Q&A: Alignment to atlas explained

The Cortechs.ai Support team is often asked to clarify error messages when a series of images cannot be processed by NeuroQuant software. The number 1 question we receive has to do with alignment of brain to atlas being reported as unsuccessful.

Why is Alignment to Atlas Important?
To achieve high-quality segmentation results, NeuroQuant aligns each patient’s brain image to an atlas of the brain. Segmentation accuracy can be affected when the patient’s brain deviates from the reference brain atlas. Since correct brain atlas alignment is critical to the accuracy of the segmentation results, it is also critical to the accuracy of the calculated volumes.

What Does “Processing Failed: Alignment of Brain to Atlas Unsuccessful” Indicate?
This message will be displayed in cases where a patient’s brain anatomy is significantly different than the brain atlas, such as in patients with brain tumors, surgical resections, very large lesions, or severe asymmetry. Further processing of the scan may result in inaccurate segmentation. To ensure segmentation accuracy, NeuroQuant is designed with a quality check ensuring goodness of fit to neuroanatomical atlas

What is the Measurement Index?
The measurement index (MI) is a numerical measure of the similarity (or differences) between a patient’s brain scan and the anatomical brain atlas. The MI serves as a quality check to confirm goodness of fit to the brain atlas. The measurement index uses a cutoff value to reject any scan that can likely result in segmentation errors due to the brain atlas mismatch. For clinical use, the MI must be ≤5. Exceeding this alignment error threshold will cause processing to halt and an error report to be generated. A MI >5 prevents NeuroQuant analysis of a patient’s brain, indicating brain anatomy that is significantly different than the brain atlas based on the quality check.

Can Images Still Be Processed by NeuroQuant if the MI is >5?
In some cases, yes. When the MI is between 5 and 6, turning on Research Mode allows NeuroQuant to process images for research/non-clinical needs with relaxed atlas alignment checks, like in cases, for example, that failed due to the brain atlas alignment error. Research mode generates reports marked NOT FOR CLINICAL USE. The Research Mode setting increases tolerance for certain alignment errors but requires careful review of segmentation output by the radiologist to verify segmentation quality.

In the example below, gross structural abnormalities in a patient’s brain make good alignment to atlas impossible.

Cortechs.ai | Q&A: Alignment to atlas explained

Some cases, such as the second example, can also generate this error message, but are still candidates for NeuroQuant, when processed in Research Mode.

Cortechs.ai | Q&A: Alignment to atlas explained

More information about using NeuroQuant can be found your user manual.

More Resources

03/09/2025

Advancing TBI Evaluation with AI-Driven MRI Analysis: A New Era in Brain Health

AI-driven MRI with NeuroQuant® enhances TBI assessment, tracks recovery, and supports better treatment decisions.

03/06/2025

Case Study: Leveraging NeuroQuant® for Accurate Diagnosis of Traumatic Brain Injury

This case highlights the power of advanced neuroimaging tools in delivering precise, evidence-based diagnostics to enhance patient care and clinical decisions.

02/26/2025

Traumatic Brain Injury in Athletes: The Role of the NeuroQuant and Automated Volumetric Tracking

NeuroQuant enables objective brain volume tracking for early TBI detection, recovery monitoring, and safer return-to-play decisions.

02/25/2025

OnQ™ Prostate Solution Enhances Collaboration and Improves MRI for Cancer Detection with RSI Technology

OnQ Prostate enhances MRI tissue characterization, improving sensitivity and specificity in cancer detection, & bridges gaps between radiologists and urologists

02/15/2025

NeuroQuant® Dementia: Advancing Alzheimer’s Disease Care in the Era of DMTs

AI-driven brain volumetric analysis is revolutionizing Alzheimer’s care, providing precise diagnostic support, monitoring, and early detection.

02/09/2025

NeuroQuant® MS:  Advancing Precision in Multiple Sclerosis

Dr. Suzie Bash discusses NeuroQuant MS, noting its ability to segment plaques, analyze volume, and track lesion burden for assessing disease progression
Scroll to Top