title: Sensitivity and specificity of 99Tcm-HMPAO single-headed SPECT in dementia.
abstract: The sensitivity and specificity of 99Tcm-hexamethylpropyleneamine oxime (HMPAO) single-headed single photon emission computed tomography (SPECT) in dementia were evaluated in elderly patients with a mean age of 84 years suffering from dementia (n = 59) and compared to an age- and sex-matched control group with normal cognitive function (n = 14). The demented patients were classified as suffering from primary degenerative dementia (PDD, n = 51) based on DSM-III-R criteria. Moreover, PDD patients were divided into three subgroups of severity of cognitive impairment, according to their Folstein score. Multi-infarct dementia (MID, n = 8) was diagnosed based on clinical features, computed tomographic findings and Hachinski ischaemic score. Images were assessed qualitatively by visual interpretation of shades of colour in cortical regions. A SPECT defect confined to the frontal, parietal, temporal or (parieto) occipital lobe was defined as one lesion. The mean number of SPECT lesions was 1.4 (range 0-4) in the control group, 2.4 (range 0-8) in the PDD group and 2.9 (range 2-5) in the MID group and showed a significant difference (P < 0.02) between groups. To obtain an acceptable level of specificity of 64.3%, a cut-off value of three lesions had to be chosen. In the PDD group, sensitivity was then 25% for the mildly, 43.8% for the moderately and 46.7% for the severely affected PDD subgroup. In the MID group sensitivity was then 75%. Interestingly, in this elderly patient population the location of lesions was homogenously distributed in all groups, including the control group.
authors.affiliation: Department of Nuclear Medicine, Middelheim General Hospital, Lindendreef, Antwerp, Belgium.
authors.forename: R A
authors.initials: RA
authors.lastname: Dierckx
authors.forename: M
authors.initials: M
authors.lastname: Vandewoude
authors.forename: J
authors.initials: J
authors.lastname: Saerens
authors.forename: T
authors.initials: T
authors.lastname: Hartoko
authors.forename: P
authors.initials: P
authors.lastname: Marien
authors.forename: I
authors.initials: I
authors.lastname: Capiau
authors.forename: A
authors.initials: A
authors.lastname: Vervaet
authors.forename: A
authors.initials: A
authors.lastname: Dobbeleir
authors.forename: P P
authors.initials: PP
authors.lastname: De Deyn
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003704:Dementia / Q000000981:diagnostic imaging*; D015161:Dementia, Multi-Infarct / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D008297:Male; D015609:Organotechnetium Compounds; D010091:Oximes; D012680:Sensitivity and Specificity; D019690:Technetium Tc 99m Exametazime; D015899:Tomography, Emission-Computed, Single-Photon
chemical_list: D015609:Organotechnetium Compounds; D010091:Oximes; D019690:Technetium Tc 99m Exametazime