Brain Midline Shift Measurement and Its Automation: A Review of Techniques and Algorithms

Chun-Chih Liao, Ya-Fang Chen, Furen Xiao
2018 International Journal of Biomedical Imaging  
Midline shift (MLS) of the brain is an important feature that can be measured using various imaging modalities including X-ray, ultrasound, computed tomography, and magnetic resonance imaging. Shift of midline intracranial structures helps diagnosing intracranial lesions, especially traumatic brain injury, stroke, brain tumor, and abscess. Being a sign of increased intracranial pressure, MLS is also an indicator of reduced brain perfusion caused by an intracranial mass or mass effect. We review
more » ... studies that used the MLS to predict outcomes of patients with intracranial mass. In some studies, the MLS was also correlated to clinical features. Automated MLS measurement algorithms have significant potentials for assisting human experts in evaluating brain images. In symmetry-based algorithms, the deformed midline is detected and its distance from the ideal midline taken as the MLS. In landmark-based ones, MLS was measured following identification of specific anatomical landmarks. To validate these algorithms, measurements using these algorithms were compared to MLS measurements made by human experts. In addition to measuring the MLS on a given imaging study, there were newer applications of MLS that included comparing multiple MLS measurement before and after treatment and developing additional features to indicate mass effect. Suggestions for future research are provided.
doi:10.1155/2018/4303161 pmid:29849536 pmcid:PMC5925103 fatcat:kvyxrjvbqrf2rhgtdprxla3zlu