLE had significant decreases in volume and FA but an increase in MD in the corpus callosum compared with control subjects, whereas no significant difference was noted between patients without NPSLE and control subjects. The FA was found to have better performance in differentiating NPSLE from other subjects.
  
  
  CONCLUSIONS
  A cell-competition algorithm could be used to automatically evaluate callosal atrophy and tissue alterations. Assessments of the corpus callosal volume and tissue integrity helped to demonstrate the effects of CNS involvement in patients with SLE.
authors: From the *Division of Medical Imaging, Department of Radiology, and †Division of Allergy, Immunology and Rheumatology, Department of Internal Medicine, Far Eastern Memorial Hospital; ‡Institute of Biomedical Engineering, National Taiwan University, Taipei; §Department of Medical Imaging and Radiological Sciences, and ∥Department of Healthcare Administration and Medical Informatics, Kaohsiung Medical University, Kaohsiung, Taiwan.
authors: Shiou-Ping
authors: SP
authors: Lee
authors: Chien-Sheng
authors: CS
authors: Wu
authors: Jie-Zhi
authors: JZ
authors: Cheng
authors: Chung-Ming
authors: CM
authors: Chen
authors: Yu-Chiang
authors: YC
authors: Chen
authors: Ming-Chung
authors: MC
authors: Chou
mesh_terms: D000328:Adult; D000465:Algorithms; D000704:Analysis of Variance; D001284:Atrophy; D003337:Corpus Callosum / Q000473:pathology*; D056324:Diffusion Tensor Imaging / Q000379:methods*; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods*; D020945:Lupus Vasculitis, Central Nervous System / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D015203:Reproducibility of Results