title: Comparison of automated brain volumetry methods with stereology in children aged 2 to 3 years.
abstract: BACKGROUND
  The accurate and precise measurement of brain volumes in young children is important for early identification of children with reduced brain volumes and an increased risk for neurodevelopmental impairment. Brain volumes can be measured from cerebral MRI (cMRI), but most neuroimaging tools used for cerebral segmentation and volumetry were developed for use in adults and have not been validated in infants or young children. Here, we investigate the feasibility and accuracy of three automated software methods (i.e., SPM, FSL, and FreeSurfer) for brain volumetry in young children and compare the measures with corresponding volumes obtained using the Cavalieri method of modern design stereology.
  
  
  METHODS
  Cerebral MRI data were collected from 21 children with a complex congenital heart disease (CHD) before Fontan procedure, at a median age of 27 months (range 20.9-42.4 months). Data were segmented with SPM, FSL, and FreeSurfer, and total intracranial volume (ICV) and total brain volume (TBV) were compared with corresponding measures obtained using the Cavalieri method.
  
  
  RESULTS
  Agreement between the estimated brain volumes (ICV and TBV) relative to the gold standard stereological volumes was strongest for FreeSurfer (p < 0.001) and moderate for SPM segment (ICV p = 0.05; TBV p = 0.006). No significant association was evident between ICV and TBV obtained using SPM NewSegment and FSL FAST and the corresponding stereological volumes.
  
  
  CONCLUSIONS
  FreeSurfer provides an accurate method for measuring brain volumes in young children, even in the presence of structural brain abnormalities.
authors.affiliation: Center for MR Research, University Children's Hospital of Zurich, Steinwiesstrasse 75, 8032, Zurich, Switzerland.|Pediatric Cardiology, University Children's Hospital, Zurich, Switzerland.
authors.forename: Kristina N
authors.initials: KN
authors.lastname: Mayer
authors.affiliation: Child Development Center, University Children's Hospital, Zurich, Switzerland.|Children's Research Center, University Children's Hospital, Zurich, Switzerland.
authors.forename: Beatrice
authors.initials: B
authors.lastname: Latal
authors.affiliation: Pediatric Cardiology, University Children's Hospital, Zurich, Switzerland.|Children's Research Center, University Children's Hospital, Zurich, Switzerland.
authors.forename: Walter
authors.initials: W
authors.lastname: Knirsch
authors.affiliation: Department for Diagnostic Neuroradiology, University Children's Hospital, Zurich, Switzerland.
authors.forename: Ianina
authors.initials: I
authors.lastname: Scheer
authors.affiliation: Child Development Center, University Children's Hospital, Zurich, Switzerland.
authors.forename: Michael
authors.initials: M
authors.lastname: von Rhein
authors.affiliation: Pediatric Heart Center, University Hospital Giessen, Justus-Liebig University, Giessen, Germany.
authors.forename: Bettina
authors.initials: B
authors.lastname: Reich
authors.affiliation: Pediatric Heart Center, University Hospital Giessen, Justus-Liebig University, Giessen, Germany.
authors.forename: Jürgen
authors.initials: J
authors.lastname: Bauer
authors.affiliation: Pediatric Heart Center, University Hospital Giessen, Justus-Liebig University, Giessen, Germany.
authors.forename: Kerstin
authors.initials: K
authors.lastname: Gummel
authors.affiliation: Clinical Research and Imaging Centre (CRIC), The Queens Medical Research Institute (QMRI), University of Edinburgh, Edinburgh, UK.
authors.forename: Neil
authors.initials: N
authors.lastname: Roberts
authors.affiliation: Center for MR Research, University Children's Hospital of Zurich, Steinwiesstrasse 75, 8032, Zurich, Switzerland. Ruth.Tuura@kispi.uzh.ch.|Children's Research Center, University Children's Hospital, Zurich, Switzerland. Ruth.Tuura@kispi.uzh.ch.
authors.forename: Ruth O'Gorman
authors.initials: RO
authors.lastname: Tuura
mesh_terms: D000465:Algorithms; D001921:Brain / Q000033:anatomy & histology* / Q000000981:diagnostic imaging*; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007089:Image Enhancement / Q000379:methods; D007090:Image Interpretation, Computer-Assisted / Q000379:methods*; D021621:Imaging, Three-Dimensional / Q000379:methods*; D007223:Infant; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D009929:Organ Size / Q000502:physiology; D010363:Pattern Recognition, Automated / Q000379:methods*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity
keywords: Brain segmentation; Brain volume; Children; Congenital heart disease; MRI