A comparison between the accuracy of voxel-based morphometry and hippocampal volumetry in Alzheimer's disease

J Magn Reson Imaging. 2004 Mar;19(3):274-82. doi: 10.1002/jmri.20001.


Purpose: To compare the accuracy of voxel-based morphometry (VBM) and region of interest (ROI)-based hippocampal volumetry to detect medial temporal lobe atrophy in Alzheimer's disease (AD).

Materials and methods: A total of 27 AD patients (age 74 +/- 9 years; 22 women; Mini-Mental State Exam [MMSE] 21 +/- 4) and 25 controls (age 70 +/- 8; 16 women; MMSE 29 +/- 1) were studied. Accuracy of VBM to detect gray matter loss in those seven AD patients and 11 controls with similar ROI-based hippocampal measures and of ROI-based volumetry to detect gray matter loss in those four AD patients and five controls with similar VBM-based hippocampal measures was assessed. VBM was performed with statistical parametric mapping (SPM99).

Results: The area under the curve was 0.96 (95% C.I., 0.92-1.00) for VBM, 0.89 (95% C.I., 0.80-0.98) for ROI-based hippocampal measures, and 0.99 (95% C.I., 0.96-1.00) for both. In subjects with similar ROI-based hippocampal measures, VBM detected atrophy in AD patients at P < 0.0001, while in subjects with similar VBM-based hippocampal measure, volumetry was not significant (P = 0.11). Both measures independently contributed to discrimination (P = 0.004 and P = 0.032) in a logistic regression model.

Conclusion: These results indicate that VBM is more accurate, but the combination of both methods provides the highest accuracy for detection of hippocampal atrophy in AD.

Publication types

  • Comparative Study
  • Evaluation Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Alzheimer Disease / diagnosis*
  • Area Under Curve
  • Atrophy / diagnosis
  • Brain Diseases / pathology*
  • Female
  • Hippocampus / pathology*
  • Humans
  • Image Processing, Computer-Assisted / methods
  • Imaging, Three-Dimensional / methods
  • Magnetic Resonance Imaging / methods*
  • Male
  • Predictive Value of Tests
  • ROC Curve
  • Reproducibility of Results
  • Sensitivity and Specificity
  • Temporal Lobe / pathology*