title: Feasibility of estimation of brain volume and 2-deoxy-2-(18)F-fluoro-D-glucose metabolism using a novel automated image analysis method: application in Alzheimer's disease.
abstract: The development of clinically-applicable quantitative methods for the analysis of  brain fluorine-18 fluoro desoxyglucose-positron emission tomography ((18)F-FDG-PET) images is  a major area of research in many neurologic diseases, particularly Alzheimer's disease (AD).  Region of interest visualization, evaluation, and image registration (ROVER) is a novel  commercially-available software package which provides automated partial volume corrected  measures of volume and glucose uptake from (18)F-FDG PET data.  We performed a pilot study of  ROVER analysis of brain (18)F-FDG PET images for the first time in a small cohort of patients  with AD and controls. Brain (18)F-FDG-PET and volumetric magnetic resonance imaging (MRI)  were performed on 14 AD patients and 18 age-matched controls.  Images were subjected to  ROVER analysis, and voxel-based analysis using SPM5. Volumes by ROVER were 35% lower  than MRI volumes in AD patients (as hypometabolic regions were excluded in ROVER-derived volume  measurement ) while average ROVER- and MRI-derived cortical volumes were nearly identical in control  population. Whole brain volumes when ROVER-derived and whole brain metabolic volumetric products  (MVP) were significantly lower in AD and accurately distinguished AD patients from controls  (Area Under the Curve (AUC) of Receiver Operator Characteristic (ROC) curves 0.89 and 0.86, respectively).  This diagnostic accuracy was similar to voxel-based analyses.  Analysis by ROVER of (18)F-FDG-PET images  provides a unique index of metabolically-active brain volume, and can accurately distinguish between AD  patients and controls as a proof of concept. In conclusion, our findings suggest that ROVER may  serve as a useful quantitative adjunct to visual or regional assessment and aid analysis of whole-brain  metabolism in AD and other neurologic and psychiatric diseases.
authors.affiliation: Department of Neurology, Hospital of the University of Pennsylvania, 3400 Spruce St., Philadelphia, PA 19104, USA.
authors.forename: Erik S
authors.initials: ES
authors.lastname: Musiek
authors.forename: Babak
authors.initials: B
authors.lastname: Saboury
authors.forename: Shipra
authors.initials: S
authors.lastname: Mishra
authors.forename: Yufen
authors.initials: Y
authors.lastname: Chen
authors.forename: Janet S
authors.initials: JS
authors.lastname: Reddin
authors.forename: Andrew B
authors.initials: AB
authors.lastname: Newberg
authors.forename: Jayaram K
authors.initials: JK
authors.lastname: Udupa
authors.forename: John A
authors.initials: JA
authors.lastname: Detre
authors.forename: Frank
authors.initials: F
authors.lastname: Hofheinz
authors.forename: Drew
authors.initials: D
authors.lastname: Torigian
authors.forename: Abass
authors.initials: A
authors.lastname: Alavi
mesh_terms: D000368:Aged; D000465:Algorithms; D000544:Alzheimer Disease / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D001185:Artificial Intelligence; D005240:Feasibility Studies; D005260:Female; D019788:Fluorodeoxyglucose F18 / Q000493:pharmacokinetics*; D006801:Humans; D007089:Image Enhancement / Q000379:methods; D007090:Image Interpretation, Computer-Assisted / Q000379:methods; D021621:Imaging, Three-Dimensional / Q000379:methods*; D008297:Male; D009929:Organ Size; D010363:Pattern Recognition, Automated / Q000379:methods*; D049268:Positron-Emission Tomography / Q000379:methods*; D019275:Radiopharmaceuticals / Q000493:pharmacokinetics; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity
chemical_list: D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18