title: Visual rating versus volumetry to detect frontotemporal dementia.
abstract: OBJECTIVE
  Automated, volumetrically defined atrophy in the left anterior cingulate (LAC) and anterior temporal regions (LAT) on MRI can be used to distinguish most patients with frontotemporal dementia (FTD) from controls. FTD and Alzheimer's disease (AD) can differ in the degree of anterior temporal atrophy. We explored whether clinicians can visually detect this atrophy pattern and whether they can use it to classify the 2 groups of dementia patients with the same accuracy.
  
  
  METHODS
  Four neurologists rated atrophy in the LAC and LAT regions on MRI slices from 21 FTD, 21 controls, and 14 AD participants. Inter-rater reliability and diagnostic accuracy were assessed.
  
  
  RESULTS
  All 4 raters agreed on the presence of clinically significant atrophy, and their atrophy scoring correlated with the volumes, but without translation into high inter-rater diagnostic agreement.
  
  
  CONCLUSIONS
  Volumetric analyses are difficult to translate into routine clinical practice.
authors.affiliation: Department of Medicine (Division of Neurology), University of Toronto, Ont., Canada. tchow @ rotman-baycrest.on.ca
authors.forename: T W
authors.initials: TW
authors.lastname: Chow
authors.forename: F
authors.initials: F
authors.lastname: Gao
authors.forename: K A
authors.initials: KA
authors.lastname: Links
authors.forename: J E
authors.initials: JE
authors.lastname: Ween
authors.forename: D F
authors.initials: DF
authors.lastname: Tang-Wai
authors.forename: J
authors.initials: J
authors.lastname: Ramirez
authors.forename: C J M
authors.initials: CJ
authors.lastname: Scott
authors.forename: M
authors.initials: M
authors.lastname: Freedman
authors.forename: D T
authors.initials: DT
authors.lastname: Stuss
authors.forename: S E
authors.initials: SE
authors.lastname: Black
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000175:diagnosis / Q000473:pathology; D001284:Atrophy; D001344:Autopsy; D003937:Diagnosis, Differential; D005260:Female; D057180:Frontotemporal Dementia / Q000175:diagnosis* / Q000473:pathology*; D006179:Gyrus Cinguli / Q000473:pathology; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D015203:Reproducibility of Results; D012959:Socioeconomic Factors; D013702:Temporal Lobe / Q000473:pathology