Multiple reproducibility indices for evaluation of cognitive functional MR imaging paradigms.

BACKGROUND AND PURPOSE The purpose of this study was to evaluate a variety of reproducibility indices for cognitive functional MR imaging (fMRI) paradigms that account for both overlapping and extraneous regions of activation. METHODS Eight right-handed volunteers were imaged with fMRI by using a word-generation paradigm and a forward-backward text-listening paradigm. The paradigms were performed twice in the session and repeated 1 week later. Reproducibility indices for the four repeated studies were determined on the basis of pair-wise computation of the ratio of the probability-weighted intersection volume divided by the union volume of surviving activation clusters. The intersection volume was determined by using several iterations of the morphologic dilatation operator with additional voxels accrued in the intersection weighted by an exponential function. Computed indices included global reproducibility, language area reproducibility, extraneous activation reproducibility, and laterality. RESULTS The word-generation paradigm had reproducibility values that were significantly greater than those of the forward-backward text-listening paradigm (global reproducibility, 0.75 vs 0.5, P <.005; language area reproducibility, 0.85 vs 0.6, P <.008; mean extraneous activation reproducibility, 0.68 vs 0.41, P <.002). The forward-backward text-listening paradigm demonstrated more focal activations, whereas the word-generation demonstrated larger activations outside the dominant language areas that were highly reproducible. CONCLUSION For clinically relevant language paradigms, multiple reproducibility indices should be taken into account in selecting an appropriate paradigm. Compared with a forward-backward text-listening task, a word-generation task has higher reproducibility indices at the expense of localizing ability. The forward-backward paradigm demonstrates more focal activations with less extraneous activation.