Radiological Reporting of Brain Atrophy in MRI: Real-Life Comparison Between Narrative Reports, Semiquantitative Scales and Automated Software-Based Volumetry

<b>Background</b>: Accurate assessment of brain atrophy is essential in the diagnosis and monitoring of brain aging and neurodegenerative disorders. Radiological methods range from narrative reporting to semi-quantitative visual rating scales (VRSs) and fully automated volumetric softwar...

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Main Authors: Federico Bruno, Cristina Fagotti, Gaspare Saltarelli, Giovanni Di Cerbo, Alessandra Sabatelli, Claudia De Felici, Antonio Innocenzi, Ernesto Di Cesare, Alessandra Splendiani
Format: Article
Language:English
Published: MDPI AG 2025-05-01
Series:Diagnostics
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Online Access:https://www.mdpi.com/2075-4418/15/10/1246
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author Federico Bruno
Cristina Fagotti
Gaspare Saltarelli
Giovanni Di Cerbo
Alessandra Sabatelli
Claudia De Felici
Antonio Innocenzi
Ernesto Di Cesare
Alessandra Splendiani
author_facet Federico Bruno
Cristina Fagotti
Gaspare Saltarelli
Giovanni Di Cerbo
Alessandra Sabatelli
Claudia De Felici
Antonio Innocenzi
Ernesto Di Cesare
Alessandra Splendiani
author_sort Federico Bruno
collection DOAJ
description <b>Background</b>: Accurate assessment of brain atrophy is essential in the diagnosis and monitoring of brain aging and neurodegenerative disorders. Radiological methods range from narrative reporting to semi-quantitative visual rating scales (VRSs) and fully automated volumetric software. However, their integration and consistency in clinical practice remain limited. <b>Methods</b>: In this retrospective study, brain MRI images of 43 patients were evaluated. Brain atrophy was assessed by extrapolating findings from narrative radiology reports, three validated VRSs (MTA, Koedam, Pasquier), and Pixyl.Neuro.BV, a commercially available volumetric software platform. Agreement between methods was assessed using intraclass correlation coefficients (ICCs), Cohen’s kappa, Spearman’s correlation, and McNemar tests. <b>Results</b>: Moderate correlation was found between narrative reports and VRSs (ρ = 0.55–0.69), but categorical agreement was limited (kappa = 0.21–0.30). Visual scales underestimated atrophy relative to software (mean scores: VRSs = 0.196; software = 0.279), while reports tended to overestimate. Agreement between VRSs and software was poor (kappa = 0.14–0.33), though MTA showed a significant correlation with hippocampal volume. Agreement between reports and software was lowest for global atrophy. <b>Conclusions</b>: Narrative reports, while common in practice, show low consistency with structured scales and quantitative software, especially in subtle cases. VRSs improve standardization but remain subjective and less sensitive. Integrating structured scales and volumetric tools into clinical workflows may enhance diagnostic accuracy and consistency in dementia imaging.
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spelling doaj-art-afe65ed170834e2085c7ba7256c901662025-08-20T01:56:16ZengMDPI AGDiagnostics2075-44182025-05-011510124610.3390/diagnostics15101246Radiological Reporting of Brain Atrophy in MRI: Real-Life Comparison Between Narrative Reports, Semiquantitative Scales and Automated Software-Based VolumetryFederico Bruno0Cristina Fagotti1Gaspare Saltarelli2Giovanni Di Cerbo3Alessandra Sabatelli4Claudia De Felici5Antonio Innocenzi6Ernesto Di Cesare7Alessandra Splendiani8Department of Biotechnological and Applied Clinical Sciences, University of L’Aquila, 67100 L’Aquila, ItalyDepartment of Biotechnological and Applied Clinical Sciences, University of L’Aquila, 67100 L’Aquila, ItalyDepartment of Biotechnological and Applied Clinical Sciences, University of L’Aquila, 67100 L’Aquila, ItalyDepartment of Biotechnological and Applied Clinical Sciences, University of L’Aquila, 67100 L’Aquila, ItalyDepartment of Biotechnological and Applied Clinical Sciences, University of L’Aquila, 67100 L’Aquila, ItalyDepartment of Biotechnological and Applied Clinical Sciences, University of L’Aquila, 67100 L’Aquila, ItalyDepartment of Biotechnological and Applied Clinical Sciences, University of L’Aquila, 67100 L’Aquila, ItalyDepartment of Biotechnological and Applied Clinical Sciences, University of L’Aquila, 67100 L’Aquila, ItalyDepartment of Biotechnological and Applied Clinical Sciences, University of L’Aquila, 67100 L’Aquila, Italy<b>Background</b>: Accurate assessment of brain atrophy is essential in the diagnosis and monitoring of brain aging and neurodegenerative disorders. Radiological methods range from narrative reporting to semi-quantitative visual rating scales (VRSs) and fully automated volumetric software. However, their integration and consistency in clinical practice remain limited. <b>Methods</b>: In this retrospective study, brain MRI images of 43 patients were evaluated. Brain atrophy was assessed by extrapolating findings from narrative radiology reports, three validated VRSs (MTA, Koedam, Pasquier), and Pixyl.Neuro.BV, a commercially available volumetric software platform. Agreement between methods was assessed using intraclass correlation coefficients (ICCs), Cohen’s kappa, Spearman’s correlation, and McNemar tests. <b>Results</b>: Moderate correlation was found between narrative reports and VRSs (ρ = 0.55–0.69), but categorical agreement was limited (kappa = 0.21–0.30). Visual scales underestimated atrophy relative to software (mean scores: VRSs = 0.196; software = 0.279), while reports tended to overestimate. Agreement between VRSs and software was poor (kappa = 0.14–0.33), though MTA showed a significant correlation with hippocampal volume. Agreement between reports and software was lowest for global atrophy. <b>Conclusions</b>: Narrative reports, while common in practice, show low consistency with structured scales and quantitative software, especially in subtle cases. VRSs improve standardization but remain subjective and less sensitive. Integrating structured scales and volumetric tools into clinical workflows may enhance diagnostic accuracy and consistency in dementia imaging.https://www.mdpi.com/2075-4418/15/10/1246MRIdementiabrain atrophybrain volumetryautomated software
spellingShingle Federico Bruno
Cristina Fagotti
Gaspare Saltarelli
Giovanni Di Cerbo
Alessandra Sabatelli
Claudia De Felici
Antonio Innocenzi
Ernesto Di Cesare
Alessandra Splendiani
Radiological Reporting of Brain Atrophy in MRI: Real-Life Comparison Between Narrative Reports, Semiquantitative Scales and Automated Software-Based Volumetry
Diagnostics
MRI
dementia
brain atrophy
brain volumetry
automated software
title Radiological Reporting of Brain Atrophy in MRI: Real-Life Comparison Between Narrative Reports, Semiquantitative Scales and Automated Software-Based Volumetry
title_full Radiological Reporting of Brain Atrophy in MRI: Real-Life Comparison Between Narrative Reports, Semiquantitative Scales and Automated Software-Based Volumetry
title_fullStr Radiological Reporting of Brain Atrophy in MRI: Real-Life Comparison Between Narrative Reports, Semiquantitative Scales and Automated Software-Based Volumetry
title_full_unstemmed Radiological Reporting of Brain Atrophy in MRI: Real-Life Comparison Between Narrative Reports, Semiquantitative Scales and Automated Software-Based Volumetry
title_short Radiological Reporting of Brain Atrophy in MRI: Real-Life Comparison Between Narrative Reports, Semiquantitative Scales and Automated Software-Based Volumetry
title_sort radiological reporting of brain atrophy in mri real life comparison between narrative reports semiquantitative scales and automated software based volumetry
topic MRI
dementia
brain atrophy
brain volumetry
automated software
url https://www.mdpi.com/2075-4418/15/10/1246
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