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Related Experiment Video

Updated: Jan 20, 2026

High-resolution In Vivo Manual Segmentation Protocol for Human Hippocampal Subfields Using 3T Magnetic Resonance Imaging
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Segmentation errors and intertest reliability in automated and manually traced hippocampal volumes.

Benjamin H Brinkmann1,2, Hari Guragain1, Daniel Kenney-Jung3

  • 1Department of Neurology, Mayo Clinic, Rochester, Minnesota.

Annals of Clinical and Translational Neurology
|September 7, 2019
PubMed
Summary

Automated hippocampal segmentation is more reproducible than manual tracing in epilepsy patients. However, automated methods can fail with anatomical abnormalities and may produce clinically significant errors.

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Area of Science:

  • Neuroimaging
  • Epilepsy Research
  • Medical Image Analysis

Background:

  • Accurate hippocampal volumetry is crucial for diagnosing and monitoring epilepsy.
  • Manual tracing is time-consuming and prone to inter-rater variability.
  • Automated segmentation offers potential for increased efficiency and consistency.

Purpose of the Study:

  • To compare the accuracy, repeatability, and clinical acceptability of automated (NeuroQuant, FreeSurfer) versus manual hippocampal segmentation.
  • To evaluate performance across a range of imaging abnormalities in epilepsy patients.

Main Methods:

  • Manual and automated (NeuroQuant, FreeSurfer) hippocampal segmentation were performed on 3T MPRAGE MRI scans from 49 epilepsy patients.
  • Reproducibility was assessed through repeated manual tracings and automated measurements.
  • Performance was evaluated in cases with anatomical variations and segmentation errors.

Main Results:

  • Automated methods (NeuroQuant, FreeSurfer) demonstrated superior volume reproducibility compared to manual tracing.
  • Both automated methods showed lower asymmetry index reproducibility than manual tracing.
  • Automated segmentation failed in cases with significant anatomical deformations and produced clinically significant errors in a subset of patients.

Conclusions:

  • Automated hippocampal segmentation offers improved reproducibility over manual tracing in epilepsy.
  • Clinical application requires careful validation due to potential failures and significant segmentation errors in complex cases.