Delphi definition of the EADC-ADNI harmonized protocol for hippocampal segmentation on magnetic resonance

Marina Boccardi, Martina Bocchetta, Liana G. Apostolova, Josephine Barnes, George Bartzokis, Gabriele Corbetta, Charles Decarli, Leyla Detoledo-Morrell, Michael Firbank, Rossana Ganzola, Lotte Gerritsen, Wouter Henneman, Ronald J. Killiany, Nikolai Malykhin, Patrizio Pasqualetti, Jens C. Pruessner, Alberto Redolfi, Nicolas Robitaille, Hilkka Soininen, Daniele TolomeoLei Wang, Craig Watson, Henrike Wolf, Henri Duvernoy, Simon Duchesne, Clifford R. Jack, Giovanni B. Frisoni

Research output: Contribution to journalArticlepeer-review

87 Scopus citations


Background: This study aimed to have international experts converge on a harmonized definition of whole hippocampus boundaries and segmentation procedures, to define standard operating procedures for magnetic resonance (MR)-based manual hippocampal segmentation. Methods: The panel received a questionnaire regarding whole hippocampus boundaries and segmentation procedures. Quantitative information was supplied to allow evidence-based answers. A recursive and anonymous Delphi procedure was used to achieve convergence. Significance of agreement among panelists was assessed by exact probability on Fisher's and binomial tests. Results: Agreement was significant on the inclusion of alveus/fimbria (P 5.021), whole hippocampal tail (P 5.013), medial border of the body according to visible morphology (P 5.0006), and on this combined set of features (P 5.001). This definition captures 100% of hippocampal tissue, 100% of Alzheimer's disease-related atrophy, and demonstrated good reliability on preliminary intrarater (0.98) and inter-rater (0.94) estimates. Discussion: Consensus was achieved among international experts with respect to hippocampal segmentation using MR resulting in a harmonized segmentation protocol.

Original languageEnglish (US)
Pages (from-to)126-138
Number of pages13
JournalAlzheimer's and Dementia
Issue number2
StatePublished - 2015


  • Alzheimer's disease
  • Anatomical landmarks
  • Atrophy
  • Delphi procedure
  • Enrichment
  • Harmonization
  • Hippocampal atrophy
  • Hippocampus
  • MCI
  • Magnetic resonance
  • Manual segmentation
  • Medial temporal lobe
  • Neuroimaging
  • Reliability
  • Standard operational procedures
  • Volumetry

ASJC Scopus subject areas

  • Epidemiology
  • Health Policy
  • Developmental Neuroscience
  • Clinical Neurology
  • Geriatrics and Gerontology
  • Cellular and Molecular Neuroscience
  • Psychiatry and Mental health


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