title: Automatic temporal lobe atrophy assessment in prodromal AD: Data from the DESCRIPA study.
abstract: BACKGROUND
  In the framework of the clinical validation of research tools, this investigation presents a validation study of an automatic medial temporal lobe atrophy measure that is applied to a naturalistic population sampled from memory clinic patients across Europe.
  
  
  METHODS
  The procedure was developed on 1.5-T magnetic resonance images from the Alzheimer's Disease Neuroimaging Initiative database, and it was validated on an independent data set coming from the DESCRIPA study. All images underwent an automatic processing procedure to assess tissue atrophy that was targeted at the hippocampal region. For each subject, the procedure returns a classification index. Once provided with the clinical assessment at baseline and follow-up, subjects were grouped into cohorts to assess classification performance. Each cohort was divided into converters (co) and nonconverters (nc) depending on the clinical outcome at follow-up visit.
  
  
  RESULTS
  We found the area under the receiver operating characteristic curve (AUC) was 0.81 for all co versus nc subjects, and AUC was 0.90 for subjective memory complaint (SMCnc) versus all co subjects. Furthermore, when training on mild cognitive impairment (MCI-nc/MCI-co), the classification performance generally exceeds that found when training on controls versus Alzheimer's disease (CTRL/AD).
  
  
  CONCLUSIONS
  Automatic magnetic resonance imaging analysis may assist clinical classification of subjects in a memory clinic setting even when images are not specifically acquired for automatic analysis.
authors.affiliation: Istituto Nazionale di Fisica Nucleare, Sezione di Genova, Genova, Italy. Electronic address: andrea.chincarini@ge.infn.it.
authors.forename: Andrea
authors.initials: A
authors.lastname: Chincarini
authors.affiliation: Istituto Nazionale di Fisica Nucleare, Sezione di Genova, Genova, Italy; Dipartimento di Fisica, Università degli Studi di Genova, Genova, Italy.
authors.forename: Paolo
authors.initials: P
authors.lastname: Bosco
authors.affiliation: Istituto Nazionale di Fisica Nucleare, Sezione di Genova, Genova, Italy.
authors.forename: Gianluca
authors.initials: G
authors.lastname: Gemme
authors.affiliation: Istituto Nazionale di Fisica Nucleare, Sezione di Genova, Genova, Italy; Dipartimento di Fisica, Università degli Studi di Genova, Genova, Italy.
authors.forename: Mario
authors.initials: M
authors.lastname: Esposito
authors.affiliation: Istituto Nazionale di Fisica Nucleare, Sezione di Genova, Genova, Italy; Dipartimento di Fisica, Università degli Studi di Genova, Genova, Italy.
authors.forename: Luca
authors.initials: L
authors.lastname: Rei
authors.affiliation: Istituto Nazionale di Fisica Nucleare, Sezione di Genova, Genova, Italy; Dipartimento di Fisica, Università degli Studi di Genova, Genova, Italy.
authors.forename: Sandro
authors.initials: S
authors.lastname: Squarcia
authors.affiliation: Dipartimento Interateneo di Fisica "M. Merlin" and TIRES, Università degli Studi di Bari, Bari, Italy; Istituto Nazionale di Fisica Nucleare, Sezione di Bari, Bari, Italy.
authors.forename: Roberto
authors.initials: R
authors.lastname: Bellotti
authors.affiliation: Clinical Memory Research Unit, Department of Clinical Sciences, Malmö Lund University, Malmo, Sweden.
authors.forename: Lennart
authors.initials: L
authors.lastname: Minthon
authors.affiliation: IRCCS Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Frisoni
authors.affiliation: Alzheimer Centre, Department of Neurology, VU University Medical Centre, Amsterdam, The Netherlands.
authors.forename: Philip
authors.initials: P
authors.lastname: Scheltens
authors.affiliation: Department of Geriatric Psychiatry, Zentralinstitut für Seelische Gesundheit, University of Heidelberg, Mannheim, Germany.
authors.forename: Lutz
authors.initials: L
authors.lastname: Frölich
authors.affiliation: Department of Neurology, University of Eastern Finland and Kuopio University Hospital, Kuopio, Finland.
authors.forename: Hilkka
authors.initials: H
authors.lastname: Soininen
authors.affiliation: Alzheimer Centre, Department of Neurology, VU University Medical Centre, Amsterdam, The Netherlands; Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University, Maastricht, The Netherlands.
authors.forename: Pieter-Jelle
authors.initials: PJ
authors.lastname: Visser
authors.affiliation: Neurofisiologia Clinica, Dipartimento di Neuroscienze, Oftalmologia e Genetica, Azienda Ospedale-Università S. Martino, Genova, Italy.
authors.forename: Flavio
authors.initials: F
authors.lastname: Nobili
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000150:complications*; D001284:Atrophy / Q000175:diagnosis; D060825:Cognitive Dysfunction / Q000175:diagnosis / Q000209:etiology; D016208:Databases, Factual / Q000706:statistics & numerical data; D005260:Female; D005500:Follow-Up Studies; D006624:Hippocampus / Q000473:pathology; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods*; D008279:Magnetic Resonance Imaging; D008297:Male; D008609:Mental Status Schedule; D062706:Prodromal Symptoms; D015203:Reproducibility of Results; D013702:Temporal Lobe / Q000473:pathology*
keywords: Alzheimer's disease; Hippocampus; Image analysis; MRI; Medial temporal lobe; Memory clinics; Naturalistic population