Towards validation in clinical routine: a comparative analysis of visual MTA ratings versus the automated ratio between inferior lateral ventricle and hippocampal volumes in Alzheimer’s disease diagnosis
Purpose To assess the performance of the inferior lateral ventricle (ILV) to hippocampal (Hip) volume ratio on brain MRI, for Alzheimer’s disease (AD) diagnostics, comparing it to individual automated ILV and hippocampal volumes, and visual medial temporal lobe atrophy (MTA) consensus ratings. Metho...
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| Veröffentlicht in: | Neuroradiology 2024-04, Vol.66 (4), p.487-506 |
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| creator | Wittens, Mandy M. J. Allemeersch, Gert-Jan Sima, Diana M. Vanderhasselt, Tim Raeymaeckers, Steven Fransen, Erik Smeets, Dirk de Mey, Johan Bjerke, Maria Engelborghs, Sebastiaan |
| description | Purpose
To assess the performance of the inferior lateral ventricle (ILV) to hippocampal (Hip) volume ratio on brain MRI, for Alzheimer’s disease (AD) diagnostics, comparing it to individual automated ILV and hippocampal volumes, and visual medial temporal lobe atrophy (MTA) consensus ratings.
Methods
One-hundred-twelve subjects (
mean age
±
SD
, 66.85 ± 13.64 years) with varying degrees of cognitive decline underwent MRI using a Philips Ingenia 3T. The MTA scale by Scheltens, rated on coronal 3D T1-weighted images, was determined by three experienced radiologists, blinded to diagnosis and sex. Automated volumetry was computed by icobrain dm (v. 5.10) for total, left, right hippocampal, and ILV volumes. The ILV/Hip ratio, defined as the percentage ratio between ILV and hippocampal volumes, was calculated and compared against a normative reference population (
n
= 1903). Inter-rater agreement, association, classification accuracy, and clinical interpretability on patient level were reported.
Results
Visual MTA scores showed excellent inter-rater agreement. Ordinal logistic regression and correlation analyses demonstrated robust associations between automated brain segmentations and visual MTA ratings, with the ILV/Hip ratio consistently outperforming individual hippocampal and ILV volumes. Pairwise classification accuracy showed good performance without statistically significant differences between the ILV/Hip ratio and visual MTA across disease stages, indicating potential interchangeability. Comparison to the normative population and clinical interpretability assessments showed commensurability in classifying MTA “severity” between visual MTA and ILV/Hip ratio measurements.
Conclusion
The ILV/Hip ratio shows the highest correlation to visual MTA, in comparison to automated individual ILV and hippocampal volumes, offering standardized measures for diagnostic support in different stages of cognitive decline. |
| doi_str_mv | 10.1007/s00234-024-03280-8 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_10937807</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2929059436</sourcerecordid><originalsourceid>FETCH-LOGICAL-c426t-b54eadfe87ab460ba21a8650f0aa23d63f90695051b0d1fcf52837a2ddb66d4c3</originalsourceid><addsrcrecordid>eNp9kk2O1DAQhSMEYpqBC7BAltiwCVTs_DhsUGvEnzSITbO2KnGl2yPHbuykR8OKa3AoLsFJcKaH4WfBwvLiffXqWX5Z9riA5wVA8yICcFHmwNMRXEIu72SrohQ8L1oOd7NV0mUu2hJOsgcxXgCAaERzPzsRkpfQ1M0q-77xlxh0ZAe0RuNkvGPGsd4aZ3q0LPh5Mo5eMmS9H_cYEnIghg7tVTSR-YEdTJwT-WGzZovqtsmMQpwjm3aJnCc_4kT6WvSso-mSaFkyUDA-MJvEkOYP5KZgeruYa7Yz-73vMW1MirfzSHHJtbZfdmRGCj--fotMm0gYKd24dT7FeZjdG9BGenRzn2af3rzenL3Lzz--fX-2Ps_7ktdT3lUloR5INtiVNXTIC5R1BQMgcqFrMbRQtxVURQe6GPqh4lI0yLXu6lqXvTjNXh1993M3ku6X6GjVPpgRw5XyaNTfijM7tfUHVUArGglNcnh24xD855nipEYTe7IWHfk5Kt7yFqq2FHVCn_6DXvg5pA9YqKoupWzaNlH8SPXBxxhouE1TgFrqoo51Uaku6rouSqahJ3--43bkVz8SII5ATJLbUvi9-z-2PwGOQtMD</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2956488799</pqid></control><display><type>article</type><title>Towards validation in clinical routine: a comparative analysis of visual MTA ratings versus the automated ratio between inferior lateral ventricle and hippocampal volumes in Alzheimer’s disease diagnosis</title><source>SpringerLink Journals - AutoHoldings</source><creator>Wittens, Mandy M. J. ; Allemeersch, Gert-Jan ; Sima, Diana M. ; Vanderhasselt, Tim ; Raeymaeckers, Steven ; Fransen, Erik ; Smeets, Dirk ; de Mey, Johan ; Bjerke, Maria ; Engelborghs, Sebastiaan</creator><creatorcontrib>Wittens, Mandy M. J. ; Allemeersch, Gert-Jan ; Sima, Diana M. ; Vanderhasselt, Tim ; Raeymaeckers, Steven ; Fransen, Erik ; Smeets, Dirk ; de Mey, Johan ; Bjerke, Maria ; Engelborghs, Sebastiaan</creatorcontrib><description>Purpose
To assess the performance of the inferior lateral ventricle (ILV) to hippocampal (Hip) volume ratio on brain MRI, for Alzheimer’s disease (AD) diagnostics, comparing it to individual automated ILV and hippocampal volumes, and visual medial temporal lobe atrophy (MTA) consensus ratings.
Methods
One-hundred-twelve subjects (
mean age
±
SD
, 66.85 ± 13.64 years) with varying degrees of cognitive decline underwent MRI using a Philips Ingenia 3T. The MTA scale by Scheltens, rated on coronal 3D T1-weighted images, was determined by three experienced radiologists, blinded to diagnosis and sex. Automated volumetry was computed by icobrain dm (v. 5.10) for total, left, right hippocampal, and ILV volumes. The ILV/Hip ratio, defined as the percentage ratio between ILV and hippocampal volumes, was calculated and compared against a normative reference population (
n
= 1903). Inter-rater agreement, association, classification accuracy, and clinical interpretability on patient level were reported.
Results
Visual MTA scores showed excellent inter-rater agreement. Ordinal logistic regression and correlation analyses demonstrated robust associations between automated brain segmentations and visual MTA ratings, with the ILV/Hip ratio consistently outperforming individual hippocampal and ILV volumes. Pairwise classification accuracy showed good performance without statistically significant differences between the ILV/Hip ratio and visual MTA across disease stages, indicating potential interchangeability. Comparison to the normative population and clinical interpretability assessments showed commensurability in classifying MTA “severity” between visual MTA and ILV/Hip ratio measurements.
Conclusion
The ILV/Hip ratio shows the highest correlation to visual MTA, in comparison to automated individual ILV and hippocampal volumes, offering standardized measures for diagnostic support in different stages of cognitive decline.</description><identifier>ISSN: 0028-3940</identifier><identifier>EISSN: 1432-1920</identifier><identifier>DOI: 10.1007/s00234-024-03280-8</identifier><identifier>PMID: 38240767</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer Berlin Heidelberg</publisher><subject>Alzheimer's disease ; Atrophy ; Authorship ; Automation ; Biomarkers ; Brain ; Brain research ; Cerebrospinal fluid ; Classification ; Clinical medicine ; Cognitive ability ; Comparative analysis ; Correlation analysis ; Dementia ; Diagnosis ; Diagnostic Neuroradiology ; Hippocampus ; Imaging ; Magnetic resonance imaging ; Medical diagnosis ; Medicine ; Medicine & Public Health ; Neurodegenerative diseases ; Neurology ; Neuropsychology ; Neuroradiology ; Neurosciences ; Neurosurgery ; Patients ; Performance assessment ; Radiology ; Ratings ; Ratings & rankings ; Robustness (mathematics) ; Statistical analysis ; Temporal lobe ; Ventricle ; Ventricles (cerebral)</subject><ispartof>Neuroradiology, 2024-04, Vol.66 (4), p.487-506</ispartof><rights>The Author(s) 2024</rights><rights>2024. The Author(s).</rights><rights>The Author(s) 2024. This work is published under http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c426t-b54eadfe87ab460ba21a8650f0aa23d63f90695051b0d1fcf52837a2ddb66d4c3</cites><orcidid>0000-0001-5253-3106</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00234-024-03280-8$$EPDF$$P50$$Gspringer$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00234-024-03280-8$$EHTML$$P50$$Gspringer$$Hfree_for_read</linktohtml><link.rule.ids>230,314,780,784,885,27923,27924,41487,42556,51318</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/38240767$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Wittens, Mandy M. J.</creatorcontrib><creatorcontrib>Allemeersch, Gert-Jan</creatorcontrib><creatorcontrib>Sima, Diana M.</creatorcontrib><creatorcontrib>Vanderhasselt, Tim</creatorcontrib><creatorcontrib>Raeymaeckers, Steven</creatorcontrib><creatorcontrib>Fransen, Erik</creatorcontrib><creatorcontrib>Smeets, Dirk</creatorcontrib><creatorcontrib>de Mey, Johan</creatorcontrib><creatorcontrib>Bjerke, Maria</creatorcontrib><creatorcontrib>Engelborghs, Sebastiaan</creatorcontrib><title>Towards validation in clinical routine: a comparative analysis of visual MTA ratings versus the automated ratio between inferior lateral ventricle and hippocampal volumes in Alzheimer’s disease diagnosis</title><title>Neuroradiology</title><addtitle>Neuroradiology</addtitle><addtitle>Neuroradiology</addtitle><description>Purpose
To assess the performance of the inferior lateral ventricle (ILV) to hippocampal (Hip) volume ratio on brain MRI, for Alzheimer’s disease (AD) diagnostics, comparing it to individual automated ILV and hippocampal volumes, and visual medial temporal lobe atrophy (MTA) consensus ratings.
Methods
One-hundred-twelve subjects (
mean age
±
SD
, 66.85 ± 13.64 years) with varying degrees of cognitive decline underwent MRI using a Philips Ingenia 3T. The MTA scale by Scheltens, rated on coronal 3D T1-weighted images, was determined by three experienced radiologists, blinded to diagnosis and sex. Automated volumetry was computed by icobrain dm (v. 5.10) for total, left, right hippocampal, and ILV volumes. The ILV/Hip ratio, defined as the percentage ratio between ILV and hippocampal volumes, was calculated and compared against a normative reference population (
n
= 1903). Inter-rater agreement, association, classification accuracy, and clinical interpretability on patient level were reported.
Results
Visual MTA scores showed excellent inter-rater agreement. Ordinal logistic regression and correlation analyses demonstrated robust associations between automated brain segmentations and visual MTA ratings, with the ILV/Hip ratio consistently outperforming individual hippocampal and ILV volumes. Pairwise classification accuracy showed good performance without statistically significant differences between the ILV/Hip ratio and visual MTA across disease stages, indicating potential interchangeability. Comparison to the normative population and clinical interpretability assessments showed commensurability in classifying MTA “severity” between visual MTA and ILV/Hip ratio measurements.
Conclusion
The ILV/Hip ratio shows the highest correlation to visual MTA, in comparison to automated individual ILV and hippocampal volumes, offering standardized measures for diagnostic support in different stages of cognitive decline.</description><subject>Alzheimer's disease</subject><subject>Atrophy</subject><subject>Authorship</subject><subject>Automation</subject><subject>Biomarkers</subject><subject>Brain</subject><subject>Brain research</subject><subject>Cerebrospinal fluid</subject><subject>Classification</subject><subject>Clinical medicine</subject><subject>Cognitive ability</subject><subject>Comparative analysis</subject><subject>Correlation analysis</subject><subject>Dementia</subject><subject>Diagnosis</subject><subject>Diagnostic Neuroradiology</subject><subject>Hippocampus</subject><subject>Imaging</subject><subject>Magnetic resonance imaging</subject><subject>Medical diagnosis</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Neurodegenerative diseases</subject><subject>Neurology</subject><subject>Neuropsychology</subject><subject>Neuroradiology</subject><subject>Neurosciences</subject><subject>Neurosurgery</subject><subject>Patients</subject><subject>Performance assessment</subject><subject>Radiology</subject><subject>Ratings</subject><subject>Ratings & rankings</subject><subject>Robustness (mathematics)</subject><subject>Statistical analysis</subject><subject>Temporal lobe</subject><subject>Ventricle</subject><subject>Ventricles (cerebral)</subject><issn>0028-3940</issn><issn>1432-1920</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><sourceid>C6C</sourceid><recordid>eNp9kk2O1DAQhSMEYpqBC7BAltiwCVTs_DhsUGvEnzSITbO2KnGl2yPHbuykR8OKa3AoLsFJcKaH4WfBwvLiffXqWX5Z9riA5wVA8yICcFHmwNMRXEIu72SrohQ8L1oOd7NV0mUu2hJOsgcxXgCAaERzPzsRkpfQ1M0q-77xlxh0ZAe0RuNkvGPGsd4aZ3q0LPh5Mo5eMmS9H_cYEnIghg7tVTSR-YEdTJwT-WGzZovqtsmMQpwjm3aJnCc_4kT6WvSso-mSaFkyUDA-MJvEkOYP5KZgeruYa7Yz-73vMW1MirfzSHHJtbZfdmRGCj--fotMm0gYKd24dT7FeZjdG9BGenRzn2af3rzenL3Lzz--fX-2Ps_7ktdT3lUloR5INtiVNXTIC5R1BQMgcqFrMbRQtxVURQe6GPqh4lI0yLXu6lqXvTjNXh1993M3ku6X6GjVPpgRw5XyaNTfijM7tfUHVUArGglNcnh24xD855nipEYTe7IWHfk5Kt7yFqq2FHVCn_6DXvg5pA9YqKoupWzaNlH8SPXBxxhouE1TgFrqoo51Uaku6rouSqahJ3--43bkVz8SII5ATJLbUvi9-z-2PwGOQtMD</recordid><startdate>20240401</startdate><enddate>20240401</enddate><creator>Wittens, Mandy M. J.</creator><creator>Allemeersch, Gert-Jan</creator><creator>Sima, Diana M.</creator><creator>Vanderhasselt, Tim</creator><creator>Raeymaeckers, Steven</creator><creator>Fransen, Erik</creator><creator>Smeets, Dirk</creator><creator>de Mey, Johan</creator><creator>Bjerke, Maria</creator><creator>Engelborghs, Sebastiaan</creator><general>Springer Berlin Heidelberg</general><general>Springer Nature B.V</general><scope>C6C</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QO</scope><scope>7TK</scope><scope>7U7</scope><scope>8FD</scope><scope>C1K</scope><scope>FR3</scope><scope>K9.</scope><scope>NAPCQ</scope><scope>P64</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0001-5253-3106</orcidid></search><sort><creationdate>20240401</creationdate><title>Towards validation in clinical routine: a comparative analysis of visual MTA ratings versus the automated ratio between inferior lateral ventricle and hippocampal volumes in Alzheimer’s disease diagnosis</title><author>Wittens, Mandy M. J. ; Allemeersch, Gert-Jan ; Sima, Diana M. ; Vanderhasselt, Tim ; Raeymaeckers, Steven ; Fransen, Erik ; Smeets, Dirk ; de Mey, Johan ; Bjerke, Maria ; Engelborghs, Sebastiaan</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c426t-b54eadfe87ab460ba21a8650f0aa23d63f90695051b0d1fcf52837a2ddb66d4c3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>Alzheimer's disease</topic><topic>Atrophy</topic><topic>Authorship</topic><topic>Automation</topic><topic>Biomarkers</topic><topic>Brain</topic><topic>Brain research</topic><topic>Cerebrospinal fluid</topic><topic>Classification</topic><topic>Clinical medicine</topic><topic>Cognitive ability</topic><topic>Comparative analysis</topic><topic>Correlation analysis</topic><topic>Dementia</topic><topic>Diagnosis</topic><topic>Diagnostic Neuroradiology</topic><topic>Hippocampus</topic><topic>Imaging</topic><topic>Magnetic resonance imaging</topic><topic>Medical diagnosis</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Neurodegenerative diseases</topic><topic>Neurology</topic><topic>Neuropsychology</topic><topic>Neuroradiology</topic><topic>Neurosciences</topic><topic>Neurosurgery</topic><topic>Patients</topic><topic>Performance assessment</topic><topic>Radiology</topic><topic>Ratings</topic><topic>Ratings & rankings</topic><topic>Robustness (mathematics)</topic><topic>Statistical analysis</topic><topic>Temporal lobe</topic><topic>Ventricle</topic><topic>Ventricles (cerebral)</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Wittens, Mandy M. J.</creatorcontrib><creatorcontrib>Allemeersch, Gert-Jan</creatorcontrib><creatorcontrib>Sima, Diana M.</creatorcontrib><creatorcontrib>Vanderhasselt, Tim</creatorcontrib><creatorcontrib>Raeymaeckers, Steven</creatorcontrib><creatorcontrib>Fransen, Erik</creatorcontrib><creatorcontrib>Smeets, Dirk</creatorcontrib><creatorcontrib>de Mey, Johan</creatorcontrib><creatorcontrib>Bjerke, Maria</creatorcontrib><creatorcontrib>Engelborghs, Sebastiaan</creatorcontrib><collection>Springer Nature OA Free Journals</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Biotechnology Research Abstracts</collection><collection>Neurosciences Abstracts</collection><collection>Toxicology Abstracts</collection><collection>Technology Research Database</collection><collection>Environmental Sciences and Pollution Management</collection><collection>Engineering Research Database</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Premium</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Neuroradiology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Wittens, Mandy M. J.</au><au>Allemeersch, Gert-Jan</au><au>Sima, Diana M.</au><au>Vanderhasselt, Tim</au><au>Raeymaeckers, Steven</au><au>Fransen, Erik</au><au>Smeets, Dirk</au><au>de Mey, Johan</au><au>Bjerke, Maria</au><au>Engelborghs, Sebastiaan</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Towards validation in clinical routine: a comparative analysis of visual MTA ratings versus the automated ratio between inferior lateral ventricle and hippocampal volumes in Alzheimer’s disease diagnosis</atitle><jtitle>Neuroradiology</jtitle><stitle>Neuroradiology</stitle><addtitle>Neuroradiology</addtitle><date>2024-04-01</date><risdate>2024</risdate><volume>66</volume><issue>4</issue><spage>487</spage><epage>506</epage><pages>487-506</pages><issn>0028-3940</issn><eissn>1432-1920</eissn><abstract>Purpose
To assess the performance of the inferior lateral ventricle (ILV) to hippocampal (Hip) volume ratio on brain MRI, for Alzheimer’s disease (AD) diagnostics, comparing it to individual automated ILV and hippocampal volumes, and visual medial temporal lobe atrophy (MTA) consensus ratings.
Methods
One-hundred-twelve subjects (
mean age
±
SD
, 66.85 ± 13.64 years) with varying degrees of cognitive decline underwent MRI using a Philips Ingenia 3T. The MTA scale by Scheltens, rated on coronal 3D T1-weighted images, was determined by three experienced radiologists, blinded to diagnosis and sex. Automated volumetry was computed by icobrain dm (v. 5.10) for total, left, right hippocampal, and ILV volumes. The ILV/Hip ratio, defined as the percentage ratio between ILV and hippocampal volumes, was calculated and compared against a normative reference population (
n
= 1903). Inter-rater agreement, association, classification accuracy, and clinical interpretability on patient level were reported.
Results
Visual MTA scores showed excellent inter-rater agreement. Ordinal logistic regression and correlation analyses demonstrated robust associations between automated brain segmentations and visual MTA ratings, with the ILV/Hip ratio consistently outperforming individual hippocampal and ILV volumes. Pairwise classification accuracy showed good performance without statistically significant differences between the ILV/Hip ratio and visual MTA across disease stages, indicating potential interchangeability. Comparison to the normative population and clinical interpretability assessments showed commensurability in classifying MTA “severity” between visual MTA and ILV/Hip ratio measurements.
Conclusion
The ILV/Hip ratio shows the highest correlation to visual MTA, in comparison to automated individual ILV and hippocampal volumes, offering standardized measures for diagnostic support in different stages of cognitive decline.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer Berlin Heidelberg</pub><pmid>38240767</pmid><doi>10.1007/s00234-024-03280-8</doi><tpages>20</tpages><orcidid>https://orcid.org/0000-0001-5253-3106</orcidid><oa>free_for_read</oa></addata></record> |
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| subjects | Alzheimer's disease Atrophy Authorship Automation Biomarkers Brain Brain research Cerebrospinal fluid Classification Clinical medicine Cognitive ability Comparative analysis Correlation analysis Dementia Diagnosis Diagnostic Neuroradiology Hippocampus Imaging Magnetic resonance imaging Medical diagnosis Medicine Medicine & Public Health Neurodegenerative diseases Neurology Neuropsychology Neuroradiology Neurosciences Neurosurgery Patients Performance assessment Radiology Ratings Ratings & rankings Robustness (mathematics) Statistical analysis Temporal lobe Ventricle Ventricles (cerebral) |
| title | Towards validation in clinical routine: a comparative analysis of visual MTA ratings versus the automated ratio between inferior lateral ventricle and hippocampal volumes in Alzheimer’s disease diagnosis |
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