Diagnosis of suspected Alzheimer's disease is improved by automated analysis of regional cerebral blood flow.
OBJECTIVE
Accurate diagnosis of Alzheimer's disease (AD), the most common form of dementia, remains difficult. In order to assess whether fully automated stereotactic surface projection (3D-SSP) presentation contributes to the diagnosis of AD by single-photon emission computed tomography (SPECT), we investigated the diagnostic accuracy of transaxial display with and without 3D-SSP analysis as well as the correlation between cerebral perfusion in different cortical areas and the mini mental score (MMS).


METHODS
Seventy-two patients referred because of cognitive impairment were included in the study. According to the National Institute of Neurological and Communicative Disorders and Stroke (NINCDS) and the Alzheimer's disease and Related Disorders Association (ADRDA) criteria, 27 patients were diagnosed as having probable AD while 45 were classified as non-AD patients. 3D-SSP was used to quantify the regional cerebral blood flow (rCBF) acquired from SPECT imaging.


RESULTS
Compared with the transaxial section presentation alone, 3D-SSP presentation improved the area under the receiver operating curve (p<0.05) as well as intra-observer (k=0.73 vs 0.88) and inter-observer (k=0.50 vs 0.84) reproducibility. Upon normalisation of regional to thalamic activity, multiple regression analysis revealed a strong correlation between the MMS and rCBF in the right parietal cortex (p=0.002).


CONCLUSIONS
Addition of 3D-SSP to the transaxial section display of ECD-SPECT studies improves the reproducibility and the diagnostic performance in respect of AD in patients with cognitive impairment and provides a valid tool for assessment of the severity of cortical perfusion abnormalities in such patients.
Tang
Bich-Ngoc-Thanh
BN
Department of Nuclear Medicine, Mont-Godinne University Hospital, UCL-Université Catholique de Louvain, Yvoir, Belgium. thanh.tang@ulb.ac.be
Minoshima
Satoshi
S
George
Jean
J
Robert
Annie
A
Swine
Christian
C
Laloux
Patrice
P
Borght
Thierry Vander
TV
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000465:Algorithms; D000544:Alzheimer Disease / Q000145:classification / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D001185:Artificial Intelligence; D001783:Blood Flow Velocity; D001921:Brain / Q000098:blood supply* / Q000000981:diagnostic imaging*; D001931:Brain Mapping / Q000379:methods; D002560:Cerebrovascular Circulation; D005260:Female; D006801:Humans; D007089:Image Enhancement / Q000379:methods; D007090:Image Interpretation, Computer-Assisted / Q000379:methods*; D021621:Imaging, Three-Dimensional / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011877:Radionuclide Imaging; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index