Neurology Medical News about hippocampal volumetry, hippocampal sclerosis, temporal lobe epilepsy

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Hippocampal volume assessment in temporal lobe epilepsy: How good is automated segmentation?
Epilepsia, 08/24/09

Pardoe HR et al. – Expert manual hippocampal volumetry is more sensitive than both automated methods for the detection of hippocampal atrophy associated with mesial temporal lobe epilepsy with hippocampal sclerosis (mTLE). Freesurfer was the most sensitive to hippocampal atrophy in mTLE and is an alternative if expert manual segmentation is unavailable.

Methods

Comparison of 2 automated hippocampal volume methodologies and manual hippocampal volumetry to determine which technique is most sensitive for the detection of hippocampal atrophy in mTLE
Acquistion of 3D volumetric sequence in 10 pts with left-lateralized mTLE and 10 age-matched controls
Manual measurement of hippocampal volumes
Use of software packages Freesurfer and FSL-FIRST
Comparison of sensitivities of techniques by determining effect size for average volume reduction in pts with mTLE vs controls
Comparison of volumes and spatial overlap of automated and manual segmentations

Results

Significant volume reduction in affected hippocampi in mTLE vs controls on manual hippocampal volume measurement (effect size 33.2%), Freesurfer (effect size 20.8%), and FSL-FIRST (effect size 13.6%) after correction for brain volume
Freesurfer correlated reasonably with this manual segmentation and correlated relatively poorly with FSL-FIRST
Spatial overlap between manual and automated segmentation reduced in affected hippocampi, suggesting accuracy of automated segmentation is reduced in pathologic brains

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