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Improved reliability of hippocampal atrophy rate measurement in mild cognitive impairment using fluid registration
L A van de Pol1, J Barnes, R I Scahill
1Department of Neurology, Alzheimer Centre, VU Medical Centre, PO Box 7057, 1007 MB Amsterdam, The Netherlands. L.vandepol@vumc.nl
Abstract:
MRI-derived rates of hippocampal atrophy may serve as surrogate markers of disease progression in mild cognitive impairment (MCI). Manual delineation is the gold standard in hippocampal volumetry; however, this technique is time-consuming and subject to errors. We aimed to compare regional non-linear (fluid) registration measurement of hippocampal atrophy rates against manual delineation in MCI. Hippocampi of 18 subjects were manually outlined twice on MRI scan-pairs (interval+/-SD: 2.01+/-0.11 years), and volumes were subtracted to calculate change over time. Following global affine and local rigid registration, regional fluid registration was performed from which atrophy rates were derived from the Jacobian determinants over the hippocampal region. Atrophy rates as derived by fluid registration were computed using both forward (repeat onto baseline) and backward (baseline onto repeat) registration. Reliability for both methods and agreement between methods was assessed. Mean+/-SD hippocampal atrophy rates (%/year) derived by manual delineation were: left: 2.13+/-1.62; right: 2.36+/-1.78 and for regional fluid registration: forward: left: 2.39+/-1.68; right: 2.49+/-1.52 and backward: left: 2.21+/-1.51; right: 2.42+/-1.49. Mean hippocampal atrophy rates did not differ between both methods. Reliability for manual hippocampal volume measurements (cross-sectional) was high (intraclass correlation coefficient (ICC): baseline and follow-up, left and right, >0.99). However, the resulting ICC for manual measurements of hippocampal volume change (longitudinal) was considerably lower (left: 0.798; right: 0.850) compared with regional fluid registration (forward: left: 0.985; right: 0.988 and backward: left: 0.975; right: 0.989). We conclude that regional fluid registration is more reliable than manual delineation in assessing hippocampal atrophy rates, without sacrificing sensitivity to change. This method may be useful to quantify hippocampal volume change, given the reduction in operator time and improved precision.
Insights
Regional fluid registration offers a more reliable method for measuring hippocampal atrophy rates in mild cognitive impairment (MCI) compared to manual delineation. This advanced technique improves precision and reduces operator time for tracking disease progression.
Area of Science:
- Neuroimaging
- Medical Physics
- Neurology
Background:
- Hippocampal atrophy rates measured by MRI can indicate disease progression in mild cognitive impairment (MCI).
- Manual hippocampal volumetry is the current standard but is labor-intensive and prone to errors.
- Automated methods are needed to improve the efficiency and reliability of atrophy rate assessment.
Purpose of the Study:
- To compare the reliability of regional non-linear (fluid) registration for measuring hippocampal atrophy rates against manual delineation in MCI patients.
- To assess the sensitivity to change and operator time efficiency of the fluid registration method.
Main Methods:
- Eighteen MCI subjects underwent two MRI scans with an average interval of two years.
- Manual hippocampal outlining was performed twice for each subject.
- Regional fluid registration was applied to MRI scan pairs, deriving atrophy rates from Jacobian determinants.
- Both forward and backward registration directions were used for fluid registration analysis.
Main Results:
- Mean hippocampal atrophy rates did not significantly differ between manual delineation and fluid registration.
- Fluid registration demonstrated substantially higher reliability (intraclass correlation coefficient >0.97) for longitudinal volume change compared to manual delineation (ICC <0.85).
- Fluid registration significantly reduced operator time and improved measurement precision.
Conclusions:
- Regional fluid registration is a more reliable and precise method for quantifying hippocampal atrophy rates in MCI than manual delineation.
- This automated approach maintains sensitivity to change while offering significant improvements in efficiency and reproducibility.
- Fluid registration represents a valuable tool for monitoring disease progression in MCI.
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