Distribution characteristics, reproducibility, and precision of region of interest-based hippocampal diffusion tensor imaging measures.
OBJECTIVE
For adequate interpretation of diffusion tensor imaging (DTI) parameters empirical distribution characteristics, precision, and reproducibility should be known. The present study investigated distribution and reliability parameters of hippocampal fractional anisotropy (FA) and mean diffusivity (MD).


METHODS
FA and MD values were averaged in hippocampal regions of interest in 20 subjects (10 women and 10 men; age range, 25-69 years). Regions of interest were manually placed bilaterally by one investigator at 2 occasions, and by a second independent investigator. Sample distributions of FA and MD values were compared with normal distributions. Intraclass coefficients (ICCs), standard errors of measurement (SEMs), and coefficients of variation (CVs) with confidence intervals (CI95s) were computed.


RESULTS
The results did not show any deviation of averaged FA (0.237 +/- 0.017) and MD (775 +/- 28 microm2/s) values from normal distribution. Intraobserver reliability (ICC > or = 0.90) and precision (CV < or = 3.5%) were high for all measures. Interobserver reliability reached values of ICC > or = 0.84 and CV < or = 4.1%. FA yielded lower precision (CV 2.2-4.1%) than MD (CV 1.3-2.5%), CI95s were around +/-0.015-0.020 and +/-25-30 microm2/s for FA and MD, respectively. FA differences of 0.020-0.030 and MD differences of 40-50 microm2/s can be assumed to reflect reliably distinct values in hippocampal regions.


CONCLUSIONS
The results are in line with previous reports on reliability of DTI measures by using different designs and methodology. Notwithstanding the difficulties associated with region of interest-derived DTI measurements in hippocampal regions, the present approach provides estimates of distribution characteristics and precision applicable to routine assessments of DTI parameters in clinical and research context.
Department of Psychiatry, University of Mainz, Germany.
M J
MJ
Müller
M
M
Mazanek
C
C
Weibrich
P R
PR
Dellani
P
P
Stoeter
A
A
Fellgiebel
D000328:Adult; D000368:Aged; D038524:Diffusion Magnetic Resonance Imaging / Q000379:methods*; D005260:Female; D006624:Hippocampus / Q000033:anatomy & histology*; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods*; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D012016:Reference Values; D015203:Reproducibility of Results