Hugo J. Kuijf, Susanne J. van Veluw, Mirjam I. Geerlings, Max A. Viergever, Geert Jan Biessels, Koen L. Vincken
The midsagittal surface separates the two hemispheres of the cerebrum. This surface is often typified as a geometrical plane: the midsagittal plane. However, in subjects with a considerable amount of naturally occurring brain torque, the midsagittal surface deviates to a large extent from a plane. In the present study, an automated method to extract the midsagittal surface is proposed, evaluated on a large dataset, and compared to a conventional midsagittal plane representation. The midsagittal plane was extracted from MR images with a technique based on the Kullback–Leibler measure. This plane was used to initialize a surface, that was deformed to represent the midsagittal surface. One hundred subjects were selected from the SMART-MR study: fifty subjects with brain torque and fifty random subjects. Manual delineations of the midsagittal surface were used for evaluation. The extracted midsagittal planes and surfaces were compared to the manual delineations by assessing the absolute volume of misclassified cerebrum tissue. The midsagittal surface resulted in significantly better separations of the hemispheres. In the randomly selected subjects, the error reduced from 2.71 ± 1.05 ml to 2.20 ± 0.66 ml and in subjects with brain torque from 4.85 ± 2.79 ml to 2.23 ± 0.77 ml, with improvements up to 16.6 ml in individual subjects with marked brain torque.