Use of fuzzy edge single-photon emission computed tomography analysis in definite Alzheimer's disease--a retrospective study.
BACKGROUND
Definite Alzheimer's disease (AD) requires neuropathological confirmation. Single-photon emission computed tomography (SPECT) may enhance diagnostic accuracy, but due to restricted sensitivity and specificity, the role of SPECT is largely limited with regard to this purpose.


METHODS
We propose a new method of SPECT data analysis. The method is based on a combination of parietal lobe selection (as regions-of-interest (ROI)), 3D fuzzy edge detection, and 3D watershed transformation. We applied the algorithm to three-dimensional SPECT images of human brains and compared the number of watershed regions inside the ROI between AD patients and controls. The Student's two-sample t-test was used for testing domain number equity in both groups.


RESULTS
AD patients had a significantly reduced number of watershed regions compared to controls (p < 0.01). A sensitivity of 94.1% and specificity of 80% was obtained with a threshold value of 57.11 for the watershed domain number. The narrowing of the SPECT analysis to parietal regions leads to a substantial increase in both sensitivity and specificity.


CONCLUSIONS
Our non-invasive, relatively low-cost, and easy method can contribute to a more precise diagnosis of AD.
Rusina
Robert
R
Department of Neurology, Thomayer Teaching Hospital and Institute for Postgraduate Education in Medicine, Prague, Czech Republic. robert.rusina@ftn.cz
Kukal
Jaromír
J
Belícek
Tomás
T
Buncová
Marie
M
Matej
Radoslav
R
D000368:Aged; D000369:Aged, 80 and over; D000465:Algorithms; D000544:Alzheimer Disease / Q000000981:diagnostic imaging*; D001921:Brain / Q000000981:diagnostic imaging*; D005260:Female; D017143:Fuzzy Logic; D006801:Humans; D007089:Image Enhancement / Q000379:methods; D007090:Image Interpretation, Computer-Assisted / Q000379:methods*; D008297:Male; D008875:Middle Aged; D010363:Pattern Recognition, Automated / Q000379:methods*; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D015899:Tomography, Emission-Computed, Single-Photon / Q000379:methods*
Lancet Neurol. 2003 Oct;2(10):605-13
14505582
Neurobiol Aging. 1998 Mar-Apr;19(2):109-16
9558143
Phys Med Biol. 2010 May 21;55(10):2807-17
20413829
Radiology. 1997 Mar;202(3):793-7
9051035
J Nucl Med. 2000 Jul;41(7):1155-62
10914904
Am J Geriatr Psychiatry. 2004 Nov-Dec;12(6):554-70
15545324
Neurology. 2001 May 8;56(9):1143-53
11342678
Ann Nucl Med. 2009 Jan;23(1):25-31
19205835
Eur J Neurol. 2010 Jan;17(1):23-30
19572947
Eur J Nucl Med Mol Imaging. 2010 Mar;37(3):589-93
19820929
J Nucl Med. 2004 Sep;45(9):1450-7
15347711
Brain. 2007 Sep;130(Pt 9):2320-6
17586559
Dement Geriatr Cogn Disord. 1999 Mar-Apr;10(2):109-14
10026384
Ann Neurol. 1997 Jul;42(1):85-94
9225689