title: Automated cerebellar segmentation: Validation and application to detect smaller volumes in children prenatally exposed to alcohol.
abstract: OBJECTIVE
  To validate an automated cerebellar segmentation method based on active shape and appearance modeling and then segment the cerebellum on images acquired from adolescents with histories of prenatal alcohol exposure (PAE) and non-exposed controls (NC).
  
  
  METHODS
  Automated segmentations of the total cerebellum, right and left cerebellar hemispheres, and three vermal lobes (anterior, lobules I-V; superior posterior, lobules VI-VII; inferior posterior, lobules VIII-X) were compared to expert manual labelings on 20 subjects, studied twice, that were not used for model training. The method was also used to segment the cerebellum on 11 PAE and 9 NC adolescents.
  
  
  RESULTS
  The test-retest intraclass correlation coefficients (ICCs) of the automated method were greater than 0.94 for all cerebellar volume and mid-sagittal vermal area measures, comparable or better than the test-retest ICCs for manual measurement (all ICCs > 0.92). The ICCs computed on all four cerebellar measurements (manual and automated measures on the repeat scans) to compare comparability were above 0.97 for non-vermis parcels, and above 0.89 for vermis parcels. When applied to patients, the automated method detected smaller cerebellar volumes and mid-sagittal areas in the PAE group compared to controls (p < 0.05 for all regions except the superior posterior lobe, consistent with prior studies).
  
  
  CONCLUSIONS
  These results demonstrate excellent reliability and validity of automated cerebellar volume and mid-sagittal area measurements, compared to manual measurements. These data also illustrate that this new technology for automatically delineating the cerebellum leads to conclusions regarding the effects of prenatal alcohol exposure on the cerebellum consistent with prior studies that used labor intensive manual delineation, even with a very small sample.
authors: Neurobehavioral Research, Inc., Ala Moana Pacific Center, 1585 Kapiolani Blvd., Suite 1030, Honolulu, HI 96814, USA.
authors: Valerie A
authors: VA
authors: Cardenas
authors: Neurobehavioral Research, Inc., Ala Moana Pacific Center, 1585 Kapiolani Blvd., Suite 1030, Honolulu, HI 96814, USA.
authors: Mathew
authors: M
authors: Price
authors: Center for Behavioral Teratology, San Diego State University, San Diego, CA 92120, USA.
authors: M Alejandra
authors: MA
authors: Infante
authors: Center for Behavioral Teratology, San Diego State University, San Diego, CA 92120, USA.
authors: Eileen M
authors: EM
authors: Moore
authors: Center for Behavioral Teratology, San Diego State University, San Diego, CA 92120, USA ; Department of Psychology, San Diego State University, San Diego, CA 92182, USA.
authors: Sarah N
authors: SN
authors: Mattson
authors: Center for Behavioral Teratology, San Diego State University, San Diego, CA 92120, USA ; Department of Psychology, San Diego State University, San Diego, CA 92182, USA.
authors: Edward P
authors: EP
authors: Riley
authors: Neurobehavioral Research, Inc., Ala Moana Pacific Center, 1585 Kapiolani Blvd., Suite 1030, Honolulu, HI 96814, USA.
authors: George
authors: G
authors: Fein
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000437:Alcoholism / Q000473:pathology*; D000465:Algorithms; D001284:Atrophy / Q000473:pathology; D002531:Cerebellum / Q000473:pathology*; D002648:Child; D002675:Child, Preschool; D005260:Female; D063647:Fetal Alcohol Spectrum Disorders / Q000473:pathology*; D006801:Humans; D007089:Image Enhancement / Q000379:methods; D007090:Image Interpretation, Computer-Assisted / Q000379:methods; D021621:Imaging, Three-Dimensional / Q000379:methods*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D010363:Pattern Recognition, Automated / Q000379:methods*; D011247:Pregnancy; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D055815:Young Adult
keywords: Alcohol; Cerebellum; Fetal alcohol spectrum disorders (FASD); Segmentation; Vermis