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Longitudinal automated brain volumetry versus expert visual assessment of atrophy progression on MRI: an exploratory study

Automated tools have been proposed to quantify brain volume for suspected dementia diagnoses. However, their robustness in longitudinal, real-life cohorts remains unexplored. This exploratory study examined if expert visual assessment (EVA) of atrophy progression is reflected by automated volumetric...

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Main Authors: Gebest, Max Philipp (Author) , Weiß, Christel (Author) , Cho, Chang Gyu (Author) , Hausner, Lucrezia (Author) , Frölich, Lutz (Author) , Förster, Alex (Author) , Santhanam, Nandhini (Author) , Fontana, Johann (Author) , Groden, Christoph (Author) , Wenz, Holger (Author) , Maros, Máté E. (Author)
Format: Article (Journal)
Language:English
Published: 29 April 2025
In: Scientific reports
Year: 2025, Volume: 15, Pages: 1-10
ISSN:2045-2322
DOI:10.1038/s41598-025-98360-x
Online Access:Verlag, kostenfrei, Volltext: https://doi.org/10.1038/s41598-025-98360-x
Verlag, kostenfrei, Volltext: http://www.nature.com/articles/s41598-025-98360-x
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Author Notes:Max Gebest, Christel Weiß, Chang-Gyu Cho, Lucrezia Hausner, Lutz Frölich, Alex Förster, Nandhini Santhanam, Johann Fontana, Christoph Groden, Holger Wenz and Máté E. Maros
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Summary:Automated tools have been proposed to quantify brain volume for suspected dementia diagnoses. However, their robustness in longitudinal, real-life cohorts remains unexplored. This exploratory study examined if expert visual assessment (EVA) of atrophy progression is reflected by automated volumetric analyses (AVA) on sequential MR-imaging. We analyzed a random subset of 20 patients with two consecutive 3D T1-weighted examinations (median follow-up 4.0 years, LQ-UQ: 2.1-5.2, range: 0.2-10). Thirteen (65%) with cognitive decline, the remaining with other neuropsychiatric diseases. EVA was performed by two blinded neuroradiologists using a 3 or 5-point Likert scale for atrophy progression (scores $$\pm$$0-2: no, probable and certain progression or decrease, respectively) in dementia-relevant brain regions (frontal-, parietal-, temporal lobes, hippocampi, ventricles). Differences of AVA-volumes were normalized to baseline (delta). Inter-rater agreement of EVA scores was excellent (κ = 0.92). AVA-delta and EVA showed significant global associations for the right hippocampus (pKW = 0.035), left temporal lobe (pKW = 0.0092), ventricle volume (pKW = 0.0091) and a weak association for the parietal lobe (pKW = 0.067). Post hoc testing revealed additional significant link for the left hippocampus (pWSRT = 0.039). In conclusion, the associations between volumetric deltas and EVA of atrophy progression showed promising results for certain brain regions. However, AVA-deltas exhibited unexpected variance, highlighting the need for caution and expert visual confirmation, particularly when scanners or acquisition protocols vary during follow-ups. Therefore, further validation, ideally in large prospective cohorts, is necessary before AVA can be recommended for routine clinical implementation in longitudinal follow-ups.
Item Description:Gesehen am 10.06.2025
Physical Description:Online Resource
ISSN:2045-2322
DOI:10.1038/s41598-025-98360-x

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