Despite its generally low annual global incidence rate, Creutzfeldt-Jakob disease (CJD) has become a subject of considerable interest in recent years. This is due to concerns that there may be a possible causitive link with Bovine Spongiform Encephalopathy and that this may forewarn of a future epidemic of CJD in Humans. Despite recent discoveries of CJD related abnormalites in lymph-node tissues, in-vivo diagnosis of CJD is difficult and relies on a series of clinical tests and observations to provide a probabilistic diagnosis of the disease. The confirmed diagnosis is currently only obtainable via biopsy or post-mortem histology. Medical imaging, specifically Magnetic Resonance Imaging (MRI), may offer a potential in-vivo diagnostic aid due to the reported presence of observable abnormalities in the MRI of CJD patients. To date research in this field has been hampered by a general lack of clinical data and the published work has been forced to consider exclusively the results of in-vivo MRI measurements. The National Creutzfeldt-Jakob disease Surveillance Unit in Edinburgh, U.K. has compiled a large and unique MRI dataset of post-mortem images of the Human brain from all deceased patients whose clinical presentation suggested CJD. Post-mortem confirmation of diagnosis is also held. This thesis describes the findings of an investigation to evaluate the potential of this post-mortem MRI dataset to provide diagnostically useful information in the task of assessing the CJD status of a patient. It uses image intensity analysis based tests to provide results whose performance may be compared to the accepted radiological methods of visual inspection of hard-copy data. By plotting distributions of statistical intensity metrics for specific regions of interest, known to have shown abnormalities in in-vivo MRI cases, the relationship between the MR image intensity for these regions and the ultimate patient diagnosis was determined. Additional work investigating methods for determining shape and intensity symmetry, which can help differentiate between disorders, is also described. Through the analysis of specific brain regions, it is shown that the MRI tests described display sensitivity to the condition of CJD. Future work is needed to investigate whether equivalent results can be produced by similar tests on in-vivo MRI data, when this becomes available. This could potentially offer a useful non-invasive pre-mortem test for CJD that would aid the task of clinical patient assessment.
| Identifer | oai:union.ndltd.org:bl.uk/oai:ethos.bl.uk:652093 |
| Date | January 2002 |
| Creators | Harding, Mark R. |
| Publisher | University of Edinburgh |
| Source Sets | Ethos UK |
| Detected Language | English |
| Type | Electronic Thesis or Dissertation |
| Source | http://hdl.handle.net/1842/10934 |
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