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Sensitivity and specificity of medial temporal lobe visual ratings and multivariate regional MRI classification in Alzheimer's disease.
PLoS One 2011; 6(7):e22506Plos

Abstract

BACKGROUND

Visual assessment rating scales for medial temporal lobe (MTL) atrophy have been used by neuroradiologists in clinical practice to aid the diagnosis of Alzheimer's disease (AD). Recently multivariate classification methods for magnetic resonance imaging (MRI) data have been suggested as alternative tools. If computerized methods are to be implemented in clinical practice they need to be as good as, or better than experienced neuroradiologists and carefully validated. The aims of this study were: (1) To compare the ability of MTL atrophy visual assessment rating scales, a multivariate MRI classification method and manually measured hippocampal volumes to distinguish between subjects with AD and healthy elderly controls (CTL). (2) To assess how well the three techniques perform when predicting future conversion from mild cognitive impairment (MCI) to AD.

METHODS

High resolution sagittal 3D T1w MP-RAGE datasets were acquired from 75 AD patients, 101 subjects with MCI and 81 CTL from the multi-centre AddNeuroMed study. An automated analysis method was used to generate regional volume and regional cortical thickness measures, providing 57 variables for multivariate analysis (orthogonal partial least squares to latent structures using seven-fold cross-validation). Manual hippocampal measurements were also determined for each subject. Visual rating assessment of MTL atrophy was performed by an experienced neuroradiologist according to the approach of Scheltens et al.

RESULTS

We found prediction accuracies for distinguishing between AD and CTL of 83% for multivariate classification, 81% for the visual rating assessments and 89% for manual measurements of total hippocampal volume. The three different techniques showed similar accuracy in predicting conversion from MCI to AD at one year follow-up.

CONCLUSION

Visual rating assessment of the MTL gave similar prediction accuracy to multivariate classification and manual hippocampal volumes. This suggests a potential future role for computerized methods as a complement to clinical assessment of AD.

Authors+Show Affiliations

Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden. eric.westman@ki.seNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

21811624

Citation

Westman, Eric, et al. "Sensitivity and Specificity of Medial Temporal Lobe Visual Ratings and Multivariate Regional MRI Classification in Alzheimer's Disease." PloS One, vol. 6, no. 7, 2011, pp. e22506.
Westman E, Cavallin L, Muehlboeck JS, et al. Sensitivity and specificity of medial temporal lobe visual ratings and multivariate regional MRI classification in Alzheimer's disease. PLoS ONE. 2011;6(7):e22506.
Westman, E., Cavallin, L., Muehlboeck, J. S., Zhang, Y., Mecocci, P., Vellas, B., ... Wahlund, L. O. (2011). Sensitivity and specificity of medial temporal lobe visual ratings and multivariate regional MRI classification in Alzheimer's disease. PloS One, 6(7), pp. e22506. doi:10.1371/journal.pone.0022506.
Westman E, et al. Sensitivity and Specificity of Medial Temporal Lobe Visual Ratings and Multivariate Regional MRI Classification in Alzheimer's Disease. PLoS ONE. 2011;6(7):e22506. PubMed PMID: 21811624.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Sensitivity and specificity of medial temporal lobe visual ratings and multivariate regional MRI classification in Alzheimer's disease. AU - Westman,Eric, AU - Cavallin,Lena, AU - Muehlboeck,J-Sebastian, AU - Zhang,Yi, AU - Mecocci,Patrizia, AU - Vellas,Bruno, AU - Tsolaki,Magda, AU - Kłoszewska,Iwona, AU - Soininen,Hilkka, AU - Spenger,Christian, AU - Lovestone,Simon, AU - Simmons,Andrew, AU - Wahlund,Lars-Olof, AU - ,, Y1 - 2011/07/21/ PY - 2011/04/14/received PY - 2011/06/22/accepted PY - 2011/8/4/entrez PY - 2011/8/4/pubmed PY - 2011/12/13/medline SP - e22506 EP - e22506 JF - PloS one JO - PLoS ONE VL - 6 IS - 7 N2 - BACKGROUND: Visual assessment rating scales for medial temporal lobe (MTL) atrophy have been used by neuroradiologists in clinical practice to aid the diagnosis of Alzheimer's disease (AD). Recently multivariate classification methods for magnetic resonance imaging (MRI) data have been suggested as alternative tools. If computerized methods are to be implemented in clinical practice they need to be as good as, or better than experienced neuroradiologists and carefully validated. The aims of this study were: (1) To compare the ability of MTL atrophy visual assessment rating scales, a multivariate MRI classification method and manually measured hippocampal volumes to distinguish between subjects with AD and healthy elderly controls (CTL). (2) To assess how well the three techniques perform when predicting future conversion from mild cognitive impairment (MCI) to AD. METHODS: High resolution sagittal 3D T1w MP-RAGE datasets were acquired from 75 AD patients, 101 subjects with MCI and 81 CTL from the multi-centre AddNeuroMed study. An automated analysis method was used to generate regional volume and regional cortical thickness measures, providing 57 variables for multivariate analysis (orthogonal partial least squares to latent structures using seven-fold cross-validation). Manual hippocampal measurements were also determined for each subject. Visual rating assessment of MTL atrophy was performed by an experienced neuroradiologist according to the approach of Scheltens et al. RESULTS: We found prediction accuracies for distinguishing between AD and CTL of 83% for multivariate classification, 81% for the visual rating assessments and 89% for manual measurements of total hippocampal volume. The three different techniques showed similar accuracy in predicting conversion from MCI to AD at one year follow-up. CONCLUSION: Visual rating assessment of the MTL gave similar prediction accuracy to multivariate classification and manual hippocampal volumes. This suggests a potential future role for computerized methods as a complement to clinical assessment of AD. SN - 1932-6203 UR - https://www.unboundmedicine.com/medline/citation/21811624/Sensitivity_and_specificity_of_medial_temporal_lobe_visual_ratings_and_multivariate_regional_MRI_classification_in_Alzheimer's_disease_ L2 - http://dx.plos.org/10.1371/journal.pone.0022506 DB - PRIME DP - Unbound Medicine ER -