title: A region-of-interest template for three-dimensional stereotactic surface projection images: initial application to the analysis of Alzheimer's disease and mild cognitive impairment.
abstract: OBJECTIVE
  To construct a region-of-interest (ROI) template for Z-score images of three-dimensional stereotactic surface projections (3-D SSP) and to assess whether the ROI template can be a useful tool for evaluation of brain perfusion abnormalities of neurological disorders.
  
  
  METHODS
  We constructed the ROI template for Z-score images of 3-D SSP based on the standardized magnetic resonance imaging data of 10 healthy volunteers. We assigned a total of 26 ROIs to Z-score images and superimposed it on Z-score images constructed from the brain perfusion SPECT data of 15 patients with Alzheimer's disease and 10 patients with mild cognitive impairment (MCI) who developed Alzheimer's disease within the following 2 years. We then obtained the mean Z-scores of each ROI and examined them to determine whether the hypoperfusion typical of Alzheimer's disease had been demonstrated quantitatively. We also visually inspected the Z-score image of each patient in both groups to determine whether the areas with the highest Z-scores were demonstrated within the ROIs of regions typical of Alzheimer's disease.
  
  
  RESULTS
  In the patients with Alzheimer's disease, our ROI template quantitatively demonstrated hypoperfusion in regions typical of the disease and the Z-scores were very high. In the MCI patients, the mean Z-scores of the ROI in the posterior cingulated gyrus were the highest among all regions. Visual inspection of the Z-score images of each patient in both groups confirmed that the areas with the highest Z-scores were demonstrated within the ROIs in regions typical of Alzheimer's disease in all cases.
  
  
  CONCLUSIONS
  Use of 3-D SSP methods and our ROI template enables automated quantitative evaluation of brain function images over the entire brain surface. In addition, the ROI template may facilitate visual interpretation of functional images of individual patients with neurological disorders.
authors.affiliation: Department of Radiology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Japan. tkubota@koto.kpu-m.ac.jp
authors.forename: Takao
authors.initials: T
authors.lastname: Kubota
authors.forename: Yo
authors.initials: Y
authors.lastname: Ushijima
authors.forename: Chio
authors.initials: C
authors.lastname: Okuyama
authors.forename: Tsunehiko
authors.initials: T
authors.lastname: Nishimura
mesh_terms: D000328:Adult; D000368:Aged; D000465:Algorithms; D000544:Alzheimer Disease / Q000150:complications / Q000000981:diagnostic imaging*; D001921:Brain / Q000000981:diagnostic imaging* / Q000503:physiopathology; D001931:Brain Mapping / Q000379:methods*; D003072:Cognition Disorders / Q000000981:diagnostic imaging* / Q000209:etiology; D005260:Female; D006801:Humans; D007090:Image Interpretation, Computer-Assisted / Q000379:methods*; D021621:Imaging, Three-Dimensional / Q000379:methods*; D008297:Male; D010363:Pattern Recognition, Automated / Q000379:methods; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013382:Subtraction Technique; D015899:Tomography, Emission-Computed, Single-Photon / Q000379:methods*