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Accurate measurement of traumatic intracranial hematoma volume is important for assessing disease progression and prognosis, as well as for serving as an important end-point in clinical trials aimed at preventing hematoma expansion. While the ABC/2 formula has traditionally been used for volume estimation in spontaneous intracerebral hemorrhage, its adaptation to traumatic hematomas lacks validation. This study aimed to compare the accuracy of ABC/2 with computer-assisted volumetric analysis (CAVA) in estimating the volumes of traumatic intracranial hematomas. We performed a dual-center observational study that included adult patients with moderate-to-severe traumatic brain injury. Volumes of intracerebral, subdural (SDHs), and epidural hematomas from admission computed tomography scans were measured using ABC/2 and CAVA, and compared using the Wilcoxon signed-rank test, Spearman's rank correlation, Lin's concordance correlation coefficient (CCC), and Bland-Altman plots. Prognostic significance for outcomes was evaluated through logistic and linear regression models. In total, 1,179 patients with 1,543 hematomas were included. Despite a high correlation (Spearman coefficients between 0.95 and 0.98) and excellent concordance (Lin's CCC from 0.89 to 0.96) between ABC/2 and CAVA, ABC/2 overestimated hematoma volumes compared with CAVA, in some instances exceeding 50 ml. Bland-Altman analysis highlighted wide limits of agreement, especially in SDH. While both methods demonstrated comparable accuracy in predicting outcomes, CAVA was slightly better at predicting craniotomies and midline shift. We conclude that while ABC/2 provides a generally reliable volumetric assessment suitable for descriptive purposes and as baseline variables in studies, CAVA should be the gold standard in clinical situations and studies requiring more precise volume estimations, such as those using hematoma expansion as an outcome.

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BACKGROUND/OBJECTIVES: Intracranial hemorrhage (ICH) volume assessment is an important part of patient management and is routinely obtained by non-contrast head CT (NCHCT) using the validated ABC/2 measurement method. Because conventional MRI imaging sequences demonstrate variability in ICH appearance, volumetric analyses for MRI bleed volume in a standardized manner using ABC/2 is not possible. The recently introduced multiecho-complex total field inversion quantitative susceptibility mapping (mcTFI QSM) MRI technique, which maps brain tissue susceptibility to both depict brain tissue structures and quantify tissue susceptibility, may provide a viable alternative. In this study we evaluated mcTFI QSM ABC/2 ICH volume assessment relative to NCHCT. METHODS: Patients with ICH who had undergone NCHCT and MRI brain scans within 48 h were recruited for this retrospective study. The ABC/2 method was applied to estimate the bleed volume for both NCHCT and MRI by a CAQ-certified neuroradiologist with 10 years of experience and a trained laboratory assistant. Results were analyzed via Bland-Altman (B-A) and linear regression. RESULTS: 54 patients (27 females) who had undergone NCHCT and MRI within 48 h (<24 h., n = 31, 24-48 h, n = 10) were enrolled. mcTFI QSM ICH volume measurement method showed a positive correlation (99.5%) compared to NCHCT. B-A plot comparing ABC/2 ICH volume on NCHCT and mcTFI MRI done for patients within 24 h demonstrates a bias of -0.09%. CONCLUSIONS: ICH volume calculation using ABC/2 on mcTFI QSM showed a high correlation with NCHCT measurement. These results suggest mcTFI QSM is a promising MRI method for ABC/2 for bleed volume measurement.

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This study described intra-task fine motor skill components of the Manual Dexterity tasks (Posting Coins; PC, Threading Beads; TB, Drawing Trail; DT) of the Movement Assessment Battery for Children-2 Test for typically developing children and investigated age- and sex-related differences. Three- to six-year-old Dutch children (n = 182, Mage 4.5 ± 1.1 years, 51.1% boys) were observed with regard to intra-task fine motor skill components, and changes in intra-task components of the Manual Dexterity tasks were analyzed across age using of the Kruskal-Wallis test with post-hoc Mann-Whitney U tests, and differences between sexes using the Mann-Whitney U test. The following intra-task components were observed: grip type, manipulation, non-dominant or non-writing hand, grip position, posture, head, coin placement, placement of the bead on the lace tip and joint movement. Results showed that the younger children (3-year-olds) more frequently used a grasp with the full hand (PC, TB), more often put the coin on the container and sliding it in (PC), more often supported the side or top of the container (PC), used more bi-manual manipulation (transferring from hand-to-hand or hand, body or surface assist) (TB, DT), more frequently used primitive, too high grips, predominantly used their proximal joints, and did not support the paper (DT). This in comparison with more frequent use of three-point pinch, direct coin placement, grabbing the front or back of the container, in-hand-manipulation, mature grips and correct height, distal joint use and supporting the paper from the side or below by most 5- and 6-year-olds. Furthermore, most sex-related differences were found in the younger age-groups (3- and 4-year-olds) in the DT tasks with girls outperforming boys. Results from this study add to the knowledge on qualitative fine motor skill performance in a convenience sample of 3- to 6-year-old typically developing children. A limitation of the current study was the relatively small sample size of 6-year-old children. The strength of the current study is its novelty in providing qualitative descriptions of intra-task fine motor skill components in typically developing 3- to 6-year-old children.

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The computation of hematoma volume is the key parameter for treatment planning of Intracerebral hemorrhage (ICH). Non-contrast computed tomography (NCCT) imaging is routinely used for the diagnosis of ICH. Hence, the development of computer-aided tools for three-dimensional (3D) computed tomography (CT) image analysis is essential to estimate the gross volume of hematoma. We propose a methodology for automatic estimation of the hematoma volume from 3D CT volumes. Our approach integrates two different methods, multiple abstract splitting (MAS) and seeded region growing (SRG) to develop a unified hematoma detection pipeline from pre-processed CT volumes. The proposed methodology was tested on 80 cases. The volume was estimated from the delineated hematoma region, validated against the ground-truth volumes, and compared with those obtained from the conventional ABC/2 approach. We also compared our results with the U-Net model (supervised technique) to show the applicability of the proposed method. The volume calculated from manually segmented hematoma was considered the ground truth. TheR2correlation coefficient between the volume obtained from the proposed algorithm and the ground truth is 0.86, which is equivalent to theR2value resulting from the comparison between the volume calculated by ABC/2 and the ground truth. The experimental results of the proposed unsupervised approach are comparable to the deep neural architecture (U-Net models). The average computation time was 132.76 ± 14 seconds. The proposed methodology provides a fast and automatic estimation of hematoma volume, which is similar to the baseline user-guided ABC/2 approach. Implementation of our method does not demand a high-end computational setup. Thus, recommended in clinical practice for computer-assistive volume estimation of hematoma from 3D CT volumes and can be implemented in a simple computer system.

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BACKGROUND: There is little consensus on how lesion size impacts long-term cognitive outcome after pediatric arterial ischemic stroke (AIS). This study, therefore, compared two techniques to assessed lesion size in the chronic phase after AIS and determined their measurement agreement in relation to cognitive functions in patients after pediatric stroke. METHODS: Twenty-five patients after pediatric AIS were examined in the chronic phase (>2 years after stroke) in respect to intelligence, memory, executive functions, visuo-motor functions, motor abilities, and disease-specific outcome. Lesion size was measured using the ABC/2 formula and segmentation technique (3D Slicer). Correlation analysis determined the association between volumetry techniques and outcome measures in respect to long-term cognitive outcome. RESULTS: The measurements from the ABC/2 and segmentation technique were strongly correlated (r = 0.878, p < .001) and displayed agreement in particular for small lesions. Lesion size from both techniques was significantly correlated with disease-specific outcome (p < .001) and processing speed (p < .005) after controlling for age at stroke and multiple comparison. CONCLUSION: The two techniques showed convergent validity and were both significantly correlated with long-term outcome after pediatric AIS. Compared to the time-consuming segmentation technique, ABC/2 facilitates clinical and research work as it requires relatively little time and is easy to apply.

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BACKGROUND: Target mismatch (ischemic core, mismatch volume and mismatch ratio) in patients with acute ischemic stroke (AIS) highly relies on the automated perfusion analysis software. PURPOSE: To evaluate the feasibility and accuracy of using the ABC/2 method to rapidly estimate the target mismatch on computed tomography perfusion (CTP) imaging in patients with AIS, using RAPID results as a reference. MATERIAL AND METHODS: In total, 243 patients with anterior circulation AIS who underwent CTP imaging were retrospectively reviewed. Target mismatch associated perfusion parameters were derived from RAPID results and calculated using the ABC/2 method. Paired t-test was used to assess the difference of volumetric parameters between the two methods. The ability of using the ABC/2 method to predict the important cutoff volumetric metrics was also evaluated. RESULT: There was no significant difference in the volumes of ischemic core (P = 0.068), ischemic area (P = 0.209), and mismatch volume (P = 0.518) between ABC/2 and RAPID. Using RAPID results as reference, the ABC/2 method showed high accuracy for predicting perfusion parameters (70 mL and 90 mL: sensitivity=98.5% and 98.5%, specificity=100% and 100%, positive predictive value [PPV]=100% and 100%, negative predictive value [NPV]=93.8% and 92.9%; 10 mL and 15mL: sensitivity=99.6% and 99.5%, specificity=55.6% and 50.0%, PPV=96.6% and 94.8%, NPV=90.9% and 92.3%; 1.2 and 1.8: sensitivity=99.6% and 94.8%, specificity=75.0% and 96.9%, PPV=98.7% and 99.5%, NPV=90.0% and 73.8%). CONCLUSION: The ABC/2 method may be a feasible alternative to RAPID for estimation of target mismatch parameters on CTP in patients with AIS.

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Objective:To investigate the efficacy and safety of precise mechanical thrombectomy based on ABC 2D scale in acute intracranial large artery occlusion stroke (ALVOs). Methods:A prospective study was performed. Two hundred and two patients with ALVOs accepted early mechanical thrombectomy in Department of Neurology, Maoming Clinical School of Guangdong Medical University from January 2021 to February 2022 were enrolled. They were randomly divided into experimental group ( n=102) and control group ( n=100). Stent retriever partially retracted with intermediate catheter for mechanical thrombectomy (SWIM) was the first choice for patients in control group. ABC 2D scale was used to prejudge the pathogenesis of patients in experimental group: patients with scores of 0-3 were considered as having embolic occlusion and a direct aspiration first pass technique (ADAPT) was the first choice, and SWIM would be chosen if suction catheter could not be in place; patients with scores of 4-7 were considered as having intracranial atherosclerotic stenosis occlusion and SWIM was the first choice. The clinical data, surgical effectiveness, surgical safety, and good prognosis rate 90 d after mechanical thrombectomy (modified Rankin scale scores of 0-2 as good prognosis) of the 2 groups were compared. Results:Experimental group had significantly shorter time from puncture to recanalization (51.0[35.0, 78.5] min vs. 67.0[45.0, 100.0] min), and statistically lower NIHSS scores 24 h after mechanical thrombectomy (10.00[4.75, 16.25] vs. 13.00[8.00, 19.00]), significantly higher good prognosis rate 90 d after mechanical thrombectomy (69.6% vs. 46.0%), statistically lower mortality 90 d after mechanical thrombectomy (3.9% vs. 13.0%) compared with control group ( P<0.05). No significant differences were noted in first-pass effect rate, successful vascular revascularization rate, or incidences of symptomatic intracranial hemorrhage (sICH) and ectopic embolization between the control group and experimental group ( P>0.05). Conclusion:Patients with ALVOs accepted early mechanical thrombectomy can have shorter time from puncture to vascular recanalization and better prognosis after etiologically prejudging by ABC 2D scale for thrombectomy.

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BACKGROUND: Postoperative pneumocephalus is associated with a higher risk of recurrence of chronic subdural hematoma (cSDH). However, there is no verified simple way to measure the pneumocephalus volume at the bedside for daily clinical use. The ABC/2 method was shown to be a simple and reliable technique to estimate volumes of intracranial lesions, such as intracranial hematomas. This study aims to evaluate the accuracy of the ABC/2 formula in estimating volumes of pneumocephalus, as compared to the gold standard with computer-assisted volumetric analysis. METHODS: A total of 141 postoperative computed tomographic (CT) brain scans of cSDH patients with burr-hole drainage were analysed. Pneumocephalus volume was measured independently by both the ABC/2 formula and the computer-assisted volumetric measurement. For the computer-assisted measurement, the volume of the air was semiautomatically segmented and calculated by computer software. Linear regression was used to determine the correlation between the ABC/2 method and computer-assisted measurement. RESULTS: The postoperative pneumocephalus volume after bilateral burr-hole drainage was significantly larger than that of unilateral burr-hole drainage (29.34 ml versus 12.21 ml, p < 0.001). The estimated volumes by the formula ABC/2 significantly correlated to the volumes as measured by the computer-assisted volumetric technique, with r = 0.992 (p < 0.001). The Pearson correlation coefficient is very close to 1, which signifies a very strong positive correlation, and it is statistically significant. CONCLUSIONS: An excellent correlation is observed between the ABC/2 method and the computer-assisted measurement. This study verified that the ABC/2 method is an accurate and simple "bedside" technique to estimate pneumocephalus volume.

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Background: Very preterm birth may affect motor performance and social competence up to adulthood. Our objective was to describe perceived loneliness and social competence in children born very preterm in relation to motor impairment. Methods: 165 children born very preterm (birth weight ≤ 1500 g and/or gestational age < 32 weeks) were assessed at 11 years of age. Cerebral palsy (CP) was diagnosed by 2 years of age. At 11 years of age, motor outcome was assessed using the Movement Assessment Battery for Children­Second edition (Movement ABC-2). Loneliness was evaluated by using the Peer Network and Dyadic Loneliness scale and social competence by using the Multisource Assessment of Children's Social Competence Scale. Results: In total, 6 (4%) children had CP, 18 (11%) had Developmental Coordination Disorder (DCD) (Movement ABC-2 ≤ 5th percentiles), and 141 (85%) had typical motor development. There was no correlation between percentiles for total scores of the Movement ABC-2 and perceived loneliness or social competence when the children with motor impairment (CP or DCD) were excluded. Children with DCD reported less perceived loneliness, but more problems with social competence compared to children with CP. Conclusions: It is important to recognize children born very preterm with DCD to provide interventions and support services to prevent social exclusion.

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Sensorimotor disorders have been frequently reported in children and adults with dyslexia over the past 30 years. The present study aimed to determine the impact of sensorimotor comorbidity risks in dyslexia by investigating the functional links between phonological and sensorimotor representations in young dyslexic adults. Using 52 dyslexic participants and 58 normo-readers, we investigated whether the underlying phonological deficit, which is reported in the literature, was associated with a general impairment of sensorimotor representations of articulatory and bodily actions. Internal action representations were explored through motor imagery tasks, consisting of measuring and comparing the durations of performed or imagined actions chosen from their current repertoire of daily life activities. To detect sensorimotor deficits, all participants completed the extended version of the M-ABC 2, as a reference test. We found sensorimotor impairments in 27% of the young adult dyslexics, then considered as sensorimotor comorbid, as opposed to much less in the normo-reader group (5%). While motor slowdown, reflecting motor difficulty, was present in all dyslexic adults, motor imagery performance was impacted only in the specific dyslexic subgroup with sensorimotor impairments. Moreover, in contrast with slowness, only the comorbid subgroup showed an increased variability in execution durations. The present study highlights the importance of the quality of perception-action coupling, questions the relevance of investigating sensorimotor impairment profiles beyond phonological deficits and provides new arguments supporting the perspective of multiple deficits approaches in dyslexia.

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Candida krusei (C. krusei) has been recently recognized as an important pathogen involved in mycotic mastitis of cows. The phenotypic and molecular characteristics of 15 C. krusei clinical isolates collected from cows with clinical mastitis in three herds of Yinchuan, Ningxia, were identified by matrix-assisted laser desorption ionization-time of flight mass spectrometry. In addition to sequencing analysis, the ERG11 gene that encodes 14α-demethylases, the expression of the ERG11 gene, and efflux transporters ABC1 and ABC2 in itraconazole-susceptible (S), itraconazole-susceptible dose dependent (SDD), and itraconazole-resistant (R) C. krusei isolates was also quantified by a quantitative real-time reverse transcription polymerase chain reaction (qRT-PCR) assay. Sequencing analysis revealed three synonymous codon substitutions of the ERG11 gene including T939C, A756T, and T642C in these C. krusei clinical isolates. Among them, T642C and T939C mutations were detected in itraconazole-resistant and -susceptible C. krusei isolates, but the A756T substitution was found only in itraconazole-resistant isolates. Importantly, the expression of the ERG11 gene in itraconazole-resistant isolates was significantly higher compared with itraconazole-SDD and itraconazole-susceptible isolates (p = 0.052 and p = 0.012, respectively), as determined by the qRT-PCR assay. Interestingly, the expression of the ABC2 gene was also significantly higher in itraconazole-resistant isolates relative to the itraconazole-SDD and itraconazole-susceptible strains. Notably, the expression of ERG11 was positively associated with resistance to itraconazole (p = 0.4177 in SDD compared with S, p = 0.0107 in SDD with R, and p = 0.0035 in S with R, respectively). These data demonstrated that mutations of the ERG11 gene were involved in drug resistance in C. krusei. The A756T synonymous codon substitution of the ERG11 gene was correlated with an increased expression of drug-resistant genes including ERG11 and ABC2 in itraconazole-resistant C. krusei isolates examined in this study.

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While many studies have investigated links between motor and visual spatial cognitive abilities in typically developing children, only a few studies have tested this link among children with innate handicaps. Therefore, we assessed motor abilities (using the M-ABC-2) and visual spatial cognitive skills (using the Block Design subtest of the WPPSI-III and a picture mental rotation task, PRT) of 5-7 year old typically developing children (n= 17) and same-aged children with severe deficits in stereopsis due to infantile esotropia (n= 17). Compared to the typically developing children, children with esotropia showed significantly poorer motor performances, especially in manual dexterity and ball skills, and significantly poorer and slower performance on the visual spatial cognitive tasks. Especially the girls treated for infantile esotropia needed more time to mentally rotate the pictures of the PRT correctly. Overall, this study showed that perceptual, motor and cognitive processes are interconnected and that children treated for infantile esotropia had an increased risk of motor and visual spatial cognitive deficits.

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The Test component of the Movement Assessment Battery for Children 2nd Edition (Movement ABC-2) is used worldwide to identify children with Developmental Coordination Disorder (DCD). In China, practitioners have been using this test with the assumption that the published UK norms are valid for Chinese children. However no systematic investigation has previously been undertaken to check this assumption. 2185 children aged 3-10 years old from a national representative sample in China were therefore recruited to the current study. Performance on the Movement ABC-2 was assessed and compared with the UK standardization norms. Gender differences were also examined. The comparisons revealed that Chinese children were generally better in Manual Dexterity and Balance tasks compared to their UK peers; while UK children were better in Aiming & Catching tasks. Further analysis showed an interaction of country and age with mixed results. For both countries, girls were generally better in Manual Dexterity and Balance tasks, and boys were generally better in Aiming & Catching. Possible explanations for the country differences are discussed. The results suggest that local norms for the Movement ABC-2 Test are needed in China.

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BACKGROUND: The Movement Assessment Battery for Children-Second Edition (Movement ABC-2) is widely used to assess children's motor function, yet there is a lack of normative data for many countries. AIMS: To assess the extent to which the application of different population reference norms for the Movement ABC-2 affects the classification and prevalence of motor impairment. DESIGN: Data were obtained from two Portuguese regions participating in the Screening to Improve Health in Very Preterm Infants in Europe (SHIPS) Study, which was a five year follow-up of a cohort of children born at <32 weeks' gestation in 2011-2012 in 19 regions in 11 European countries. Perinatal data were extracted from medical records and the Movement ABC-2 was administered at five years of age. SUBJECTS: Of 542 Portuguese children eligible for the five-year follow-up, 413 (76.2%) were evaluated. OUTCOME MEASURES: Movement ABC-2 raw scores were converted to standardized scores using norms from four countries with national standardisations (UK, Netherlands/Belgium, France and Italy). RESULTS: The prevalence of significant movement difficulties (total score ≤ 5th percentile) was 28.5% using Dutch/Flemish norms, 23.3% using French norms, 16.5% using UK norms and 11.4% using Italian norms; 10.8% and 68.3% of the children were consistently classified as having significant movement difficulties and as not having significant movement difficulties, respectively, according to any norms. However, for 20.9% of children there was a disagreement in motor function status using different norms. CONCLUSION: The use of different test norms has a large impact on the proportion of children classified with significant movement difficulties, with implications for clinical referrals, healthcare costs and research. Our results underscore the importance of using appropriately validated tests with sound psychometric properties, and raise questions about the large differences in norms for the Movement ABC-2 in European countries.

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Five Candida krusei isolates (susceptible and resistant) recovered from the urine of a kidney transplant patient treated with voriconazole (VRC) 200 mg twice daily for 20 days were studied. Eight unrelated clinical isolates of C. krusei were exposed in vitro to VRC 0.001 µg/ml for 30 days. Development of VRC transient resistance occurred in vivo, and induction of permanent resistance occurred in vitro Mostly, ABC1 and ERG11 genes were overexpressed, and a homozygous T418C mutation in the ERG11 gene was found.

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AIMS: Manual planimetry is the current method defining infarct volume on magnetic resonance (MR) diffusion-weighted image. ABC/2 method is an ellipsoid geometric formula with advantage estimation of intraparenchymal hemorrhage volume. Our study aimed to find the reliability and reproducibility of ABC/2 method compared to manual planimetric segmentation method. SETTINGS AND DESIGN: This was a cross-sectional analytical study with retrospective and prospective data collection. SUBJECTS AND METHODS: A total of 109 patients with acute ischemic stroke and underwent MR images at Ramathibodi Hospital were retrospectively reviewed. Relationship between manual planimetric segmentation and ABC/2 methods (nonadjusted ABC/2 method and adjusted ABC*/2 method) was determined using Wilcoxon signed-rank test, linear regression analysis, and Bland-Altman plot. Subgroup analysis by location, onset, shape, and size of infarct volume was performed. Interobserver reliability was established using intraclass correlation coefficient and Bland-Altman plot. STATISTICAL ANALYSIS USED: Wilcoxon signed-rank test, linear regression analysis, and Bland-Altman plot were used for statistical analysis. RESULTS: Infarct volume measured with nonadjusted ABC/2 method (23.56, 48.81, 4.25, 0.11, 318.94) (mean, standard deviation, median, minimum, maximum) and adjusted ABC*/2 method (13.37, 28.3, 2.08, 0.06, 170.10) was smaller than manual planimetric method (28.50, 58.64, 5.56, 0.27, 335.49) (P < 0.001). Linear regression's slope confirmed underestimation of volume infarct. In round-to-ellipsoid shape and white matter group, the differences found between nonadjusted ABC/2 and manual planimetric methods are not statistically significant. CONCLUSIONS: ABC/2 method is a simple, rapid, and reproducible method with an excellent positive correlation of both adjusted and nonadjusted ABC/2 methods to manual planimetric segmentation method but tendency to underestimated infarct volume. High interobserver reliability and good agreement between two observers have been established. The utilization of nonadjusted ABC/2 method should be used with caution due to its tendency to underestimate the infarct volume.

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INTRODUCTION: Measurement of tumor growth rates over time for patients with meningiomas has important prognostic and therapeutic implications. Our objective was to compare two methods of measuring meningioma volume: (1) the simplified ellipsoid (ABC/2) method; and (2) perimetric volume measurements using imaging software modules. METHODS: Patients with conservatively managed meningiomas for at least 1.5 years were retrospectively identified from the VCU Brain and Spine Tumor Registry over a 10-year period (2005-2015). Tumor volumes were independently measured using the simplified ellipsoid and computerized perimetric methods. Intra class correlations (CC) and Bland-Altman analyses were performed. RESULTS: A total of 26 patients representing 29 tumors were identified. Across 146 images, there were 24 (16%) images that were non-measurable using standard application commands with the computerized perimetric method. The mean volume obtained using the ABC/2 and computerized perimetric methods were 3.2 ± 3.4 cm3 and 3.4 ± 3.5 cm3, respectively. The mean volume difference was 0.2 cm3 (SE = 0.12; p = 0.10) across measurement methods. The concordance correlation coefficient (CCC) between methods was 0.95 (95% CI 0.91, 0.98). CONCLUSIONS: There is excellent correlation between the simplified ellipsoid and computerized perimetric methods of volumetric analysis for conservatively managed meningiomas. The simplified ellipsoid method remains an excellent method for meningioma volume assessment and had an advantage over the perimetric method which failed to allow measurement of roughly one in six tumors on imaging.

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BACKGROUND: Outcomes of stereotactic radiosurgery in the treatment of cerebral arteriovenous malformations (AVMs) are volume-dependent. The ability to estimate AVM volume has significant value in guiding AVM management. OBJECTIVE: To determine whether AVM volume measurement calculated from the ABC/2 formula is accurate compared to volume calculated by a computer-assisted planimetric method for large AVMs. METHODS: Retrospective review of 42 intracranial AVMs >3 cm in diameter that underwent treatment with dose-staged hypofractionated stereotactic radiotherapy (HSRT) from 2001 to 2018. Two raters independently measured pre- and post-HSRT volumes using both the ABC/2 formula and computer-assisted planimetry in a blinded fashion. Inter-rater reliability was assessed by calculation of intra-class correlation coefficient (ICC). Absolute volumes and percent volume change following HSRT as determined using the two methods were compared using paired t-tests, linear regression, and Bland-Altman plot analyses. RESULTS: The ICC between the 2 raters for planimetric and ABC/2 volumes was 0.859 and 0.799, respectively. ABC/2 volumes, 26.1 ±â€¯26.6 cm3, were statistically smaller than planimetric volumes, 28.6 ±â€¯27.1 cm3 (P = .008). Despite differences, the two methods were highly correlated (R2 = 0.904, linear regression). The percent volume change following HSRT was significantly greater with the ABC/2 method than compared to planimetry (P = .009). CONCLUSION: The ABC/2 and planimetric methods are reproducible for measuring cerebral AVM volumes. Although the ABC/2 method of volume estimation underestimates planimetric AVM volume, the high correlation between the two suggests utility of the ABC/2 method if one understands its limits, particularly with respect to estimating change in AVM volume after treatment.

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Background The assessment of pituitary tumor (PT) volume is important in the treatment and follow-up of patients with PT. Previously, PT volume estimation has been performed by conventional geometric equations (CGE) such as abc/2 (simplified ellipsoid volume equation) and 4πr 3 /3 (sphere), both presuming a symmetric tumor shape, which occurs uncommonly in patients with PT. In contrast, three-dimensional (3D) voxel-based software segmentation takes the irregular and asymmetric shapes that PTs often possess into account and might be a more accurate method for PT volume segmentation. The purpose of this study is twofold. (1) To compare 3D segmentation with CGE for PT volume estimation. (2) To assess inter-rater reliability in 3D segmentation of PTs. Methods Nineteen high-resolution (1mm slice thickness) T1-weighted MRI examinations of patients with PT were independently analyzed and manually segmented, using the software ITK-SNAP, by two certified neuroradiologists. Concurrently, the volumes of the PTs were estimated with abc/2 and 4πr 3 /3 by a clinician, and the results were compared with the corresponding segmented volumes. Results There was a significant decrease in PT volume attained from the segmentations compared with the calculations made with abc/2 ( p < 0.001, mean volume 18% higher than segmentation) and 4πr 3 /3 ( p < 0.001, mean volume 28% higher than segmentation). The intraclass correlation coefficient (ICC) for the two sets of segmented PTs was 0.99. Conclusion CGE ( abc/2 and 4πr 3 /3 ) significantly overestimates PT volume compared with 3D volumetric segmentation. The inter-rater agreement on manual 3D volumetric software segmentation is excellent.

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BACKGROUND: The aim of this study was to assess the sensibility of the hand in children with a neonatal brachial plexus palsy (NBPP) involving the C5 and C6, and to correlate results with dexterity. METHODS: Fifty children with NBPP (30 after nerve surgery, mean age 9.8 years) and 25 healthy controls (mean age 9.6 years) were investigated. Sensibility was assessed with two-point discrimination and Semmes-Weinstein monofilaments. Dexterity was evaluated with a single item from the Movement Assessment Battery for Children-2. We compared the affected side with the nondominant hand of the control group. RESULTS: The sensibility in the first and second fingers was significantly diminished in the NBPP for both two-point discrimination (P = 0.005 and P = 0.014, respectively) and monofilament test (P < 0.001). Dexterity was significantly lower in the NBPP group than in control group, corrected for age (P = 0.023). There was a significant difference toward decreasing hand function with decreasing sensibility according to the Semmes-Weinstein test for the thumb (Jonckheere-Terpstra nonparametric trend test, P = 0.036). CONCLUSIONS: The sensibility of the thumb and index finger in children with an upper plexus lesion (either surgically or conservatively treated) is diminished. The decreased sensibility has a negative impact on hand function. Appreciation of diminished hand function in patients with NBPP involving C5 and C6 is important to optimize treatment.

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