Evidence map›Paper›PMID 38378906›Full record

ArticleNeuroradiology2024

Removing outliers from the normative database improves regional atrophy detection in single-subject voxel-based morphometry.

Vivian Schultz, Dennis M Hedderich, Benita Schmitz-Koep, David Schinz, Claus Zimmer, Igor Yakushev, Ivayla Apostolova, Cansu Özden, Roland Opfer, Ralph Buchert

Abstract read
In one paragraph

Article in Neuroradiology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed, 2 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 2 syntheses or guidelines pooled it.

  1. Practical Brain MRI Guidelines for Anti-Aβ Antibody Treatment in Early Symptomatic Alzheimer's Disease.Magnetic resonance in medical sciences : MRMS : an official journal of Japan Society of Magnetic Resonance in Medicine · 2025
    Guideline
  2. Guideline
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Vivian SchultzDepartment of Neuroradiology, Klinikum Rechts Der Isar, Technical University of Munich, School of Medicine and Health, Ismaninger Str. 22, 81675, Munich, Germany. vivian.schultz@tum.de.ORCID http://orcid.org/0009-0006-0938-8154
Dennis M HedderichDepartment of Neuroradiology, Klinikum Rechts Der Isar, Technical University of Munich, School of Medicine and Health, Ismaninger Str. 22, 81675, Munich, Germany.
Benita Schmitz-KoepDepartment of Neuroradiology, Klinikum Rechts Der Isar, Technical University of Munich, School of Medicine and Health, Ismaninger Str. 22, 81675, Munich, Germany.
David SchinzDepartment of Neuroradiology, Klinikum Rechts Der Isar, Technical University of Munich, School of Medicine and Health, Ismaninger Str. 22, 81675, Munich, Germany.
Claus ZimmerDepartment of Neuroradiology, Klinikum Rechts Der Isar, Technical University of Munich, School of Medicine and Health, Ismaninger Str. 22, 81675, Munich, Germany.
Igor YakushevDepartment of Nuclear Medicine, Klinikum Rechts Der Isar, Technical University of Munich, School of Medicine and Health, Munich, Germany.
Ivayla ApostolovaDepartment of Diagnostic and Interventional Radiology and Nuclear Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Cansu ÖzdenDepartment of Diagnostic and Interventional Radiology and Nuclear Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Roland OpferJung Diagnostics GmbH, Hamburg, Germany.
Ralph BuchertDepartment of Diagnostic and Interventional Radiology and Nuclear Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeSingle-subject voxel-based morphometry (VBM) compares an individual T1-weighted MRI to a sample of normal MRI in a normative database (NDB) to detect regional atrophy. Outliers in the NDB might result in reduced sensitivity of VBM. The primary aim of the current study was to propose a method for outlier removal ("NDB cleaning") and to test its impact on the performance of VBM for detection of Alzheimer's disease (AD) and frontotemporal lobar degeneration (FTLD).

methodsT1-weighted MRI of 81 patients with biomarker-confirmed AD (n = 51) or FTLD (n = 30) and 37 healthy subjects with simultaneous FDG-PET/MRI were included as test dataset. Two different NDBs were used: a scanner-specific NDB (37 healthy controls from the test dataset) and a non-scanner-specific NDB comprising 164 normal T1-weighted MRI from 164 different MRI scanners. Three different quality metrics based on leave-one-out testing of the scans in the NDB were implemented. A scan was removed if it was an outlier with respect to one or more quality metrics. VBM maps generated with and without NDB cleaning were assessed visually for the presence of AD or FTLD.

resultsSpecificity of visual interpretation of the VBM maps for detection of AD or FTLD was 100% in all settings. Sensitivity was increased by NDB cleaning with both NDBs. The effect was statistically significant for the multiple-scanner NDB (from 0.47 [95%-CI 0.36-0.58] to 0.61 [0.49-0.71]).

conclusionNDB cleaning has the potential to improve the sensitivity of VBM for the detection of AD or FTLD without increasing the risk of false positive findings.

Indexed as

Alzheimer DiseaseFrontotemporal Lobar DegenerationAtrophyBrainHumansMagnetic Resonance ImagingPositron-Emission TomographyBrainMagnetic resonance imagingNeurodegenerationNormative databaseVoxel-based-morphometry

Identifiers

PMID38378906
PMCPMC10937771

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.