Linear normalization of MR brain images in pediatric patients with periventricular leukomalacia

The feasibility of linear normalization of child brain images with structural abnormalities due to periventricular leukomalacia (PVL) was assessed in terms of success rate and accuracy of the normalization algorithm. Ten T1-weighted brain images from healthy adult subject and 51 from children (4-11 years of age) were linearly transformed to achieve spatial registration with the standard MNI brain template. Twelve of the child brain images were radiologically normal, 22 showed PVL and 17 showed PVL with additional enlargement of the lateral ventricles. The effects of simple modifications to the normalization process were evaluated: changing the initial orientation and zoom parameters, masking non-brain areas, smoothing the images and using a pediatric template instead of the MNI template. Normalization failure was reduced by changing the initial zoom parameters and by removing background noise. The overall performance of the normalization algorithm was only improved when background noise was removed from the images. The results show that linear normalization of PVL affected brain images is feasible.