Performance of computed tomography and magnetic resonance morphometry in evaluating brain atrophy in Down syndrome

BACKGROUND To compare the performance of computed tomography (CT) with that of magnetic resonance imaging (MRI) in assessing brain atrophy in Down syndrome (DS). METHODS Retrospective comparison of CT‐derived gray and white matter measurements with those obtained by MRI using voxel‐based morphometry (VBM) in adults with DS who underwent both scanning modalities with a maximum interval of 1 year. The concordance of both tests was compared across sample quartiles. RESULTS Eleven of 23 participants had some degree of cognitive decline. When comparing VBM outputs of both imaging techniques, an overlap of voxels negatively correlated with dementia severity was observed in the right temporal lobe. Observed agreement was 92.3% (quadratic‐weighted kappa index 0.71) for both gray and white matter. DISCUSSION CT and MRI analyses showed a similar decrease in brain volume as cognitive decline increased. Our results highlight the potential use of CT in computational neuroanatomy studies of DS. Highlights Voxel‐based morphometry shows that computed tomography (CT) and magnetic resonance imaging (MRI) yield similar brain atrophy patterns in DS. Strong agreement (kappa index 0.71) was found between CT and MRI assessments. CT‐identified right temporal lobe volume loss linked to cognitive decline in DS. CT offers a practical, accessible alternative to MRI for brain imaging in DS. Artificial intelligence–based CT analysis enhances neuroimaging for DS with reduced motion issues.