MR Imaging of Brain Volumes: Evaluation of a Fully Automatic Software

BACKGROUND AND PURPOSE: Automatic assessment of brain volumes is needed in research and clinical practice. Manual tracing is still the criterion standard but is time-consuming. It is important to validate the automatic tools to avoid the problems of clinical studies drawing conclusions on the basis of brain volumes estimated with methodologic errors. The objective of this study was to evaluate a new commercially available fully automatic software for MR imaging of brain volume assessment. Automatic and expert manual brain volumes were compared. MATERIALS AND METHODS: MR imaging (3T, axial 12 and FLAIR) was performed in 41 healthy elderly volunteers (mean age, 70 +/- 6 years) and 20 patients with hydrocephalus (mean age, 73 +/- 7 years). The software Brain Q was used to manually and automatically measure the following brain volumes: ICV, BTV, W, and WMHV. The manual method has been previously validated and was used as the reference. Agreement between the manual and automatic methods was evaluated by using linear regression and Bland-Altman plots. RESULTS: There were significant differences between the automatic and manual methods regarding all volumes. The mean differences were ICV = 49 +/- 93 mL (mean +/- 2SD, n = 611, BTV = 11 +/- 70 mL, VV = -6 +/- 10 mL, and WMHV = 2.4 +/- 9 mL. The automatic calculations of brain volumes took approximately 2 minutes per investigation. CONCLUSIONS: The automatic tool is promising and provides rapid assessment of brain volumes. However, the software needs improvement before it is incorporated into research or daily use. Manual segmentation remains the reference method.