title: The impact of automated hippocampal volumetry on diagnostic confidence in patients with suspected Alzheimer's disease: A European Alzheimer's Disease Consortium study.
abstract: BACKGROUND
  Hippocampal volume is a core biomarker of Alzheimer's disease (AD). However, its contribution over the standard diagnostic workup is unclear.
  
  
  METHODS
  Three hundred fifty-six patients, under clinical evaluation for cognitive impairment, with suspected AD and Mini-Mental State Examination ≥20, were recruited across 17 European memory clinics. After the traditional diagnostic workup, diagnostic confidence of AD pathology (DCAD) was estimated by the physicians in charge. The latter were provided with the results of automated hippocampal volumetry in standardized format and DCAD was reassessed.
  
  
  RESULTS
  An increment of one interquartile range in hippocampal volume was associated with a mean change of DCAD of -8.0% (95% credible interval: [-11.5, -5.0]). Automated hippocampal volumetry showed a statistically significant impact on DCAD beyond the contributions of neuropsychology,18F-fluorodeoxyglucose positron emission tomography/single-photon emission computed tomography, and cerebrospinal fluid markers (-8.5, CrI: [-11.5, -5.6]; -14.1, CrI: [-19.3, -8.8]; -10.6, CrI: [-14.6, -6.1], respectively).
  
  
  CONCLUSIONS
  There is a measurable effect of hippocampal volume on DCAD even when used on top of the traditional diagnostic workup.
authors.affiliation: Laboratory of Alzheimer's Neuroimaging and Epidemiology, IRCCS Istituto Centro S. Giovanni di Dio Fatebenefratelli, Brescia, Italy.
authors.forename: Paolo
authors.initials: P
authors.lastname: Bosco
authors.affiliation: Laboratory of Alzheimer's Neuroimaging and Epidemiology, IRCCS Istituto Centro S. Giovanni di Dio Fatebenefratelli, Brescia, Italy.
authors.forename: Alberto
authors.initials: A
authors.lastname: Redolfi
authors.affiliation: Department of Neurodegenerative Disease, Dementia Research Centre, UCL Institute of Neurology, London, UK.
authors.forename: Martina
authors.initials: M
authors.lastname: Bocchetta
authors.affiliation: IRCCS Istituto Centro S. Giovanni di Dio Fatebenefratelli, Brescia, Italy.
authors.forename: Clarissa
authors.initials: C
authors.lastname: Ferrari
authors.affiliation: Laboratory of Alzheimer's Neuroimaging and Epidemiology, IRCCS Istituto Centro S. Giovanni di Dio Fatebenefratelli, Brescia, Italy.
authors.forename: Anna
authors.initials: A
authors.lastname: Mega
authors.affiliation: Laboratory of Alzheimer's Neuroimaging and Epidemiology, IRCCS Istituto Centro S. Giovanni di Dio Fatebenefratelli, Brescia, Italy.
authors.forename: Samantha
authors.initials: S
authors.lastname: Galluzzi
authors.affiliation: IXICO Plc, London, UK.
authors.forename: Mark
authors.initials: M
authors.lastname: Austin
authors.affiliation: INFN, Genova, Italy.
authors.forename: Andrea
authors.initials: A
authors.lastname: Chincarini
authors.affiliation: McConnell Brain Imaging Centre, Montreal Neurological Institute, McGill University, Montreal, Quebec, Canada; True Positive Medical Devices Inc., Quebec City, Quebec, Canada.
authors.forename: D Louis
authors.initials: DL
authors.lastname: Collins
authors.affiliation: True Positive Medical Devices Inc., Quebec City, Quebec, Canada.
authors.forename: Simon
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authors.lastname: Duchesne
authors.affiliation: Advanced Clinical Imaging Technology (HC CMEA SUI DI BM PI), Siemens Healthcare AG, Lausanne, Switzerland; Department of Radiology, University Hospital (CHUV), Lausanne, Switzerland; LTS5, École Polytechnique Fédérale de Lausanne, Lausanne, Switzerland.
authors.forename: Bénédicte
authors.initials: B
authors.lastname: Maréchal
authors.affiliation: Advanced Clinical Imaging Technology (HC CMEA SUI DI BM PI), Siemens Healthcare AG, Lausanne, Switzerland; Department of Radiology, University Hospital (CHUV), Lausanne, Switzerland; LTS5, École Polytechnique Fédérale de Lausanne, Lausanne, Switzerland.
authors.forename: Alexis
authors.initials: A
authors.lastname: Roche
authors.affiliation: INFN, Genova, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Sensi
authors.affiliation: IXICO Plc, London, UK.
authors.forename: Robin
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authors.affiliation: Alzheimer Research Center and Memory Clinic, Fundació ACE, Institut Català de Neurociències Aplicades, Barcelona, Spain.
authors.forename: Montserrat
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authors.lastname: Alegret
authors.affiliation: University Hospitals and University of Geneva, Geneva, Switzerland.
authors.forename: Frederic
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authors.affiliation: Alzheimer's and Other Cognitive Disorder Unit, Hospital Clinic, Barcelona, Spain.
authors.forename: Mircea
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authors.affiliation: GIGA-CRC In vivo Imaging and Memory Clinic, University of Liège, Liège, Belgium.
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authors.affiliation: First Department of Neurology, Eginition Hospital Kapodistrian University, Medical School of Athens, Athens, Greece.
authors.forename: Anastasia
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authors.affiliation: Department of Psychology, Dokuz Eylül University, Izmir, Turkey; Izmir International Biomedicine and Genome Center, Dokuz Eylul University, Izmir, Turkey.
authors.forename: Derya Durusu
authors.initials: DD
authors.lastname: Emek-Savaş
authors.affiliation: Reference Center for Biological Markers of Dementia (BIODEM), University of Antwerp, Antwerp, Belgium; Memory Clinic and Department of Neurology, Hospital Network Antwerp (ZNA) Hoge Beuken and Middelheim, Antwerp, Belgium.
authors.forename: Sebastiaan
authors.initials: S
authors.lastname: Engelborghs
authors.affiliation: Klinikum rechts der Isar, Technische Universität München, Munich, Germany.
authors.forename: Timo
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authors.affiliation: Radiology and Medical Imagery, Elias University Clinical Hospital, Bucharest, Romania.
authors.forename: Galina
authors.initials: G
authors.lastname: Grosu
authors.affiliation: Department of Neurology, Centre for Cognitive Impairments, University Medical Center Ljubljana, Ljubljana, Slovenia.
authors.forename: Milica G
authors.initials: MG
authors.lastname: Kramberger
authors.affiliation: Mercer's Institute for Successful Ageing, St. James's Hospital, Dublin, Ireland.
authors.forename: Brian
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authors.lastname: Lawlor
authors.affiliation: Institute of Neurology, CCS, Belgrade, Serbia.
authors.forename: Gorana
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authors.lastname: Mandic Stojmenovic
authors.affiliation: Department of Geriatrics-Gerontology and Old Age Psychiatry, Elias University Clinic, Bucharest, Romania.
authors.forename: Mihaela
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authors.lastname: Marinescu
authors.affiliation: Istituto di Gerontologia e Geriatria, Università degli Studi di Perugia, Perugia, Italy.
authors.forename: Patrizia
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authors.lastname: Mecocci
authors.affiliation: Alzheimer's and Other Cognitive Disorder Unit, Hospital Clinic, Barcelona, Spain.
authors.forename: José Luis
authors.initials: JL
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authors.affiliation: Medical Imaging Department, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal.
authors.forename: Ricardo
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authors.affiliation: Reference Center for Biological Markers of Dementia (BIODEM), University of Antwerp, Antwerp, Belgium.
authors.forename: Ellis
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authors.affiliation: Clinical Neurology (DINOGMI), University of Genoa and IRCCS AOU San Martino-IST, Genoa, Italy.
authors.forename: Flavio
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authors.lastname: Nobili
authors.affiliation: 3rd Department of Neurology, Aristotle University of Thessaloniki, Thessaloniki, Greece.
authors.forename: Konstantinos
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authors.affiliation: Mercer's Institute for Successful Ageing, St. James's Hospital, Dublin, Ireland.
authors.forename: Sarah
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authors.affiliation: First Department of Neurology, Eginition Hospital Kapodistrian University, Medical School of Athens, Athens, Greece.
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authors.initials: GP
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authors.affiliation: Istituto di Gerontologia e Geriatria, Università degli Studi di Perugia, Perugia, Italy.
authors.forename: Luca
authors.initials: L
authors.lastname: Pelini
authors.affiliation: Clinical Neurology (DINOGMI), University of Genoa and IRCCS AOU San Martino-IST, Genoa, Italy; Memory Clinic and LANVIE-Laboratory of Neuroimaging of Aging, University Hospitals and University of Geneva, Geneva, Switzerland.
authors.forename: Agnese
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authors.affiliation: GIGA-CRC In vivo Imaging and Memory Clinic, University of Liège, Liège, Belgium.
authors.forename: Eric
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authors.affiliation: Neurology Department, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal.
authors.forename: Isabel
authors.initials: I
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authors.affiliation: Alzheimer Research Center and Memory Clinic, Fundació ACE, Institut Català de Neurociències Aplicades, Barcelona, Spain.
authors.forename: Oscar
authors.initials: O
authors.lastname: Sotolongo-Grau
authors.affiliation: Carol Davila University of Medicine, Bucharest, Romania; Ana Aslan Intl Foundation-Memory Clinic, Bucharest, Romania.
authors.forename: Luiza
authors.initials: L
authors.lastname: Spiru
authors.affiliation: Institute of Neurology, CCS, Belgrade, Serbia; Faculty of Medicine, University of Belgrade, Belgrade, Serbia.
authors.forename: Elka
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authors.lastname: Stefanova
authors.affiliation: Clinical Institute of Radiology, University Medical Center Ljubljana, Slovenia.
authors.forename: Katarina Surlan
authors.initials: KS
authors.lastname: Popovic
authors.affiliation: 3rd Department of Neurology, Aristotle University of Thessaloniki, Thessaloniki, Greece.
authors.forename: Magda
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authors.lastname: Tsolaki
authors.affiliation: Izmir International Biomedicine and Genome Center, Dokuz Eylul University, Izmir, Turkey; Department of Neurology, Dokuz Eylül University, Izmir, Turkey; Brain Dynamics Multidisciplinary Research Center, Dokuz Eylül University, Izmir, Turkey.
authors.forename: Görsev G
authors.initials: GG
authors.lastname: Yener
authors.affiliation: Department of Internal Medicine, Rehabilitation and Geriatrics, University Hospitals and University of Geneva, Geneva, Switzerland.
authors.forename: Dina
authors.initials: D
authors.lastname: Zekry
authors.affiliation: Laboratory of Alzheimer's Neuroimaging and Epidemiology, IRCCS Istituto Centro S. Giovanni di Dio Fatebenefratelli, Brescia, Italy; Memory Clinic and LANVIE-Laboratory of Neuroimaging of Aging, University Hospitals and University of Geneva, Geneva, Switzerland. Electronic address: gfrisoni@fatebenefratelli.eu.
authors.forename: Giovanni B
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authors.lastname: Frisoni
mesh_terms: D000544:Alzheimer Disease / Q000134:cerebrospinal fluid / Q000150:complications / Q000175:diagnosis* / Q000473:pathology*; D016229:Amyloid beta-Peptides / Q000134:cerebrospinal fluid; D003072:Cognition Disorders / Q000000981:diagnostic imaging / Q000209:etiology*; D003936:Diagnosis, Computer-Assisted; D003937:Diagnosis, Differential; D018450:Disease Progression; D005060:Europe; D005260:Female; D019788:Fluorodeoxyglucose F18 / Q000378:metabolism; D006624:Hippocampus / Q000473:pathology*; D006801:Humans; D008297:Male; D009483:Neuropsychological Tests; D010446:Peptide Fragments / Q000134:cerebrospinal fluid; D049268:Positron-Emission Tomography; D015899:Tomography, Emission-Computed, Single-Photon; D016875:tau Proteins / Q000134:cerebrospinal fluid
chemical_list: D016229:Amyloid beta-Peptides; D010446:Peptide Fragments; C075222:amyloid beta-protein (1-42); D016875:tau Proteins; D019788:Fluorodeoxyglucose F18
keywords: Alzheimer's disease; Biomarkers; Diagnostic confidence of AD; Hippocampal volume; Medial temporal lobe atrophy