title: Improved segmentation of cerebellar structures in children.
abstract: BACKGROUND
  Consistent localization of cerebellar cortex in a standard coordinate system is important for functional studies and detection of anatomical alterations in studies of morphometry. To date, no pediatric cerebellar atlas is available.
  
  
  METHODS
  The probabilistic Cape Town Pediatric Cerebellar Atlas (CAPCA18) was constructed in the age-appropriate National Institute of Health Pediatric Database asymmetric template space using manual tracings of 16 cerebellar compartments in 18 healthy children (9-13 years) from Cape Town, South Africa. The individual atlases of the training subjects were also used to implement multi atlas label fusion using multi atlas majority voting (MAMV) and multi atlas generative model (MAGM) approaches. Segmentation accuracy in 14 test subjects was compared for each method to 'gold standard' manual tracings.
  
  
  RESULTS
  Spatial overlap between manual tracings and CAPCA18 automated segmentation was 73% or higher for all lobules in both hemispheres, except VIIb and X. Automated segmentation using MAGM yielded the best segmentation accuracy over all lobules (mean Dice Similarity Coefficient 0.76; range 0.55-0.91; mean Hausdorff distance 0.9 mm; range 0.8-2.7 mm).
  
  
  METHODS
  In all lobules, spatial overlap of CAPCA18 segmentations with manual tracings was similar or higher than those obtained with SUIT (spatially unbiased infra-tentorial template), providing additional evidence of the benefits of an age appropriate atlas. MAGM segmentation accuracy was comparable to values reported recently by Park et al. (Neuroimage 2014;95(1):217) in adults (across all lobules mean DSC=0.73, range 0.40-0.89).
  
  
  CONCLUSIONS
  CAPCA18 and the associated multi-subject atlases of the training subjects yield improved segmentation of cerebellar structures in children.
authors.affiliation: Department of Human Biology, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa; MRC/UCT Medical Imaging Research Unit, Division of Biomedical Engineering, University of Cape Town, Cape Town, South Africa. Electronic address: priyalakshmi79@gmail.com.
authors.forename: Priya Lakshmi
authors.initials: PL
authors.lastname: Narayanan
authors.affiliation: Department of Human Biology, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa.
authors.forename: Christopher
authors.initials: C
authors.lastname: Warton
authors.affiliation: Department of Human Biology, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa.
authors.forename: Natalie
authors.initials: N
authors.lastname: Rosella Boonzaier
authors.affiliation: Department of Psychiatry and Mental Health, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa.
authors.forename: Christopher D
authors.initials: CD
authors.lastname: Molteno
authors.affiliation: Department of Human Biology, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa; MRC/UCT Medical Imaging Research Unit, Division of Biomedical Engineering, University of Cape Town, Cape Town, South Africa.
authors.forename: Jesuchristopher
authors.initials: J
authors.lastname: Joseph
authors.affiliation: Department of Human Biology, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa; Department of Psychiatry and Mental Health, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa; Department of Psychiatry and Behavioral Neurosciences, Wayne State University School of Medicine, Detroit, MI, United States.
authors.forename: Joseph L
authors.initials: JL
authors.lastname: Jacobson
authors.affiliation: Department of Human Biology, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa; Department of Psychiatry and Mental Health, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa; Department of Psychiatry and Behavioral Neurosciences, Wayne State University School of Medicine, Detroit, MI, United States.
authors.forename: Sandra W
authors.initials: SW
authors.lastname: Jacobson
authors.affiliation: Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Boston, MA, United States.
authors.forename: Lilla
authors.initials: L
authors.lastname: Zöllei
authors.affiliation: Department of Human Biology, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa; MRC/UCT Medical Imaging Research Unit, Division of Biomedical Engineering, University of Cape Town, Cape Town, South Africa.
authors.forename: Ernesta M
authors.initials: EM
authors.lastname: Meintjes
mesh_terms: D000293:Adolescent; D000716:Anatomy, Artistic; D001271:Atlases as Topic; D001931:Brain Mapping; D002531:Cerebellum / Q000033:anatomy & histology* / Q000000981:diagnostic imaging*; D002648:Child; D016208:Databases, Factual / Q000706:statistics & numerical data; D007839:Functional Laterality; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008279:Magnetic Resonance Imaging
keywords: CAPCA18; Cerebellum; Multi atlas segmentation; Pediatric probabilistic atlas