JRM
Journal of Radiology in Medicine

Journal of Radiology in Medicine is an international journal that published original research and articles in all areas of radiology. Its publishes original research articles, review articles, case reports, editorial commentaries, letters to the editor, educational articles, and conference/meeting announcements.

eISSN: 3023-6487
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Original Article
Contribution of automated hippocampal volume measurements to radiological diagnosis in cases of mesial temporal sclerosis
Abstract
Aims: Epilepsy, particularly drug-resistant epilepsy in adults, is often caused by Mesial Temporal Sclerosis (MTS), which can develop after brain injury from febrile illnesses or trauma. Magnetic Resonance Imaging (MRI) is crucial for diagnosing MTS, although challenges such as patient movement and mild or bilateral hippocampal atrophy can complicate the diagnosis. T1-weighted hippocampal volume measurements are effective in detecting MTS, with recent software advancements enabling automatic hippocampal segmentation. This study compared the hippocampal volumes and indices between adults with MTS and a control group of similar age and sex in the Turkish population. This study aimed to highlight structural differences in the hippocampus associated with MTS.
Methods: This study involved a retrospective review of cranial MRIs scans from patients with MTS, confirmed through histopathological examination after epilepsy surgery. To ensure unbiased comparisons, a control group was selected using propensity score matching by age and gender. Two experienced neuroradiologists independently assessed the MRIs findings for MTS without knowledge of hippocampal volumetric data. Hippocampal volumes were measured using FreeSurfer software and standardized using the hippocampal volume index (HVI) and hippocampal asymmetry index (HAI).
Results: In our study of 38 patients, MTS was found in 55.2% of patients on the right side and in 44.8% of patients on the left side, with no bilateral cases. Visual MRI analysis identified MTS in 84.2% of patients, with an area under of curve (AUC) of 0.921. Automatic volumetry detected MTS in 23 patients with an AUC of 0.791. Combining both methods, MTS was diagnosed in 33 patients, with an AUC of 0.922.
Conclusion: Automated volumetric analyses have been shown to enhance the detection of hippocampal volume loss in patients with MTS.

Keywords : Mesial temporal sclerosis, hypocampus volume, automated segmentation

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1. Blumcke I. Neuropathology of focal epilepsies: a critical review. <em>Epilepsy Behav</em>. 2009;15(1):34-39.
2. French JA, Williamson PD, Thadani VM, et al. Characteristics of medial temporal lobe epilepsy: I. Results of history and physical examination. <em>Ann Neurol.</em> 1993;34(6):774-780.
3. Thom, M. Hippocampal sclerosis in epilepsy. <em>Neuropathol Appl Neurobiol</em>. 2014;40(5):520-543. doi:10.1111/nan.12150
4. Barkovich AJ, Kuzniecky RI: Neuroimaging of focal malformations of cortical development. <em>J Clin Neurophysiol</em>. 1996;13(6):481-494.
5. Jones AL, Cascino GD. Evidence on use of neuroimaging for surgical treatment of temporal lobe epilepsy: a systematic review. <em>JAMA Neurol.</em> 2016;73(4):464-470.
6. Ramey WL, Martirosyan NL, Lieu CM, et al. Current management and surgical outcomes of medically intractable epilepsy. <em>Clin Neurol Neurosurg</em>. 2013;115(12):2411-2418.
7. Jack CR Jr, Sharbrough FW, Twomey CK, et al. Temporal lobe seizures: lateralization with MR volume measurements of the hippo campal formation. <em>Radiology</em>. 1990;175(2):423-429.
8. Farid N, Girard HM, Kemmotsu N, et al. Temporal lobe epilepsy: quantitative MR volumetry in detection of hippocampal atrophy. Radiology. 2012;264(2):542-550.
9. Farid N, Girard HM, Kemmotsu N, et al. Temporal lobe epilepsy: quantitative MR volumetry in detection of hippocampal atrophy. <em>Radiology</em>. 2012; 264(2):542-550
10. Van Paesschen W, Sisodiya S, Connelly A, et al. Quantitative hippocampal MRI and intractable temporal lobe epilepsy. <em>Neurology</em>. 1995;45(12):2233-2240.
11. Briellmann, RS, Syngeniotis, A, Jackson, GD. Comparison of hippocampal volumetry at 1.5 T and at 3 T. <em>Epilepsia</em>. 2001;42(8):1021-1022
12. Cherbuin N, Anstey KJ, Reglade-Meslin C, et al. In vivo hippocampal measurement and memory: a comparison of manual tracing and automated segmentation in a large community-based sample. <em>PloS One</em>. 2009;4(4):e5265.
13. Tae WS, Kim SS, Lee KU, et al. Validation of hippocampal volumes measured using a manual method and two automated methods (FreeSurfer and IBASPM) in chronic major depressive disorder. <em>Neuroradiology.</em> 2008; 50(7):569-581.
14. Granados S&aacute;nchez AM, Orejuela Zapata JF. Diagnosis of mesial temporal sclerosis: sensitivity, specificity and predictive values of the quantitative analysis of magnetic resonance imaging. <em>Neuroradiol J</em>. 2018;31(1): 50-59. doi:10.1177/1971400917731301
15. Fischl B, Salat DH, Busa E, et al. Whole Brain segmentation: automated labeling of neuroanatomical structures in the human brain. <em>Neuron</em>. 2002; 33(3):341-355. doi: 10.1016/S0896-6273(02)00569-X
16. Granados A, Orejuela J, Rodriguez-Takeuchi S. Neuroimaging evaluation in refractory epilepsy. <em>Neuroradiol J.</em> 2015;28(5):529-535.
17. Jette N, Wiebe S. Update on the surgical treatment of epilepsy. <em>Curr Opin Neurol</em>. 2013;26(2):201-207.
18. McLachlan RS, Nicholson RL, Black S, et al. Nuclear magnetic resonance imaging, a new approach to the investigation of refractory temporal lobe epilepsy. <em>Epilepsia</em> 1985;26(6):555-562.
19. Coan AC, Kubota B, Bergo FPG, et al. 3T MRI Quantification of hippocampal volume and signal in mesial temporal lobe epilepsy improves detection of hippocampal sclerosis. <em>Am J Neuroradiol</em>. 2014;35(1):77-83.
20. Silva G, Martins C, Moreira da Silva N, et al. Automated volumetry of hippocampus is useful to confirm unilateral mesial temporal sclerosis in patients with radiologically positive findings. <em>Neuroradiol J</em>. 2017;30(4):318-323.
21. Azab M, Carone M, Ying SH, et al. Mesial temporal sclerosis: accuracy of NeuroQuant versus neuroradiologist. <em>AJNR Am J Neuroradiol.</em> 2015;36(8): 1400-1406.
22. Von Oertzen J, Urbach H, Jungbluth S, et al. Standard magnetic resonance imaging is inadequate for patients with refractory focal epilepsy. <em>J Neurol Neurosurg Psychiatry</em>. 2002;73(6):643-647.
23. Ono SE, de Carvalho Neto A, Joaquim MJM, Dos Santos GR, de Paola L, Silvado CES. Mesial temporal lobe epilepsy: revisiting the relation of hippocampal volumetry with memory deficits. <em>Epilepsy Behav</em>. 2019;100(Pt A):106516. doi: 10.1016/j.yebeh.2019.106516. Epub 2019 Sep 28.
24. Reutens DC, Stevens JM, Kingsley D, et al. Reliability of visual inspection for detection of volumetric hippocampal asymmetry. <em>Neuroradiology</em> 1996; 38(3):221-225.
25. Akhondi-Asl A, Jafari-Khouzani K, Elise vich K, Soltanian-Zadeh H. Hippocampal volumetry for lateralization of temporal lobe epilepsy: automated versus manual methods. <em>Neuroimage</em>. 2011;54(Suppl 1):218-226.
26. Pardoe HR, Pell GS, Abbott DF, Jackson GD. Hippocampal volume assessmentintem poral lobe epilepsy: how good is automated segmentation? <em>Epilepsia</em>. 2009;50(12):2586-2592.
27. Silva NM, Rozanski VE, Cunha JPS. A 3D multi modal approach to precisely locate DBS electrodes in the basal ganglia brain region. 2015 7th International IEEE/ EMBS Conference on Neural Engineering (NER) 2015;pp.292-295.
28. Hsu YY, Schuff N, Du AT, et al. Comparison of automated and manual MRI volumetry of hippocampus in normal aging and dementia. <em>J Magn Reson Imag: JMRI</em>. 2002;16(3):305-310.
29. Wenger E, Martensson J, Noack H, et al. Comparing manual and automatic segmentation of hippocampal volumes: reliability and validity issues in younger and older brains. <em>Human Brain Mapping</em>. 2014;35(8):4236-4248.
30. Akos-Szabo C, Xiong J, Lancaster JL, et al. Amygdalar and hippocampal volumetry in control participants: differences regarding handedness. <em>AJNR Am J Neuroradiol</em>. 2001;22(7):1342-1345.
31. Ashtari M, Barr WB, Schaul N, et al. Three-dimensional fast low-angle shot imaging and computerized volume measurement of the hippocampus in patients with chronic epilepsy of the temporal lobe. <em>AJNR Am J Neuroradiol</em>. 1991;12(5):941-947.
32. Mohandas AN, Bharath RD, Prathyusha PV, et al. Hippocampal volumetry: normative data in the Indian population. <em>Ann Ind Acad Neurol</em>. 2014;17(3):267-271.
Article available in :
Volume 1, Issue 4, 2024
Page : 58-64
https://doi.org/10.51271/JRM-0016
Article Information
Received : 04 Eyl 2024
Accepted : 08 Eki 2024
Published : 30 Eki 2024
Corresponding Author :

Kerime Hatun Acar: Department of Radiology, Cerrahpaşa Faculty of Medicine, İstanbul University-Cerrahpasa, İstanbul, Turkiye

[email protected]
Citation : Acar KH, Sarıahmetoğlu ÖF, Arslan S, et al. Contribution of automated hippocampal volume measurements to radiological diagnosis in cases of mesial temporal sclerosis. J Radiol Med. 2024;1(4):58-64.

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