Computer-aided diagnosis of leukoencephalopathy in children treated for acute lymphoblastic leukemia

John O. Glass, Chin-Shang Li, Kathleen J. Helton, Wilburn E. Reddick

Research output: Chapter in Book/Report/Conference proceedingConference contribution


The purpose of this study was to use objective quantitative MR imaging methods to develop a computer-aided diagnosis tool to differentiate white matter (WM) hyperintensities as either leukoencephalopathy (LE) or normal maturational processes in children treated for acute lymphoblastic leukemia with intravenous high dose methotrexate. A combined imaging set consisting of T1, T2, PD, and FLAIR MR images and WM, gray matter, and cerebrospinal fluid a priori maps from a spatially normalized atlas were analyzed with a neural network segmentation based on a Kohonen Self-Organizing Map. Segmented regions were manually classified to identify the most hyperintense WM region and the normal appearing genu region. Signal intensity differences normalized to the genu within each examination were generated for two time points in 203 children. An unsupervised hierarchical clustering algorithm with the agglomeration method of McQuitty was used to divide data from the first examination into normal appearing or LE groups. A C-support vector machine (C-SVM) was then trained on the first examination data and used to classify the data from the second examination. The overall accuracy of the computer-aided detection tool was 83.5% (299 / 358) with sensitivity to normal WM of 86.9% (199 / 229) and specificity to LE of 77.5% (100 / 129) when compared to the readings of two expert observers. These results suggest that subtle therapy-induced leukoencephalopathy can be objectively and reproducibly detected in children treated for cancer using this computer-aided detection approach based on relative differences in quantitative signal intensity measures normalized within each examination.

Original languageEnglish (US)
Title of host publicationProgress in Biomedical Optics and Imaging - Proceedings of SPIE
EditorsJ.M. Fitzpatrick, J.M. Reinhardt
Number of pages8
StatePublished - 2005
Externally publishedYes
EventMedical Imaging 2005 - Image Processing - San Diego, CA, United States
Duration: Feb 13 2005Feb 17 2005


OtherMedical Imaging 2005 - Image Processing
Country/TerritoryUnited States
CitySan Diego, CA


  • Computer Aided Diagnosis
  • Neurotoxicity
  • Pediatric Oncology
  • Segmentation
  • White Matter

ASJC Scopus subject areas

  • Engineering(all)


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