Uncertainty Assessment of Quantitative Measurements in Medical Imaging: Applications in Cross-Sectional and Longitudinal Diffusion MRI

Medical imaging measurements have been increasingly investigated as imaging biomarkers for detecting physiological and pathological changes. It is critical to evaluate the reliability of the changes in measurements observed in an individual patient for any clinical decision making. The purpose of this article is to review the utility of uncertainty analysis in medical imaging measurements for individual patients undergoing any pathology or medical therapy. We specifically show how to assess whether the observed alterations in measurements are true changes, i.e. the changes due to medical conditions alone, beyond the uncertainty associated with the imaging, image analysis, or natural physiological occurrences. In order to elaborate the uncertainty concept and the potential applications of uncertainty analysis in the field of medical imaging, we reopen two of our previous articles published in the “journal of Physics in Medicine and Biology” [1], and the “Journal of neurological sciences” [2], respectively. The first study delineates the uncertainty analysis in the context of longitudinal imaging for evaluating the validity of serial measurements for assessing radiation-induced neurotoxicity in patients who had low-grade or benign tumors and were treated by partial brain radiation therapy. The second work intricates such an application for estimation of interhemispheric variation uncertainty to identify the epileptogenic side in the patients with temporal lobe epilepsy in a cross-sectional study.