The challenges of neuroradiology and neurodegenerative diseases

Prof. Vernooij experiences an important challenge in her daily reporting work of brain scans of patients from the memory clinic or the Alzheimer center at Erasmus MC. The challenge is that visually distinguishing neurodegenerative pathology from normal age related changes to the brain can be very difficult, especially in young individuals. Because of this, semi-quantitative visual rating scales are not very useful. 

Introducing Quantib^® ND to gather quantitative insights

Quantib^® ND provides automatic quantifications of brain and brain structures volumes and it provides a set of normative reference curves that enable the comparison of the values of your patient to those of a non-demented population, which really helped Dr. Vernooij and the rest of the Erasmus MC team.

As for the impact of using Quantib^® ND, Dr. Vernooij states that they use the quantification and the relative information from the normative reference data, on top of their visual assessment, to add to their radiology reports and increase their understanding of whether the brain atrophy is normal or abnormal and get to a better diagnosis for each patient. 

"Quantib^® ND can help us to indicate if there are any changes happening in the brain earlier in the disease process" said Dr. Vernooij. 

What working with Quantib^® ND looks like for Dr. Vernooij

In her work as a neuroradiologist, besides her visual assessment, Dr. Vernooij uses Quantib^® ND as an extra tool to help her make the best diagnosis for the individual patient. So, after the visual read of the brain MRI, she runs the software and she integrates the insights gathered from both in order to create her radiology report.

Quantib^® ND adds value to her workflow as, sometimes, Quantib^® ND shows her something that she might have missed in her visual assessment that then triggers a second retrospective visual assessment. Other times, the software provides information that would have been impossible to assess visually. All in all, Dr. Vernooij uses Quantib^® ND to increase her own diagnostic accuracy and her confidence in her radiology reports. 

A clinical case in which Quantib^® ND can be especially helpful

A very specific illustration of how Quantib^® ND can have added value is in younger individuals (e.g. in their 40s or 50s) who carry familial genetic mutations that will eventually lead to fronto-temporal dementia (FTD). In these people the imaging scans, and especially the quantification obtained from Quantib^® ND, may already show that the structural volumes are deteriorating, even when they don’t have any symptoms and the neuropsychological exams don't manifest any disease development. So it helps them to see that imaging changes are indeed happening earlier in the disease process. 

"During our MDT meetings, we always pull up the report from Quantib^® ND and use it as extra information to come to a joint decision on the best diagnosis and clinical management of the patient" said Dr. Vernooij. 

The added value of Quantib^® ND in the rest of the diagnostic process beyond radiology

As part of her job as neuroradiologist, Dr. Vernooij attends MTD meetings with their referring clinicians, like neurologists and geriatricians. In those MTD meetings, she always shares the Quantib^® ND report to use it as extra information to come to a joint decision on the best diagnosis and clinical management of the patient. Dr. Vernooij also believes that the quantitative information reveals another layer of how the team gets to a certain diagnosis and, therefore, it increases the confidence of referring clinicians regarding the diagnosis. 

Furthermore, referring clinicians use the Quantib^® ND report when communicating with patients to explain why a specific decision was made. 

"The application of AI in radiology, like Quantib^® ND, will provide us with extra information. And our task as a radiologist will be to integrate all this information and be a communicator to our referring clinicians and in the diagnostic process." said Dr. Vernooij.