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

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Abstract
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. J. Magn. Reson. Imaging 2004;19:274–282.