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Delphi definition of the EADC-ADNI Harmonized Protocol for hippocampal segmentation on magnetic resonance.

ABSTRACT: This study aimed to have international experts converge on a harmonized definition of whole hippocampus boundaries and segmentation procedures, to define standard operating procedures for magnetic resonance (MR)-based manual hippocampal segmentation.The panel received a questionnaire regarding whole hippocampus boundaries and segmentation procedures. Quantitative information was supplied to allow evidence-based answers. A recursive and anonymous Delphi procedure was used to achieve convergence. Significance of agreement among panelists was assessed by exact probability on Fisher's and binomial tests.Agreement was significant on the inclusion of alveus/fimbria (P = .021), whole hippocampal tail (P = .013), medial border of the body according to visible morphology (P = .0006), and on this combined set of features (P = .001). This definition captures 100% of hippocampal tissue, 100% of Alzheimer's disease-related atrophy, and demonstrated good reliability on preliminary intrarater (0.98) and inter-rater (0.94) estimates.Consensus was achieved among international experts with respect to hippocampal segmentation using MR resulting in a harmonized segmentation protocol.

SUBMITTER: Boccardi M

PROVIDER: S-EPMC4419736 | biostudies-literature | 2015 Feb

REPOSITORIES: biostudies-literature

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Delphi definition of the EADC-ADNI Harmonized Protocol for hippocampal segmentation on magnetic resonance.

Boccardi Marina M Bocchetta Martina M Apostolova Liana G LG Barnes Josephine J Bartzokis George G Corbetta Gabriele G DeCarli Charles C deToledo-Morrell Leyla L Firbank Michael M Ganzola Rossana R Gerritsen Lotte L Henneman Wouter W Killiany Ronald J RJ Malykhin Nikolai N Pasqualetti Patrizio P Pruessner Jens C JC Redolfi Alberto A Robitaille Nicolas N Soininen Hilkka H Tolomeo Daniele D Wang Lei L Watson Craig C Wolf Henrike H Duvernoy Henri H Duchesne Simon S Jack Clifford R CR Frisoni Giovanni B GB Frisoni Giovanni B GB

Alzheimer's & dementia : the journal of the Alzheimer's Association 20140815 2

<h4>Background</h4>This study aimed to have international experts converge on a harmonized definition of whole hippocampus boundaries and segmentation procedures, to define standard operating procedures for magnetic resonance (MR)-based manual hippocampal segmentation.<h4>Methods</h4>The panel received a questionnaire regarding whole hippocampus boundaries and segmentation procedures. Quantitative information was supplied to allow evidence-based answers. A recursive and anonymous Delphi procedur ...[more]

PMID: 25130658

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Project description:IntroductionAs the life expectancy of children with congenital heart disease (CHD) is rapidly increasing and the adult population with CHD is growing, there is an unmet need to improve clinical workflow and efficiency of analysis. Cardiovascular magnetic resonance (CMR) is a noninvasive imaging modality for monitoring patients with CHD. CMR exam is based on multiple breath-hold 2-dimensional (2D) cine acquisitions that should be precisely prescribed and is expert and institution dependent. Moreover, 2D cine images have relatively thick slices, which does not allow for isotropic delineation of ventricular structures. Thus, development of an isotropic 3D cine acquisition and automatic segmentation method is worthwhile to make CMR workflow straightforward and efficient, as the present work aims to establish.MethodsNinety-nine patients with many types of CHD were imaged using a non-angulated 3D cine CMR sequence covering the whole-heart and great vessels. Automatic supervised and semi-supervised deep-learning-based methods were developed for whole-heart segmentation of 3D cine images to separately delineate the cardiac structures, including both atria, both ventricles, aorta, pulmonary arteries, and superior and inferior vena cavae. The segmentation results derived from the two methods were compared with the manual segmentation in terms of Dice score, a degree of overlap agreement, and atrial and ventricular volume measurements.ResultsThe semi-supervised method resulted in a better overlap agreement with the manual segmentation than the supervised method for all 8 structures (Dice score 83.23 ± 16.76% vs. 77.98 ± 19.64%; P-value ≤0.001). The mean difference error in atrial and ventricular volumetric measurements between manual segmentation and semi-supervised method was lower (bias ≤ 5.2 ml) than the supervised method (bias ≤ 10.1 ml).DiscussionThe proposed semi-supervised method is capable of cardiac segmentation and chamber volume quantification in a CHD population with wide anatomical variability. It accurately delineates the heart chambers and great vessels and can be used to accurately calculate ventricular and atrial volumes throughout the cardiac cycle. Such a segmentation method can reduce inter- and intra- observer variability and make CMR exams more standardized and efficient.

Project description:ObjectiveHippocampal sclerosis (HS) is the most common cause of drug-resistant temporal lobe epilepsy, and its accurate detection is important to guide epilepsy surgery. Radiological features of HS include hippocampal volume loss and increased T2 signal, which can both be quantified to help improve detection. In this work, we extend these quantitative methods to generate cross-sectional area and T2 profiles along the hippocampal long axis to improve the localization of hippocampal abnormalities.MethodsT1-weighted and T2 relaxometry data from 69 HS patients (32 left, 32 right, 5 bilateral) and 111 healthy controls were acquired on a 3-T magnetic resonance imaging (MRI) scanner. Automated hippocampal segmentation and T2 relaxometry were performed and used to calculate whole-hippocampal volumes and to estimate quantitative T2 (qT2) values. By generating a group template from the controls, and aligning this so that the hippocampal long axes were along the anterior-posterior axis, we were able to calculate hippocampal cross-sectional area and qT2 by a slicewise method to localize any volume loss or T2 hyperintensity. Individual patient profiles were compared with normative data generated from the healthy controls.ResultsProfiling of hippocampal volumetric and qT2 data could be performed automatically and reproducibly. HS patients commonly showed widespread decreases in volume and increases in T2 along the length of the affected hippocampus, and focal changes may also be identified. Patterns of atrophy and T2 increase in the left hippocampus were similar between left, right, and bilateral HS. These profiles have potential to distinguish between sclerosis affecting volume and qT2 in the whole or parts of the hippocampus, and may aid the radiological diagnosis in uncertain cases or cases with subtle or focal abnormalities where standard whole-hippocampal measurements yield normal values.SignificanceHippocampal profiling of volumetry and qT2 values can help spatially localize hippocampal MRI abnormalities and work toward improved sensitivity of subtle focal lesions.

Dataset Information

Delphi definition of the EADC-ADNI Harmonized Protocol for hippocampal segmentation on magnetic resonance.

Publications

Delphi definition of the EADC-ADNI Harmonized Protocol for hippocampal segmentation on magnetic resonance.

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