FLAIR histogram segmentation for measurement of leukoaraiosis volume

Clifford R. Jack, Peter C. O'Brien, Daniel W. Rettman, Maria M. Shiung, Yuecheng Xu, Raja Muthupillai, Armando Manduca, Ramesh Avula, Bradley J. Erickson

Research output: Contribution to journalArticlepeer-review

135 Scopus citations


The purposes of this study were to develop a method to measure brain and white matter hyperintensity (leukoaraiosis) volume that is based on the segmentation of the intensity histogram of fluid-attenuated inversion recovery (FLAIR) images and to assess the accuracy and reproducibility of the method. Whole-head synthetic image phantoms with manually introduced leukoaraiosis lesions of varying severity were constructed. These synthetic image phantom sets incorporated image contrast and anatomic features that mimicked leukoaraiosis found in real life. One set of synthetic image phantoms was used to develop the segmentation algorithm (FLAIR-histoseg). A second set was used to measure its accuracy. Test retest reproducibility was assessed in 10 elderly volunteers who were imaged twice. The mean absolute error of the FLAIR-histoseg method was 6.6% for measurement of leukoaraiosis volume and 1.4% for brain volume. The mean test retest coefficient of variation was 1.4% for leukoaraiosis volume and 0.3% for brain volume. We conclude that the FLAIR-histoseg method is an accurate and reproducible method for measuring leukoaraiosis and whole-brain volume in elderly subjects.

Original languageEnglish (US)
Pages (from-to)668-676
Number of pages9
JournalJournal of Magnetic Resonance Imaging
Issue number6
StatePublished - 2001


  • Dementia
  • Pulse sequences
  • Quantitative MRI
  • Segmentation
  • White matter disease

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging


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