PT - JOURNAL ARTICLE AU - F. Riederer AU - R. Seiger AU - R. Lanzenberger AU - E. Pataraia AU - G. Kasprian AU - L. Michels AU - J. Beiersdorf AU - S. Kollias AU - T. Czech AU - J. Hainfellner AU - C. Baumgartner TI - Voxel-Based Morphometry—from Hype to Hope. A Study on Hippocampal Atrophy in Mesial Temporal Lobe Epilepsy AID - 10.3174/ajnr.A6545 DP - 2020 Jun 01 TA - American Journal of Neuroradiology PG - 987--993 VI - 41 IP - 6 4099 - http://www.ajnr.org/content/41/6/987.short 4100 - http://www.ajnr.org/content/41/6/987.full SO - Am. J. Neuroradiol.2020 Jun 01; 41 AB - BACKGROUND AND PURPOSE: Automated volumetry of the hippocampus is considered useful to assist the diagnosis of hippocampal sclerosis in temporal lobe epilepsy. However, voxel-based morphometry is rarely used for individual subjects because of high rates of false-positives. We investigated whether an approach with high dimensional warping to the template and nonparametric statistics would be useful to detect hippocampal atrophy in patients with hippocampal sclerosis.MATERIALS AND METHODS: We performed single-subject voxel-based morphometry with nonparametric statistics within the framework of Statistical Parametric Mapping to compare MRI from 26 well-characterized patients with temporal lobe epilepsy individually against a group of 110 healthy controls. The following statistical threshold was used: P < .05 corrected for multiple comparisons with family-wise error over the region of interest right and left hippocampus.RESULTS: The sensitivity for the detection of atrophy related to hippocampal sclerosis was 0.92 (95% CI, 0.67–0.99) for the right hippocampus and 0.60 (0.31–0.83) for the left, and the specificity for volume changes was 0.98 (0.93–0.99). All clusters of decreased hippocampal volumes were correctly lateralized to the seizure focus. Hippocampal volume decrease was in accordance with neuronal cell loss on histology reports.CONCLUSIONS: Nonparametric voxel-based morphometry is sensitive and specific for hippocampal atrophy in patients with mesial temporal lobe epilepsy and may be useful in clinical practice.TLEtemporal lobe epilepsyVBMvoxel-based morphometryTIVtotal intracranial volumeILAEInternational League Against EpilepsyDARTELDiffeomorphic Anatomical Registration Through Exponentiated Lie AlgebraMAPMorphometric Analysis ProgramROCReceiver operating characteristic curvesAUCarea under the curveSnPMStatistical non Parametric MappingHShippocampal sclerosisFLAIRfluid attenuated inversion recoveryEEGelectroencephalography