title: Mesial Temporal Sclerosis: Accuracy of NeuroQuant versus Neuroradiologist.
abstract: OBJECTIVE
  We sought to compare the accuracy of a volumetric fully automated computer assessment of hippocampal volume asymmetry versus neuroradiologists' interpretations of the temporal lobes for mesial temporal sclerosis. Detecting mesial temporal sclerosis (MTS) is important for the evaluation of patients with temporal lobe epilepsy as it often guides surgical intervention. One feature of MTS is hippocampal volume loss.
  
  
  METHODS
  Electronic medical record and researcher reports of scans of patients with proved mesial temporal sclerosis were compared with volumetric assessment with an FDA-approved software package, NeuroQuant, for detection of mesial temporal sclerosis in 63 patients. The degree of volumetric asymmetry was analyzed to determine the neuroradiologists' threshold for detecting right-left asymmetry in temporal lobe volumes.
  
  
  RESULTS
  Thirty-six patients had left-lateralized MTS, 25 had right-lateralized MTS, and 2 had bilateral MTS. The estimated accuracy of the neuroradiologist was 72.6% with a κ statistic of 0.512 (95% CI, 0.315-0.710) [moderate agreement, P < 3 × 10(-6)]), whereas the estimated accuracy of NeuroQuant was 79.4% with a κ statistic of 0.588 (95% CI, 0.388-0.787) [moderate agreement, P < 2 × 10(-6)]). This discrepancy in accuracy was not statistically significant. When at least a 5%-10% volume discrepancy between temporal lobes was present, the neuroradiologists detected it 75%-80% of the time.
  
  
  CONCLUSIONS
  As a stand-alone fully automated software program that can process temporal lobe volume in 5-10 minutes, NeuroQuant compares favorably with trained neuroradiologists in predicting the side of mesial temporal sclerosis. Neuroradiologists can often detect even small temporal lobe volumetric changes visually.
authors.affiliation: From the Division of Neuroradiology (M.A., S.H.Y., D.M.Y.), The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins Medical Institutions, Baltimore, Maryland Department of Radiology (M.A.), Suez Canal University, Ismaïlia, Ismailia Governorate.
authors.forename: M
authors.initials: M
authors.lastname: Azab
authors.affiliation: Department of Biostatistics (M.C.), University of Washington, Seattle, Washington.
authors.forename: M
authors.initials: M
authors.lastname: Carone
authors.affiliation: From the Division of Neuroradiology (M.A., S.H.Y., D.M.Y.), The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins Medical Institutions, Baltimore, Maryland.
authors.forename: S H
authors.initials: SH
authors.lastname: Ying
authors.affiliation: From the Division of Neuroradiology (M.A., S.H.Y., D.M.Y.), The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins Medical Institutions, Baltimore, Maryland dyousem1@jhu.edu.
authors.forename: D M
authors.initials: DM
authors.lastname: Yousem
mesh_terms: D000328:Adult; D004833:Epilepsy, Temporal Lobe / Q000175:diagnosis* / Q000473:pathology; D005260:Female; D006624:Hippocampus / Q000473:pathology; D006801:Humans; D007090:Image Interpretation, Computer-Assisted / Q000379:methods*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009929:Organ Size; D012189:Retrospective Studies; D012598:Sclerosis / Q000473:pathology; D012984:Software; D013702:Temporal Lobe / Q000473:pathology*