title: Diagnosis of depression by MRI scans with the use of VSRAD - a promising auxiliary means of diagnosis: a report of 10 years research.
abstract: OBJECTIVE
  This study was designed to evaluate the usefulness of assessing subgenual anterior cingulate cortex (sACC) volume reduction by magnetic resonance imaging (MRI) as an objective auxiliary means of diagnosis of depression. The study was additionally designed to analyze the association of sACC volume reduction with the effectiveness of treatments for depression and other diseases presenting with similar symptoms, and to examine the possibility of using sACC volume reduction in the distinction between depression and bipolar disorder and determining optimum medication for these conditions.
  
  
  METHODS
  Three-dimensional T1-weighted sagittal images, taken with Achieva 1.5T NOVA (Philips), were analyzed with VSRAD plus(®) to evaluate a reduction in sACC volume. The finding from this analysis was compared with the clinical data, including the longitudinal course follow-up data based on the treatment algorithm.
  
  
  METHODS
  The study involved 88 patients aged over 54 who received MRI during 2010, ie, 71 patients with major depressive disorder (MDD), 11 patients bipolar disorder, and 6 patients in whom the initial diagnosis (MDD) was later modified. Thirty-three normal individuals served as controls.
  
  
  RESULTS
  sACC volume reduction was noted in 66 of the 71 patients receiving treatment of MDD, with sensitivity of 93%, specificity of 85%, and accuracy of 90%. In the 66 patients diagnosed as having MDD and exhibiting sACC volume reduction, the disease showed remission in response to treatment with antidepressants, but medication needed to be continued after achievement of remission. In cases initially diagnosed as having MDD but not exhibiting sACC volume reduction, the necessity of modifying the diagnosis was considered. Typical cases of bipolar disorder did not exhibit sACC volume reduction.
  
  
  CONCLUSIONS
  That patients receiving treatment of MDD often showed reduction in sACC volume suggests the usefulness of this parameter as an objective auxiliary means of diagnosis for MDD.
authors.affiliation: Nanto Clinic, Urasoe City, Okinawa, Japan;
authors.forename: Richi
authors.initials: R
authors.lastname: Niida
authors.forename: Akira
authors.initials: A
authors.lastname: Niida
authors.forename: Makoto
authors.initials: M
authors.lastname: Motomura
authors.forename: Akihiko
authors.initials: A
authors.lastname: Uechi