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Review
. 2024 Sep 3:16:1459652.
doi: 10.3389/fnagi.2024.1459652. eCollection 2024.

Automated brain segmentation and volumetry in dementia diagnostics: a narrative review with emphasis on FreeSurfer

Eya Khadhraoui  1 , Thomas Nickl-Jockschat  2   3   4 , Hans Henkes  5 , Daniel Behme  1   6 , Sebastian Johannes Müller  1
Affiliations
Review

Automated brain segmentation and volumetry in dementia diagnostics: a narrative review with emphasis on FreeSurfer

Eya Khadhraoui et al. Front Aging Neurosci. .

Abstract

Background: Dementia can be caused by numerous different diseases that present variable clinical courses and reveal multiple patterns of brain atrophy, making its accurate early diagnosis by conventional examinative means challenging. Although highly accurate and powerful, magnetic resonance imaging (MRI) currently plays only a supportive role in dementia diagnosis, largely due to the enormous volume and diversity of data it generates. AI-based software solutions/algorithms that can perform automated segmentation and volumetry analyses of MRI data are being increasingly used to address this issue. Numerous commercial and non-commercial software solutions for automated brain segmentation and volumetry exist, with FreeSurfer being the most frequently used.

Objectives: This Review is an account of the current situation regarding the application of automated brain segmentation and volumetry to dementia diagnosis.

Methods: We performed a PubMed search for “FreeSurfer AND Dementia” and obtained 493 results. Based on these search results, we conducted an in-depth source analysis to identify additional publications, software tools, and methods. Studies were analyzed for design, patient collective, and for statistical evaluation (mathematical methods, correlations).

Results: In the studies identified, the main diseases and cohorts represented were Alzheimer’s disease (n = 276), mild cognitive impairment (n = 157), frontotemporal dementia (n = 34), Parkinson’s disease (n = 29), dementia with Lewy bodies (n = 20), and healthy controls (n = 356). The findings and methods of a selection of the studies identified were summarized and discussed.

Conclusion: Our evaluation showed that, while a large number of studies and software solutions are available, many diseases are underrepresented in terms of their incidence. There is therefore plenty of scope for targeted research.

Keywords: FreeSurfer; dementia; review; segmentation; volumetry.

PubMed Disclaimer

Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
The PubMed time line of the four relevant search terms (green: 2024).
Figure 2
Figure 2
PRISMA flow chart of the included PubMed studies for both search terms.
Figure 3
Figure 3
Pie chart showing the distribution of cohorts/diseases returned by the PubMed search “FreeSurfer and Dementia” (n = 428 of 493 studies, 01/01/2024).
Figure 4
Figure 4
Pie chart of software solutions in reports retrieved from Pubmed with the search term “Alzheimer’s disease volumetric measurement brain” (most recent; descending). The newest 350 entries (from 2024 to 2015) were evaluated, 293 were included. All solutions with fewer than three entries are summarized under “Other”.
Figure 5
Figure 5
Example of FreeSurfer’s segmentation (HBT, Head Body Tail) of hippocampal subfields without nuclei of the amygdala in a 1.5-Tesla T1-MPRAGE sequence, transversal (left), coronary (middle) and sagittal (right).
See this image and copyright information in PMC

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