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J Neuroimaging. 2017 Jul;27(4):365-371. doi: 10.1111/jon.12431. Epub 2017 Feb 14.

Comparing Two Processing Pipelines to Measure Subcortical and Cortical Volumes in Patients with and without Mild Traumatic Brain Injury.

Author information

Defense and Veterans Brain Injury Center, San Antonio Military Medical Center, San Antonio, TX.
Department of Radiology, Brooke Army Medical Center, San Antonio, TX.
Alaska Radiology Associates, TBI Imaging and Research, Anchorage, AK.
Austin Radiological Association, Austin, TX.
Department of Neurology, Uniformed Services University of the Health Sciences School of Medicine, Bethesda, MD.
Department of Aeromedical Research, 711th Human Performance Wing, U.S. Air Force School of Aerospace Medicine, Dayton, OH.
Department of Radiology, 59th Medical Wing, Wilford Hall ASC, San Antonio, TX.
Missouri Institute of Mental Health, University of Missouri-St Louis, Berkeley, MO.
Department of Physical Medicine and Rehabilitation (Adjunct), Baylor College of Medicine, Houston, TX.



To compare volumetric results from NeuroQuant® and FreeSurfer in a service member setting. Since the advent of medical imaging, quantification of brain anatomy has been a major research and clinical effort. Rapid advancement of methods to automate quantification and to deploy this information into clinical practice has surfaced in recent years. NeuroQuant® is one such tool that has recently been used in clinical settings. Accurate volumetric data are useful in many clinical indications; therefore, it is important to assess the intermethod reliability and concurrent validity of similar volume quantifying tools.


Volumetric data from 148 U.S. service members across three different experimental groups participating in a study of mild traumatic brain injury (mTBI) were examined. Groups included mTBI (n = 71), posttraumatic stress disorder (n = 22), or a noncranial orthopedic injury (n = 55). Correlation coefficients and nonparametric group mean comparisons were used to assess reliability and concurrent validity, respectively.


Comparison of these methods across our entire sample demonstrates generally fair to excellent reliability as evidenced by large intraclass correlation coefficients (ICC = .4 to .99), but little concurrent validity as evidenced by significantly different Mann-Whitney U comparisons for 26 of 30 brain structures measured.


While reliability between the two segmenting tools is fair to excellent, volumetric outcomes are statistically different between the two methods. As suggested by both developers, structure segmentation should be visually verified prior to clinical use and rigor should be used when interpreting results generated by either method.


FreeSurfer; NeuroQuant®; mild TBI; quantitative MRI; service members

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