A comparison between the accuracy of voxel-based morphometry and hippocampal volumetry in Alzheimer's disease.
OBJECTIVE
To compare the accuracy of voxel-based morphometry (VBM) and region of interest (ROI)-based hippocampal volumetry to detect medial temporal lobe atrophy in Alzheimer's disease (AD).


METHODS
A total of 27 AD patients (age 74 +/- 9 years; 22 women; Mini-Mental State Exam [MMSE] 21 +/- 4) and 25 controls (age 70 +/- 8; 16 women; MMSE 29 +/- 1) were studied. Accuracy of VBM to detect gray matter loss in those seven AD patients and 11 controls with similar ROI-based hippocampal measures and of ROI-based volumetry to detect gray matter loss in those four AD patients and five controls with similar VBM-based hippocampal measures was assessed. VBM was performed with statistical parametric mapping (SPM99).


RESULTS
The area under the curve was 0.96 (95% C.I., 0.92-1.00) for VBM, 0.89 (95% C.I., 0.80-0.98) for ROI-based hippocampal measures, and 0.99 (95% C.I., 0.96-1.00) for both. In subjects with similar ROI-based hippocampal measures, VBM detected atrophy in AD patients at P < 0.0001, while in subjects with similar VBM-based hippocampal measure, volumetry was not significant (P = 0.11). Both measures independently contributed to discrimination (P = 0.004 and P = 0.032) in a logistic regression model.


CONCLUSIONS
These results indicate that VBM is more accurate, but the combination of both methods provides the highest accuracy for detection of hippocampal atrophy in AD.
Laboratory of Epidemiology and Neuroimaging, IRCCS San Giovanni di Dio - FBF, Brescia, Italy.
Cristina
C
Testa
Mikko P
MP
Laakso
Francesca
F
Sabattoli
Roberta
R
Rossi
Alberto
A
Beltramello
Hilkka
H
Soininen
Giovanni B
GB
Frisoni
D000368:Aged; D000544:Alzheimer Disease / Q000175:diagnosis*; D019540:Area Under Curve; D001284:Atrophy / Q000175:diagnosis; D001927:Brain Diseases / Q000473:pathology*; D005260:Female; D006624:Hippocampus / Q000473:pathology*; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods; D021621:Imaging, Three-Dimensional / Q000379:methods; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D011237:Predictive Value of Tests; D012372:ROC Curve; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013702:Temporal Lobe / Q000473:pathology*