Hippocampal volume assessment in temporal lobe epilepsy: How good is automated segmentation?

Abstract:

PURPOSE:Quantitative measurement of hippocampal volume using structural magnetic resonance imaging (MRI) is a valuable tool for detection and lateralization of mesial temporal lobe epilepsy with hippocampal sclerosis (mTLE). We compare two automated hippocampal volume methodologies and manual hippocampal volumetry to determine which technique is most sensitive for the detection of hippocampal atrophy in mTLE. METHODS:We acquired a three-dimensional (3D) volumetric sequence in 10 patients with left-lateralized mTLE and 10 age-matched controls. Hippocampal volumes were measured manually, and using the software packages Freesurfer and FSL-FIRST. The sensitivities of the techniques were compared by determining the effect size for average volume reduction in patients with mTLE compared to controls. The volumes and spatial overlap of the automated and manual segmentations were also compared. RESULTS:Significant volume reduction in affected hippocampi in mTLE compared to controls was detected by manual hippocampal volume measurement (p < 0.01, effect size 33.2%), Freesurfer (p < 0.01, effect size 20.8%), and FSL-FIRST (p < 0.01, effect size 13.6%) after correction for brain volume. Freesurfer correlated reasonably (r = 0.74, p < 0.01) with this manual segmentation and FSL-FIRST relatively poorly (r = 0.47, p < 0.01). The spatial overlap between manual and automated segmentation was reduced in affected hippocampi, suggesting the accuracy of automated segmentation is reduced in pathologic brains. DISCUSSION:Expert manual hippocampal volumetry is more sensitive than both automated methods for the detection of hippocampal atrophy associated with mTLE. In our study Freesurfer was the most sensitive to hippocampal atrophy in mTLE and could be used if expert manual segmentation is not available.

journal_name

Epilepsia

journal_title

Epilepsia

authors

Pardoe HR,Pell GS,Abbott DF,Jackson GD

doi

10.1111/j.1528-1167.2009.02243.x

subject

Has Abstract

pub_date

2009-12-01 00:00:00

pages

2586-92

issue

12

eissn

0013-9580

issn

1528-1167

pii

EPI2243

journal_volume

50

pub_type

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