qDESH: a method to quantify disproportionately enlarged subarachnoid space hydrocephalus
Abstract Background and purpose Disproportionately enlarged subarachnoid space hydrocephalus (DESH) is a radiological biomarker for idiopathic normal pressure hydrocephalus (iNPH). DESH is a subjective measure, based on visual assessments, which may limit its reliability. The aim of this study was t...
Saved in:
| Main Authors: | , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2025-07-01
|
| Series: | Fluids and Barriers of the CNS |
| Online Access: | https://doi.org/10.1186/s12987-025-00677-2 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1849238429012852736 |
|---|---|
| author | Sofia Behndig Afroditi Lalou Jan Axelsson Jenny Larsson Anders Wåhlin Pavel Ryska Ondrej Slezak Katrine Riklund Jan Zizka Jan Malm Anders Eklund |
| author_facet | Sofia Behndig Afroditi Lalou Jan Axelsson Jenny Larsson Anders Wåhlin Pavel Ryska Ondrej Slezak Katrine Riklund Jan Zizka Jan Malm Anders Eklund |
| author_sort | Sofia Behndig |
| collection | DOAJ |
| description | Abstract Background and purpose Disproportionately enlarged subarachnoid space hydrocephalus (DESH) is a radiological biomarker for idiopathic normal pressure hydrocephalus (iNPH). DESH is a subjective measure, based on visual assessments, which may limit its reliability. The aim of this study was to develop and validate a method for the objective quantification of DESH. Materials and methods By using a semiautomatic quantitative method, we calculated quantitative DESH (qDESH), defined as a ratio between CSF volumes at high convexities and Sylvian fissures. The analysis was based on three-dimensional T1-weighted images from 35 subjects with iNPH (mean age 74 yrs; 10 females) and 45 controls (mean age 72 yrs; 13 females). The interrater agreement for qDESH was evaluated by the intraclass correlation coefficient, and qDESH was compared with visual assessments performed by two neuroradiologists. Results All subjects with iNPH and 13% of the controls visually scored DESH positive. The median qDESH was 2.48 (5th to 95th percentile 0.88 to 5.42) for iNPH and 0.63 (5th to 95th percentile 0.37 to 1.73) for the controls. The area under the receiver operating characteristic curve for qDESH was 0.95 (95% confidence interval 0.90–1) in separating iNPH patients from controls. The interrater agreement for qDESH was 0.99 (95% CI 0.986–0.994, p < 0.001). Conclusion Unlike visual DESH, qDESH generates a continuous variable, enabling reproducible quantification of DESH severity. With this method we can objectively investigate the diagnostic accuracy and prognostic assessment of DESH in iNPH. |
| format | Article |
| id | doaj-art-f4f0eebb225e4facb724305e178f1635 |
| institution | Kabale University |
| issn | 2045-8118 |
| language | English |
| publishDate | 2025-07-01 |
| publisher | BMC |
| record_format | Article |
| series | Fluids and Barriers of the CNS |
| spelling | doaj-art-f4f0eebb225e4facb724305e178f16352025-08-20T04:01:36ZengBMCFluids and Barriers of the CNS2045-81182025-07-0122111110.1186/s12987-025-00677-2qDESH: a method to quantify disproportionately enlarged subarachnoid space hydrocephalusSofia Behndig0Afroditi Lalou1Jan Axelsson2Jenny Larsson3Anders Wåhlin4Pavel Ryska5Ondrej Slezak6Katrine Riklund7Jan Zizka8Jan Malm9Anders Eklund10Department of Diagnostics and Intervention, Biomedical Engineering and Radiation Physics, Umeå UniversityDepartment of Diagnostics and Intervention, Biomedical Engineering and Radiation Physics, Umeå UniversityDepartment of Diagnostics and Intervention, Biomedical Engineering and Radiation Physics, Umeå UniversityDepartment of Clinical Sciences, Neurosciences, Umeå UniversityDepartment of Diagnostics and Intervention, Biomedical Engineering and Radiation Physics, Umeå UniversityDepartment of Diagnostic Radiology, University Hospital Hradec KraloveDepartment of Diagnostic Radiology, University Hospital Hradec KraloveUmeå Center for Functional Brain Imaging (UFBI), Umeå UniversityDepartment of Diagnostics and Intervention, Diagnostic Radiology, Umeå UniversityDepartment of Clinical Sciences, Neurosciences, Umeå UniversityDepartment of Diagnostics and Intervention, Biomedical Engineering and Radiation Physics, Umeå UniversityAbstract Background and purpose Disproportionately enlarged subarachnoid space hydrocephalus (DESH) is a radiological biomarker for idiopathic normal pressure hydrocephalus (iNPH). DESH is a subjective measure, based on visual assessments, which may limit its reliability. The aim of this study was to develop and validate a method for the objective quantification of DESH. Materials and methods By using a semiautomatic quantitative method, we calculated quantitative DESH (qDESH), defined as a ratio between CSF volumes at high convexities and Sylvian fissures. The analysis was based on three-dimensional T1-weighted images from 35 subjects with iNPH (mean age 74 yrs; 10 females) and 45 controls (mean age 72 yrs; 13 females). The interrater agreement for qDESH was evaluated by the intraclass correlation coefficient, and qDESH was compared with visual assessments performed by two neuroradiologists. Results All subjects with iNPH and 13% of the controls visually scored DESH positive. The median qDESH was 2.48 (5th to 95th percentile 0.88 to 5.42) for iNPH and 0.63 (5th to 95th percentile 0.37 to 1.73) for the controls. The area under the receiver operating characteristic curve for qDESH was 0.95 (95% confidence interval 0.90–1) in separating iNPH patients from controls. The interrater agreement for qDESH was 0.99 (95% CI 0.986–0.994, p < 0.001). Conclusion Unlike visual DESH, qDESH generates a continuous variable, enabling reproducible quantification of DESH severity. With this method we can objectively investigate the diagnostic accuracy and prognostic assessment of DESH in iNPH.https://doi.org/10.1186/s12987-025-00677-2 |
| spellingShingle | Sofia Behndig Afroditi Lalou Jan Axelsson Jenny Larsson Anders Wåhlin Pavel Ryska Ondrej Slezak Katrine Riklund Jan Zizka Jan Malm Anders Eklund qDESH: a method to quantify disproportionately enlarged subarachnoid space hydrocephalus Fluids and Barriers of the CNS |
| title | qDESH: a method to quantify disproportionately enlarged subarachnoid space hydrocephalus |
| title_full | qDESH: a method to quantify disproportionately enlarged subarachnoid space hydrocephalus |
| title_fullStr | qDESH: a method to quantify disproportionately enlarged subarachnoid space hydrocephalus |
| title_full_unstemmed | qDESH: a method to quantify disproportionately enlarged subarachnoid space hydrocephalus |
| title_short | qDESH: a method to quantify disproportionately enlarged subarachnoid space hydrocephalus |
| title_sort | qdesh a method to quantify disproportionately enlarged subarachnoid space hydrocephalus |
| url | https://doi.org/10.1186/s12987-025-00677-2 |
| work_keys_str_mv | AT sofiabehndig qdeshamethodtoquantifydisproportionatelyenlargedsubarachnoidspacehydrocephalus AT afroditilalou qdeshamethodtoquantifydisproportionatelyenlargedsubarachnoidspacehydrocephalus AT janaxelsson qdeshamethodtoquantifydisproportionatelyenlargedsubarachnoidspacehydrocephalus AT jennylarsson qdeshamethodtoquantifydisproportionatelyenlargedsubarachnoidspacehydrocephalus AT anderswahlin qdeshamethodtoquantifydisproportionatelyenlargedsubarachnoidspacehydrocephalus AT pavelryska qdeshamethodtoquantifydisproportionatelyenlargedsubarachnoidspacehydrocephalus AT ondrejslezak qdeshamethodtoquantifydisproportionatelyenlargedsubarachnoidspacehydrocephalus AT katrineriklund qdeshamethodtoquantifydisproportionatelyenlargedsubarachnoidspacehydrocephalus AT janzizka qdeshamethodtoquantifydisproportionatelyenlargedsubarachnoidspacehydrocephalus AT janmalm qdeshamethodtoquantifydisproportionatelyenlargedsubarachnoidspacehydrocephalus AT anderseklund qdeshamethodtoquantifydisproportionatelyenlargedsubarachnoidspacehydrocephalus |