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A review of the work that supported the inclusion of this imaging modality into ADNI Phase 3 is followed by a brief description of the ADNI MTL imaging and analysis protocols and a summary of studies that have used these data. This review is supplemented by a new study that uses novel surface\u2010based tools to characterize MTL neurodegeneration across biomarker\u2010defined AD stages. This analysis reveals a pattern of spreading cortical thinning associated with increasing levels of tau pathology in the presence of elevated amyloid beta, with apparent epicenters in the transentorhinal region and inferior hippocampal subfields. The paper concludes with an outlook for high\u2010resolution imaging of the MTL in ADNI Phase 4.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Highlights<\/jats:title>\n                    <jats:p>\n                      <jats:list list-type=\"bullet\">\n                        <jats:list-item>\n                          <jats:p>As of Phase 3, the Alzheimer's Disease Neuroimaging Initiative (ADNI) magnetic resonance imaging (MRI) protocol includes a high\u2010resolution T2\u2010weighted MRI scan optimized for imaging hippocampal subfields and medial temporal lobe (MTL) subregions.<\/jats:p>\n                        <\/jats:list-item>\n                        <jats:list-item>\n                          <jats:p>These scans are processed by the ADNI core to obtain automatic segmentations of MTL subregions and to derive morphologic measurements.<\/jats:p>\n                        <\/jats:list-item>\n                        <jats:list-item>\n                          <jats:p>More detailed granular examination of MTL neurodegeneration in response to disease progression is achieved by applying surface\u2010based modeling techniques.<\/jats:p>\n                        <\/jats:list-item>\n                        <jats:list-item>\n                          <jats:p>Surface\u2010based analysis of gray matter loss in MTL subregions reveals increasing and spatially expanding patterns of neurodegeneration with advancing stages of Alzheimer's disease (AD), as defined based on amyloid and tau positron emission tomography biomarkers in accordance with recently proposed criteria.<\/jats:p>\n                        <\/jats:list-item>\n                        <jats:list-item>\n                          <jats:p>\n                            These patterns closely align with\n                            <jats:italic>post mortem<\/jats:italic>\n                            literature on spread of pathological tau in AD, supporting the role of tau pathology in the presence of elevated levels of amyloid beta as the driver of neurodegeneration.\n                          <\/jats:p>\n                        <\/jats:list-item>\n                      <\/jats:list>\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/alz.14161","type":"journal-article","created":{"date-parts":[[2024,9,16]],"date-time":"2024-09-16T03:15:22Z","timestamp":1726456522000},"page":"8113-8128","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":20,"title":["Morphometry of medial temporal lobe subregions using high\u2010resolution T2\u2010weighted MRI in ADNI3: Why, how, and what's next?"],"prefix":"10.1002","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8543-4016","authenticated-orcid":false,"given":"Paul A.","family":"Yushkevich","sequence":"first","affiliation":[{"name":"Department of Radiology University of Pennsylvania Perelman 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