Scientific Report 2003-2004 - Cleveland Clinic Lerner Research ...

THE WHITAKERBIOMEDICAL IMAGINGLABORATORYTHE FISHERLABORATORYINVESTIGATORSAndrew Cwik, B.S.Bernhard Sturm, Ph.D.Robert Holtman, M.S.GRADUATE STUDENTKunio Nakamura, B.S.COLLABORATORSJeff Cohen, M.D. 1Robert Fox, M.D. 1Mike Phillips, M.D. 2Richard Rudick, M.D. 1Lael Stone, M.D. 1Jean Tkach, Ph.D. 2Bruce Trapp, Ph.D. 31Mellen Ctr. for MS Treatmentand Research, Dept. ofNeurology, CCF2Div. of Radiology, CCF3Dept. of Neurosciences, CCFThe objectives of the neuroimaging researchprogram are to develop new imagingtechniques that provide relevant markersand predictors of disease progression in multiplesclerosis (MS) and other neurological diseases.Our research is focused on quantitative methodsfor measurement of tissue injury andneurodegeneration from magnetic resonanceimages (MRIs) of the brain. We also seek thebest ways to apply these methods to improveroutine monitoring and therapy evaluation, aswell as to gain new insights into pathologicprocesses.To quantify brainMRIs, we are workingon the development andvalidation of imageanalysis software forautomated imagesegmentation andregistration, multiprotocollesionquantification, andanatomic labeling. Amajor area of interest inour laboratory isaccurate and reliablemeasurement of brainatrophy, a marker ofirreversible tissuedamage. Application ofa new brain-atrophymeasurement methodhas demonstrated thatatrophy occurs in theearly stages of MS, iscorrelated to concurrentand future disability,and can be slowed bytreatment. Ongoing projects include a longitudinalstudy of brain atrophy, which aims todetermine the clinical, MRI, immunologic, andpathologic correlates of brain atrophy in MSpatients. This 5-year study involves the evalua-The Department of Biomedical EngineeringImaging Provides New Views on MultipleSclerosis and NeurodegenerationElizabeth Fisher, Ph.D.tion of MS patients and normal healthy volunteerswith MRI and clinical examinations. We areworking on improved methods for combinationof information from different types of imagesand more sensitive methods for detection oflesion changes over time. The relationshipsbetween clinical and MRI variables and timecourse of changes in the MRI measurements willbe investigated. A post-mortem imaging protocolhas been incorporated into an MS brain donationprogram to relate the different types of MRImeasurements to the underlying pathology. Othercollaborative research projects include a followupstudy to investigatethe predictive value ofMRI measurements overthe course of 10 years inMS patients and theanalysis of images todetermine associationsbetween specific domainsof cognitive impairmentand MRI measures ofpathology in patients withMS. Software developedin our laboratory is beingused in several clinicaltrials of new treatmentsfor MS, and efforts areunder way to incorporatebrain atrophy measurementsinto clinicalpractice.The newneuroimaging centerlocated at CCF’s MellenCenter will enable us toextend our efforts fromimage analysis into imageacquisition. Future plans include the investigationof newer imaging techniques that will providemore specific information about underlyingdisease processes in MS and other neurologicaldisorders.Fisher, E., Cothren, R.M., Tkach, J.A., Masaryk, T.J., and J.F. Cornhill (1997) Knowledge-based 3D segmentationof MR images for quantitative MS lesion tracking. SPIE Medical Imaging 3034:599-610.Rudick, R.A., Fisher, E., Lee, J.-C. and J. Simon (1999) Use of the brain parenchymal fraction to measurewhole brain atrophy in relapsing-remitting MS. Mutiple Sclerosis Collaborative Research Group. Neurology53:1698-1704.Fisher, E., Rudick, R.A., Cutter, G., Baier, M., Miller, D., Weinstock-Guttman, B., Mass, M.K., Dougherty,D.S., and N.A. Simonian (2000) Relationship between brain atrophy and disability: an 8-year follow-upstudy of multiple sclerosis patients. Multiple Sclerosis 6:373-377.Meier, D., and E. Fisher (2002) Parameter space warping: shape-based correspondence between morphologicallydifferent objects. IEEE Transactions on Medical Imaging 21:31-47.Fisher, E.. Rudick, R.A., Simon, J.H., Cutter, G., Baier, M., Lee, J.C., Miller, D., Weinstock-Guttman, B.,Mass, M.K., Dougherty, D.S., and N.A. Simonian (2002) Eight-year follow-up study of brain atrophy in patientswith MS. Neurology 59:1412-1420.28