title: Identifying quantitative imaging features of posterior fossa syndrome in longitudinal MRI.
abstract: Up to 25% of children who undergo brain tumor resection surgery in the posterior fossa develop posterior fossa syndrome (PFS). This syndrome is characterized by mutism and disturbance in speech. Our hypothesis is that there is a correlation between PFS and the occurrence of hypertrophic olivary degeneration (HOD) in structures within the posterior fossa, known as the inferior olivary nuclei (ION). HOD is exhibited as an increase in size and intensity of the ION on an MR image. Longitudinal MRI datasets of 28 patients were acquired consisting of pre-, intra-, and postoperative scans. A semiautomated segmentation process was used to segment the ION on each MR image. A full set of imaging features describing the first- and second-order statistics and size of the ION were extracted for each image. Feature selection techniques were used to identify the most relevant features among the MRI features, demographics, and data based on neuroradiological assessment. A support vector machine was used to analyze the discriminative features selected by a generative k-nearest neighbor algorithm. The results indicate the presence of hyperintensity in the left ION as the most diagnostically relevant feature, providing a statistically significant improvement in the classification of patients ([Formula: see text]) when using this feature alone.
authors.affiliation: University of Surrey , Centre for Vision, Speech, and Signal Processing, Guildford GU2 7XH, United Kingdom.
authors.forename: Michaela
authors.initials: M
authors.lastname: Spiteri
authors.affiliation: University of Surrey, Centre for Vision, Speech, and Signal Processing, Guildford GU2 7XH, United Kingdom; Middlesex University Hendon campus, School of Science and Technology, Department of Computer Science, The Burroughs, London NW4 4BT, United Kingdom.
authors.forename: David
authors.initials: D
authors.lastname: Windridge
authors.affiliation: Alder Hey Children's Hospital , Neurology Department, Eaton Road, Liverpool L12 2AP, United Kingdom.
authors.forename: Shivaram
authors.initials: S
authors.lastname: Avula
authors.affiliation: Alder Hey Children's Hospital , Neurology Department, Eaton Road, Liverpool L12 2AP, United Kingdom.
authors.forename: Ram
authors.initials: R
authors.lastname: Kumar
authors.affiliation: University of Surrey , Centre for Vision, Speech, and Signal Processing, Guildford GU2 7XH, United Kingdom.
authors.forename: Emma
authors.initials: E
authors.lastname: Lewis
keywords: hypertrophic olivary degeneration; inferior olivary nuclei; intraoperative MRI; posterior fossa syndrome
references.citation: Magn Reson Imaging. 2010 Jul;28(6):862-81
references.pmid: 20409660
references.citation: Pediatr Neurosurg. 2007;43(5):386-95
references.pmid: 17786004
references.citation: Neuro Oncol. 2012 Oct;14(10):1294-303
references.pmid: 22952198
references.citation: J Pediatr Oncol Nurs. 1995 Oct;12(4):181-7
references.pmid: 7495523
references.citation: Behav Neurol. 2000;12(4):191-200
references.pmid: 11568431
references.citation: Neurotherapeutics. 2009 Jul;6(3):478-86
references.pmid: 19560738
references.citation: AJNR Am J Neuroradiol. 2014 Apr;35(4):797-802
references.pmid: 24184519
references.citation: J Neurooncol. 2000 May;48(1):75-81
references.pmid: 11026700
references.citation: Magn Reson Med. 2009 Jun;61(6):1396-404
references.pmid: 19353671
references.citation: Pediatr Blood Cancer. 2011 Feb;56(2):206-10
references.pmid: 21157890
references.citation: Acta Neurochir Suppl. 2011;109:97-102
references.pmid: 20960327