Survey of protocols for the manual segmentation of the hippocampus: Preparatory steps towards a joint EADC-ADNI harmonized protocol

Marina Boccardi, Rossana Ganzola, Martina Bocchetta, Michela Pievani, Alberto Redolfi, George Bartzokis, Richard Camicioli, John G. Csernansky, Mony J. De Leon, Leyla Detoledo-Morrell, Ronald J. Killiany, Stéphane Lehéricy, Johannes Pantel, Jens C. Pruessner, H. Soininen, Craig Watson, Simon Duchesne, Clifford R. Jack, Giovanni B. Frisoni*

*Corresponding author for this work

Research output: Chapter in Book/Report/Conference proceedingChapter

4 Scopus citations

Abstract

Manual segmentation from magnetic resonance imaging (MR) is the gold standard for evaluating hippocampal atrophy in Alzheimer's disease (AD). Nonetheless, different segmentation protocols provide up to 2.5-fold volume differences. Here we surveyed the most frequently used segmentation protocols in the AD literature as a preliminary step for international harmonization. The anatomical landmarks (anteriormost and posteriormost slices, superior, inferior, medial, and lateral borders) were identified from 12 published protocols for hippocampal manual segmentation ([Abbreviation] first author, publication year: [B] Bartzokis, 1998; [C] Convit, 1997; [dTM] deToledo-Morrell, 2004; [H] Haller, 1997; [J] Jack, 1994; [K] Killiany, 1993; [L] Lehericy, 1994; [M] Malykhin, 2007; [Pa] Pantel, 2000; [Pr] Pruessner, 2000; [S] Soininen, 1994; [W] Watson, 1992). The hippocampi of one healthy control and one AD patient taken from the 1.5T MR ADNI database were segmented by a single rater according to each protocol. The accuracy of the protocols' interpretation and translation into practice was checked with lead authors of protocols through individual interactive web conferences. Semantically harmonized landmarks and differences were then extracted, regarding: (a) the posteriormost slice, protocol [B] being the most restrictive, and [H, M, Pa, Pr, S] the most inclusive; (b) inclusion [C, dTM, J, L, M, Pr, W] or exclusion [B, H, K, Pa, S] of alveus/fimbria; (c) separation from the parahippocampal gyrus, [C] being the most restrictive, [B, dTM, H, J, Pa, S] the most inclusive. There were no substantial differences in the definition of the anteriormost slice. This survey will allow us to operationalize differences among protocols into tracing units, measure their impact on the repeatability and diagnostic accuracy of manual hippocampal segmentation, and finally develop a harmonized protocol.

Original languageEnglish (US)
Title of host publicationHandbook of Imaging the Alzheimer Brain
EditorsJ. Wesson Ashford, Allyson Rosen, Maheen Adamson, Peter Bayley, Ansgar Furst, Osama Sabri, Sandra E. Black, Michael Weiner
Pages111-125
Number of pages15
DOIs
StatePublished - 2011

Publication series

NameAdvances in Alzheimer's Disease
Volume2
ISSN (Print)2210-5727
ISSN (Electronic)2210-5735

Keywords

  • Alzheimer's disease
  • Hippocampus
  • MRI
  • anatomical landmark
  • atrophy
  • degeneration
  • harmonization
  • manual segmentation protocol
  • manual tracing
  • medial temporal lobes

ASJC Scopus subject areas

  • Clinical Neurology

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