title: Conventional SPECT Versus 3D Thresholded SPECT Imaging in the Diagnosis of ADHD: A Retrospective Study.
abstract: Brain single photon emission CT (SPECT) scans indirectly show functional activity via measurement of regional cerebral blood flow. In conventional SPECT scans, the typical tomographic slices are produced. In three-dimensional thresholded SPECT scans, pixels representing activity below a certain threshold are discarded. A retrospective analysis of 427 patients shows that three-dimensional thresholded SPECT scans yield a sensitivity for predicting clinical attention deficit hyperactivity disorder of 54% [95% confidence interval (CI), 46%-61%; specificity, 76%; 95% CI, 71%-81%] compared with 4% sensitivity [95% CI, 2%-8%; specificity, 97%; 95% CI, 94%-98%] for conventional SPECT scans. For 170 of the patients originating from a general psychiatry practice, conventional SPECT showed 10% sensitivity (95% CI, 4%-23%) and 98% specificity (95% CI, 93%-99%), whereas three-dimensional thresholded SPECT showed 83% sensitivity (95% CI, 68%-91%) and 77% specificity (95% CI, 69%-83%). These findings indicate that a much stronger signal is obtained when the three-dimensional thresholded SPECT scan is performed rather than the conventional SPECT scan in detecting attention deficit hyperactivity disorder and suggest similar results may be obtained for other psychiatric disorders.
authors.affiliation: From Sheppard Associates, Toronto, ON, Canada (HS); Rossiter-Thornton Associates, Toronto, ON, Canada (JFT); the Dept. of Nuclear Medicine, Mount Sinai Hospital, University of Toronto, Toronto, ON, Canada (MAF); Toronto, ON, Canada (MKM, MJvL); and the Dept. of Mathematics, Massachusetts Institute of Technology, Cambridge, MA (JS).
authors.forename: Howard
authors.initials: H
authors.lastname: Schneider
authors.affiliation: From Sheppard Associates, Toronto, ON, Canada (HS); Rossiter-Thornton Associates, Toronto, ON, Canada (JFT); the Dept. of Nuclear Medicine, Mount Sinai Hospital, University of Toronto, Toronto, ON, Canada (MAF); Toronto, ON, Canada (MKM, MJvL); and the Dept. of Mathematics, Massachusetts Institute of Technology, Cambridge, MA (JS).
authors.forename: John F
authors.initials: JF
authors.lastname: Thornton
authors.affiliation: From Sheppard Associates, Toronto, ON, Canada (HS); Rossiter-Thornton Associates, Toronto, ON, Canada (JFT); the Dept. of Nuclear Medicine, Mount Sinai Hospital, University of Toronto, Toronto, ON, Canada (MAF); Toronto, ON, Canada (MKM, MJvL); and the Dept. of Mathematics, Massachusetts Institute of Technology, Cambridge, MA (JS).
authors.forename: Marc A
authors.initials: MA
authors.lastname: Freeman
authors.affiliation: From Sheppard Associates, Toronto, ON, Canada (HS); Rossiter-Thornton Associates, Toronto, ON, Canada (JFT); the Dept. of Nuclear Medicine, Mount Sinai Hospital, University of Toronto, Toronto, ON, Canada (MAF); Toronto, ON, Canada (MKM, MJvL); and the Dept. of Mathematics, Massachusetts Institute of Technology, Cambridge, MA (JS).
authors.forename: Mary K
authors.initials: MK
authors.lastname: McLean
authors.affiliation: From Sheppard Associates, Toronto, ON, Canada (HS); Rossiter-Thornton Associates, Toronto, ON, Canada (JFT); the Dept. of Nuclear Medicine, Mount Sinai Hospital, University of Toronto, Toronto, ON, Canada (MAF); Toronto, ON, Canada (MKM, MJvL); and the Dept. of Mathematics, Massachusetts Institute of Technology, Cambridge, MA (JS).
authors.forename: Muriel J
authors.initials: MJ
authors.lastname: van Lierop
authors.affiliation: From Sheppard Associates, Toronto, ON, Canada (HS); Rossiter-Thornton Associates, Toronto, ON, Canada (JFT); the Dept. of Nuclear Medicine, Mount Sinai Hospital, University of Toronto, Toronto, ON, Canada (MAF); Toronto, ON, Canada (MKM, MJvL); and the Dept. of Mathematics, Massachusetts Institute of Technology, Cambridge, MA (JS).
authors.forename: Jonathan
authors.initials: J
authors.lastname: Schneider
mesh_terms: D000293:Adolescent; D000328:Adult; D001289:Attention Deficit Disorder with Hyperactivity / Q000175:diagnosis* / Q000188:drug therapy; D001921:Brain / Q000000981:diagnostic imaging* / Q000187:drug effects / Q000473:pathology*; D001931:Brain Mapping; D005260:Female; D006801:Humans; D021621:Imaging, Three-Dimensional; D008297:Male; D008875:Middle Aged; D011569:Psychiatric Status Rating Scales; D011619:Psychotropic Drugs / Q000627:therapeutic use; D012189:Retrospective Studies; D015899:Tomography, Emission-Computed, Single-Photon; D055815:Young Adult
chemical_list: D011619:Psychotropic Drugs