• Korhan Buyukturkoglu, Enricomaria Mormina, Philip L De Jager, Claire S Riley, and Victoria M Leavitt.
• Translational Cognitive Neuroscience Laboratory, Department of Neurology, Columbia University Irving Medical Center, New York, NY.
• J Neuroimaging. 2019 Jul 1; 29 (4): 458-462.

Background And PurposeDeep gray matter (DGM) atrophy has been shown at early stages of multiple sclerosis (MS) and reported as an informative marker of cognitive dysfunction and clinical progression. Therefore, accurate measurement of DGM structure volume is a key priority in MS research. Findings from prior studies have shown that hypointense T1 lesions may impact the accuracy of global brain volume measures; however, literature on the effects of hypointense T1 lesions on DGM structure volumes is sparse.MethodsWe explored the effects of hypointense T1 lesions on data from 54 relapsing remitting MS patients. Lesions were segmented both manually and with a freely available automatic lesion segmentation/in-painting algorithm (Lesion Segmentation Tool-LST). Volumes of 14 DGM structures were calculated from non-in-painted and in-painted images and compared via paired t-tests, intraclass correlation coefficient, and Dice similarity coefficient.ResultsThere were no significant differences in DGM structural volumes between non-in-painted and in-painted images. Automatic lesion-segmentation/in-painting tool provided similar results to manual segmentation/in-painting.ConclusionsOur results suggest that lesion in-painting has a negligible impact on DGM structure volume measurement although some regions are more vulnerable to the impact of lesions than others. Furthermore, manual lesion segmentation/in-painting can be replaced by an automatic segmentation/in-painting process.© 2019 by the American Society of Neuroimaging.

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