Abstract
Background: 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. Methods: 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. Results: Agreement was significant on the inclusion of alveus/fimbria (P 5.021), whole hippocampal tail (P 5.013), medial border of the body according to visible morphology (P 5.0006), and on this combined set of features (P 5.001). 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. Discussion: Consensus was achieved among international experts with respect to hippocampal segmentation using MR resulting in a harmonized segmentation protocol.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 126-138 |
| Number of pages | 13 |
| Journal | Alzheimer's and Dementia |
| Volume | 11 |
| Issue number | 2 |
| DOIs | |
| State | Published - 2015 |
Funding
Preparatory work (reported in Boccardi et al., J Alzheimers Dis, 2011; 26:61-75 and in Boccardi et al, Alzheimer's and Dementia 2013, doi:pii: S1552-5260(13)00078-2) has been funded thanks to unrestricted grants from Lilly International (grant n. 10012941 ) and Wyeth International (a part of the Pfizer group). The project “Harmonized Protocol For Manual Hippocampal Segmentation: An EADC-ADNI Effort” has been funded thanks to an unrestricted grant from the Alzheimer's Association , Chicago, US (grant number IIRG-10-174022 ). The project PI is Giovanni B Frisoni, IRCCS Fatebenefratelli, Brescia, Italy; the co-PI is Clifford R. Jack, Mayo Clinic, Rochester, MN; the Statistical Working Group is led by Simon Duchesne, Laval University, Quebec City, Canada; project Coordinator is Marina Boccardi, IRCCS Fatebenefratelli, Brescia, Italy. EADC Centres (local PI) are: IRCCS Fatebenefratelli, Brescia, Italy (GB Frisoni); University of Kuopio and Kuopio University Hospital, Kuopio, Finland (H Soininen); Höpital Salpètriere, Paris, France (B Dubois and S Lehericy); University of Frankfurt, Frankfurt, Germany (H Hampel); University Rostock, Rostock, Germany (S Teipel); Karolinska institutet, Stockholm, Sweden (L-O Wahlund); Department of Psychiatry Research, Zurich, Switzerland (C Hock); Alzheimer Centre, Vrije Univ Medical Centre, Amsterdam, The Netherlands (F Barkhof and P Scheltens); Dementia Research Group Institute of Neurology, London, UK (N Fox); Neuromed, Centre for Neuroimaging Sciences, London, UK (A Simmons). ADNI Centres are: Mayo Clinic, Rochester, MN (CR Jack); University of California Davis, CA (C DeCarli and C Watson); University of California, Los Angeles (UCLA), CA (G Bartzokis); University of California San Francisco (UCSF), CA (M Weiner and S Mueller); Laboratory of NeuroImaging (LoNI), University of California, Los Angeles (UCLA), CA (PM Thompson and LG Apostolova); Rush University Medical Center, Chicago, IL (L deToledo-Morrell); Rush Alzheimer's Disease Center, Chicago, IL (D Bennet); Northwestern University, IL (J Csernansky); Boston University School of Medicine, MA (R Killiany); John Hopkins University, Baltimore, MD (M Albert); Center for Brain Health, New York, NY (M De Leon); Oregon Health & Science University, Portland, OR (J Kaye). Other Centres are: McGill University, Montreal, Quebec, Canada (J Pruessner); University of Alberta, Edmonton, Alberta, Canada (R Camicioli and N Malykhin); Department of Psychiatry, Psychosomatic, Medicine & Psychotherapy, Johann, Wolfgang Goethe-University, Frankfurt, Germany (J Pantel); Institute for Ageing and Health, Wolfson Research Centre, Newcastle General Hospital, Newcastle, UK (J O'Brien). Population-based studies: PATH through life, Australia (P Sachdev and JJ Maller); SMART-Medea Study, The Netherlands (MI Geerlings); Rotterdam Scan Study, The Netherlands (T denHeijer). Statistical Working Group: AFAR (Fatebenefratelli Association for Biomedical Research) San Giovanni Calibita – Fatebenefratelli Hospital – Rome, Italy (P Pasqualetti); Laval University, Quebec City, Canada (S Duchesne); MNI, McGill University, Montreal, Canada (L Collins). Advisors: Clinical issues: PJ Visser, Department of Psychiatry and Neuropsychology, Maastricht University, Maastricht, The Netherlands; EADC PIs: B Winbald, Karolinska Institute, Sweden and L Froelich, Central Institute of Mental Health, Mannheim, Germany; Dissemination & Education: G Waldemar, Copenhagen University Hospital, Copenhagen, Denmark; ADNI PI: M Weiner, University of California San Francisco (UCSF), CA; Population Studies: L Launer, National Institute on Aging (NIA), Bethesda and W Jagust, University of California, Berkeley, CA. JB is an Alzheimer's Research UK senior research fellow based at the Dementia Research Centre, Department of Neurodegenerative Disease, UCL, Institute of Neurology. The Dementia Research Centre is an Alzheimer's Research UK Coordinating Centre and has also received equipment funded by Alzheimer's Research UK and Brain Research Trust . Part of this work was supported by the NIHR Queen Square Dementia BRU .
Keywords
- Alzheimer's disease
- Anatomical landmarks
- Atrophy
- Delphi procedure
- Enrichment
- Harmonization
- Hippocampal atrophy
- Hippocampus
- MCI
- Magnetic resonance
- Manual segmentation
- Medial temporal lobe
- Neuroimaging
- Reliability
- Standard operational procedures
- Volumetry
ASJC Scopus subject areas
- Epidemiology
- Health Policy
- Developmental Neuroscience
- Clinical Neurology
- Geriatrics and Gerontology
- Cellular and Molecular Neuroscience
- Psychiatry and Mental health
