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We provide and evaluate an open-source software solution for automatically hippocampal segmentation from T1-weighted (T1w) magnetic resonance imaging (MRI). The method is applied for measuring the hippocampal volume, which allows discriminate between patients with Alzheimer's disease (AD) or mild cognitive impairment (MCI) and elderly controls (NC). The method is based on a fast patch-based label fusion method, whose selected patches and their weights are calculated from a combination of similarity measures between patches using intensity-based distances and labeling-based distances. These combined similarity measures produces better selection of the patches, and their weights are more robust. The algorithm is trained with the Harmonized Hippocampal Protocol (HarP). The proposal is compared with FreeSurfer and other label fusion methods. To evaluate the performance and the robustness of the proposed label fusion method, we employ two databases of T1w MRI of human brains. For AD vs NC, we obtain a high degree of accuracy, approximately 90 %. For MCI vs NC, we obtain accuracies around 75 %. The average time for the hippocampal segmentation from a T1w MRI is less than 17 minutes.

Hippocampal atrophy measures from magnetic resonance imaging (MRI) are powerful tools for monitoring Alzheimer's disease (AD) progression. In this paper, we introduce a longitudinal image analysis framework based on robust registration and simultaneous hippocampal segmentation and longitudinal marker classification of brain MRI of an arbitrary number of time points. The framework comprises two innovative parts: a longitudinal segmentation and a longitudinal classification step. The results show that both steps of the longitudinal pipeline improved the reliability and the accuracy of the discrimination between clinical groups. We introduce a novel approach to the joint segmentation of the hippocampus across multiple time points; this approach is based on graph cuts of longitudinal MRI scans with constraints on hippocampal atrophy and supported by atlases. Furthermore, we use linear mixed effect (LME) modeling for differential diagnosis between clinical groups. The classifiers are trained from the average residue between the longitudinal marker of the subjects and the LME model. In our experiments, we analyzed MRI-derived longitudinal hippocampal markers from two publicly available datasets (Alzheimer's Disease Neuroimaging Initiative, ADNI and Minimal Interval Resonance Imaging in Alzheimer's Disease, MIRIAD). In test/retest reliability experiments, the proposed method yielded lower volume errors and significantly higher dice overlaps than the cross-sectional approach (volume errors: 1.55% vs 0.8%; dice overlaps: 0.945 vs 0.975). To diagnose AD, the discrimination ability of our proposal gave an area under the receiver operating characteristic (ROC) curve (AUC) [Formula: see text] 0.947 for the control vs AD, AUC [Formula: see text] 0.720 for mild cognitive impairment (MCI) vs AD, and AUC [Formula: see text] 0.805 for the control vs MCI.