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AJNR Awards, New Junior Editors, and more. Read the latest AJNR updates

Research ArticleAdult Brain
Open Access

Hippocampal Sclerosis Detection with NeuroQuant Compared with Neuroradiologists

S. Louis, M. Morita-Sherman, S. Jones, D. Vegh, W. Bingaman, I. Blumcke, N. Obuchowski, F. Cendes and L. Jehi
American Journal of Neuroradiology April 2020, 41 (4) 591-597; DOI: https://doi.org/10.3174/ajnr.A6454
S. Louis
aFrom the Epilepsy Center (S.L., M.M.-S., S.J., D.V., W.B., L.J.), and
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  • ORCID record for S. Louis
M. Morita-Sherman
aFrom the Epilepsy Center (S.L., M.M.-S., S.J., D.V., W.B., L.J.), and
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  • ORCID record for M. Morita-Sherman
S. Jones
aFrom the Epilepsy Center (S.L., M.M.-S., S.J., D.V., W.B., L.J.), and
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D. Vegh
aFrom the Epilepsy Center (S.L., M.M.-S., S.J., D.V., W.B., L.J.), and
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W. Bingaman
aFrom the Epilepsy Center (S.L., M.M.-S., S.J., D.V., W.B., L.J.), and
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  • ORCID record for W. Bingaman
I. Blumcke
cInstitute of Neuropathology (I.B.), University Hospitals Erlangen, Erlangen, Germany
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N. Obuchowski
bQuantitative Health Sciences (N.O.), Cleveland Clinic, Cleveland, Ohio
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F. Cendes
dDepartment of Neurology (F.C.), University of Campinas–UNICAMP, Campinas, São Paulo, Brazil.
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L. Jehi
aFrom the Epilepsy Center (S.L., M.M.-S., S.J., D.V., W.B., L.J.), and
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Article Figures & Data

Figures

  • Tables
  • Fig 1.
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    Fig 1.

    NeuroQuant triage brain atrophy report provides volumetric percentiles of left and right regions of the brain.

  • Fig 2.
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    Fig 2.

    NeuroQuant hippocampal atrophy report provides volumetric percentiles of the left and right regions of the hippocampus as well as the normative percentile of the hippocampus compared with the normative control group of patients.

  • Fig 3.
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    Fig 3.

    PPV of visual MR imaging analysis and NeuroQuant analysis results as the prevalence of HS increases. In our study, HS had a prevalence of 42.4% (black dotted line), NeuroQuant analysis had a PPV of 84%, and MR imaging had a PPV of 89.1%. With a decreased prevalence of HS, both MR imaging and NeuroQuant (NQ) have a decreased PPV, whereas an increased prevalence of HS results in a higher PPV for both analytic methods.

  • Fig 4.
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    Fig 4.

    NPV of visual MR imaging analysis and NeuroQuant analysis results as the prevalence of HS increases. In our study, HS had a prevalence of 42.4% (black dotted line). In areas with a lower prevalence of HS than our institution, the NPV increases for both MR imaging and NeuroQuant.

Tables

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    Table 1:

    Sensitivities, specificities, PPVs, and NPVs, with varying cutoff points of NeuroQuant analysis

    NeuroQuant Cutoff PointSensitivity, %Specificity, %PPV, %NPV, %
    <7%44.368.750.962.6
    <6%42.668.750.062.0
    <5%68.890.484.079.8
    <4%39.371.150.061.5
    <3%37.774.752.362.0
    <2%31.178.351.460.7
    • View popup
    Table 2:

    Results for NeuroQuant analysis vs visual MR imaging analysis in identifying HS by using histopathology as the reference standard for HS

    Sensitivity and Specificity Analysis
    Pathology Positive HS+ (n = 61)Pathology Negative HS– (n = 83)
    NeuroQuant AnalysisVisual MR Imaging HS+Visual MR Imaging HS–Visual MR Imaging HS+Visual MR Imaging HS–
    HS+a41144
    HS–b163372
    • ↵a Defined as a NeuroQuant value of <5%.

    • ↵b Defined as a NeuroQuant value of >5%.

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    Table 3:

    Sample Demographics

    Pathology HS+Pathology HS–P
    Female, n/total n (%)27/61 (44.3)57.8/83 (57.8).13
    Age at surgery, mean ± SD, y40.40 ± 14.335.36 ± 15.6.05
    MR imaging positive for HS, n/total n (%)57/61 (93.4)7/83 (8.4)<.0001
    Ipsilateral hippocampus volume, mean ± SD (cm3)9.98 ± 22.156.04 ± 32.3<.0001
    Contralateral hippocampus volume, mean ± SD (cm3)52.79 ± 32.958.51 ± 30.0.29
    Surgery side - left, n/total n (%)33/61 (54.1)43/83 (51.8).87
    • Note:—SD indicates standard deviation.

    • View popup
    Table 4:

    Sensitivity and specificity values for NeuroQuant analysis and visual MR imaging analysis

    NeuroQuant AnalysisVisual MR Imaging AnalysisP
    Sensitivity, %68.893.4.0007
    Specificity, %90.491.6.99
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American Journal of Neuroradiology: 41 (4)
American Journal of Neuroradiology
Vol. 41, Issue 4
1 Apr 2020
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Cite this article
S. Louis, M. Morita-Sherman, S. Jones, D. Vegh, W. Bingaman, I. Blumcke, N. Obuchowski, F. Cendes, L. Jehi
Hippocampal Sclerosis Detection with NeuroQuant Compared with Neuroradiologists
American Journal of Neuroradiology Apr 2020, 41 (4) 591-597; DOI: 10.3174/ajnr.A6454

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Hippocampal Sclerosis Detection with NeuroQuant Compared with Neuroradiologists
S. Louis, M. Morita-Sherman, S. Jones, D. Vegh, W. Bingaman, I. Blumcke, N. Obuchowski, F. Cendes, L. Jehi
American Journal of Neuroradiology Apr 2020, 41 (4) 591-597; DOI: 10.3174/ajnr.A6454
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