Sub-Millimeter Imaging of Brain-Free Water for Rapid Volume Assessment in Atrophic Brains

Cerebral atrophy is a common feature in neurological diseases that contributes to disability. CSF volume increases to occupy the space left by the atrophying brain. CSF volume can be quantified by intensity thresholding a heavily T2-weighted scan. This brain-free water (BFW) volume, and BFW-volume normalized to the intracranial space, exhibited significant correlation with various clinical measures of disability in 83 multiple sclerosis cases. These measures outperformed brain volume measurements using Lesion-TOADS by 8-19%. The better performance of this new algorithm was attributed to higher resolution enabling improved visualization of sulcal spaces, and the simpler segmentation algorithm in this new BFW-method.

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