Qualitative and Quantitative Comparison of Hippocampal Volumetric Software Applications: Do All Roads Lead to Rome?

Stephanie Mangesius; Lukas Haider; Lukas Lenhart; Ruth Steiger; Ferran Prados Carrasco; Christoph Scherfler; Elke R Gizewski

doi:10.3390/biomedicines10020432

Qualitative and Quantitative Comparison of Hippocampal Volumetric Software Applications: Do All Roads Lead to Rome?

Biomedicines. 2022 Feb 12;10(2):432. doi: 10.3390/biomedicines10020432.

Authors

Stephanie Mangesius^{1

2}, Lukas Haider^{3

4}, Lukas Lenhart^{1

2}, Ruth Steiger^{1

2}, Ferran Prados Carrasco^{3

5

6}, Christoph Scherfler⁷, Elke R Gizewski^{1

2}

Affiliations

¹ Department of Neuroradiology, Medical University of Innsbruck, Anichstrasse 35, 6020 Innsbruck, Austria.
² Neuroimaging Core Facility, Medical University of Innsbruck, Anichstrasse 35, 6020 Innsbruck, Austria.
³ NMR Research Unit, Queen Square Multiple Sclerosis Centre, University College London Institute of Neurology, Russell Square House, Russell Square 10-12, London WC1B 5EH, UK.
⁴ Department of Biomedical Imaging and Image Guided Therapy, Medical University of Vienna, Währinger Gürtel 18-20, 1090 Vienna, Austria.
⁵ Centre for Medical Image Computing (CMIC), Department of Medical Physics and Biomedical Engineering, University College London, Malet Place Engineering Building, Gower Street, London WC1E 6BT, UK.
⁶ e-Health Centre, Universitat Oberta de Catalunya, Rambla del Poblenou 156, 08018 Barcelona, Spain.
⁷ Department of Neurology, Medical University of Innsbruck, Anichstrasse 35, 6020 Innsbruck, Austria.

Abstract

Brain volumetric software is increasingly suggested for clinical routine. The present study quantifies the agreement across different software applications. Ten cases with and ten gender- and age-adjusted healthy controls without hippocampal atrophy (median age: 70; 25-75% range: 64-77 years and 74; 66-78 years) were retrospectively selected from a previously published cohort of Alzheimer's dementia patients and normal ageing controls. Hippocampal volumes were computed based on 3 Tesla T1-MPRAGE-sequences with FreeSurfer (FS), Statistical-Parametric-Mapping (SPM; Neuromorphometrics and Hammers atlases), Geodesic-Information-Flows (GIF), Similarity-and-Truth-Estimation-for-Propagated-Segmentations (STEPS), and Quantib™. MTA (medial temporal lobe atrophy) scores were manually rated. Volumetric measures of each individual were compared against the mean of all applications with intraclass correlation coefficients (ICC) and Bland-Altman plots. Comparing against the mean of all methods, moderate to low agreement was present considering categorization of hippocampal volumes into quartiles. ICCs ranged noticeably between applications (left hippocampus (LH): from 0.42 (STEPS) to 0.88 (FS); right hippocampus (RH): from 0.36 (Quantib™) to 0.86 (FS). Mean differences between individual methods and the mean of all methods [mm³] were considerable (LH: FS -209, SPM-Neuromorphometrics -820; SPM-Hammers -1474; Quantib™ -680; GIF 891; STEPS 2218; RH: FS -232, SPM-Neuromorphometrics -745; SPM-Hammers -1547; Quantib™ -723; GIF 982; STEPS 2188). In this clinically relevant sample size with large spread in data ranging from normal aging to severe atrophy, hippocampal volumes derived by well-accepted applications were quantitatively different. Thus, interchangeable use is not recommended.

Keywords: atrophy; brain; hippocampus; magnetic resonance imaging; software.