PT  - JOURNAL ARTICLE
AU  - Weiss, Kenneth L.
AU  - Pan, Hai
AU  - Storrs, Judd
AU  - Strub, William
AU  - Weiss, Jane L.
AU  - Jia, Li
AU  - Eldevik, O. Petter
TI  - Clinical Brain MR Imaging Prescriptions in Talairach Space: Technologist- and Computer-Driven Methods
DP  - 2003 May 01
TA  - American Journal of Neuroradiology
PG  - 922--929
VI  - 24
IP  - 5
4099  - http://www.ajnr.org/content/24/5/922.short
4100  - http://www.ajnr.org/content/24/5/922.full
SO  - Am. J. Neuroradiol.2003 May 01; 24
AB  - BACKGROUND AND PURPOSE: Variability in patient head positioning may yield substantial interstudy image variance in the clinical setting. We describe and test three-step technologist and computer-automated algorithms designed to image the brain in a standard reference system and reduce variance.METHODS: Triple oblique axial images obtained parallel to the Talairach anterior commissure (AC)–posterior commissure (PC) plane were reviewed in a prospective analysis of 126 consecutive patients. Requisite roll, yaw, and pitch correction, as three authors determined independently and subsequently by consensus, were compared with the technologists’ actual graphical prescriptions and those generated by a novel computer automated three-step (CATS) program. Automated pitch determinations generated with Statistical Parametric Mapping ’99 (SPM’99) were also compared.RESULTS: Requisite pitch correction (15.2° ± 10.2°) far exceeded that for roll (−0.6° ± 3.7°) and yaw (−0.9° ± 4.7°) in terms of magnitude and variance (P < .001). Technologist and computer-generated prescriptions substantially reduced interpatient image variance with regard to roll (3.4° and 3.9° vs 13.5°), yaw (0.6° and 2.5° vs 22.3°), and pitch (28.6°, 18.5° with CATS, and 59.3° with SPM’99 vs 104°). CATS performed worse than the technologists in yaw prescription, and it was equivalent in roll and pitch prescriptions. Talairach prescriptions better approximated standard CT canthomeatal angulations (9° vs 24°) and provided more efficient brain coverage than that of routine axial imaging.CONCLUSION: Brain MR prescriptions corrected for direct roll, yaw, and Talairach AC-PC pitch can be readily achieved by trained technologists or automated computer algorithms. This ability will substantially reduce interpatient variance, allow better approximation of standard CT angulation, and yield more efficient brain coverage than that of routine clinical axial imaging.