title: Early-stage differentiation between presenile Alzheimer's disease and frontotemporal dementia using arterial spin labeling MRI.
abstract: OBJECTIVE
  To investigate arterial spin labeling (ASL)-MRI for the early diagnosis of and differentiation between the two most common types of presenile dementia: Alzheimer's disease (AD) and frontotemporal dementia (FTD), and for distinguishing age-related from pathological perfusion changes.
  
  
  METHODS
  Thirteen AD and 19 FTD patients, and 25 age-matched older and 22 younger controls underwent 3D pseudo-continuous ASL-MRI at 3 T. Gray matter (GM) volume and cerebral blood flow (CBF), corrected for partial volume effects, were quantified in the entire supratentorial cortex and in 10 GM regions. Sensitivity, specificity and diagnostic performance were evaluated in regions showing significant CBF differences between patient groups or between patients and older controls.
  
  
  RESULTS
  AD compared with FTD patients had hypoperfusion in the posterior cingulate cortex, differentiating these with a diagnostic performance of 74 %. Compared to older controls, FTD patients showed hypoperfusion in the anterior cingulate cortex, whereas AD patients showed a more widespread regional hypoperfusion as well as atrophy. Regional atrophy was not different between AD and FTD. Diagnostic performance of ASL to differentiate AD or FTD from controls was good (78-85 %). Older controls showed global hypoperfusion compared to young controls.
  
  
  CONCLUSIONS
  ASL-MRI contributes to early diagnosis of and differentiation between presenile AD and FTD.
  
  
  CONCLUSIONS
  ASL-MRI facilitates differentiation of early Alzheimer's disease and frontotemporal dementia. Posterior cingulate perfusion is lower in Alzheimer's disease than frontotemporal dementia. Compared to controls, Alzheimer's disease patients show hypoperfusion in multiple regions. Compared to controls, frontotemporal dementia patients show focal anterior cingulate hypoperfusion. Global decreased perfusion in older adults differs from hypoperfusion in dementia.
authors.affiliation: Department of Radiology, Erasmus MC - University Medical Center, PO Box 2040, 3000 CA, Rotterdam, The Netherlands.
authors.forename: Rebecca M E
authors.initials: RM
authors.lastname: Steketee
authors.affiliation: Biomedical Imaging Group Rotterdam, Departments of Medical Informatics and Radiology, Erasmus MC - University Medical Center, PO Box 2040, 3000 CA, Rotterdam, The Netherlands.
authors.forename: Esther E
authors.initials: EE
authors.lastname: Bron
authors.affiliation: Department of Radiology, Erasmus MC - University Medical Center, PO Box 2040, 3000 CA, Rotterdam, The Netherlands.
authors.forename: Rozanna
authors.initials: R
authors.lastname: Meijboom
authors.affiliation: GE Healthcare, 71 Great North Road, Hatfield, AL9 5EN, UK.
authors.forename: Gavin C
authors.initials: GC
authors.lastname: Houston
authors.affiliation: Biomedical Imaging Group Rotterdam, Departments of Medical Informatics and Radiology, Erasmus MC - University Medical Center, PO Box 2040, 3000 CA, Rotterdam, The Netherlands.
authors.forename: Stefan
authors.initials: S
authors.lastname: Klein
authors.affiliation: Department of Radiology, Academic Medical Center, PO Box 22660, 1100 DD, Amsterdam, The Netherlands.
authors.forename: Henri J M M
authors.initials: HJ
authors.lastname: Mutsaerts
authors.affiliation: Department of Radiology, Erasmus MC - University Medical Center, PO Box 2040, 3000 CA, Rotterdam, The Netherlands.|Department of Neurology, Erasmus MC - University Medical Center, PO Box 2040, 3000 CA, Rotterdam, The Netherlands.
authors.forename: Carolina P
authors.initials: CP
authors.lastname: Mendez Orellana
authors.affiliation: Department of Neurology, Erasmus MC - University Medical Center, PO Box 2040, 3000 CA, Rotterdam, The Netherlands.
authors.forename: Frank Jan
authors.initials: FJ
authors.lastname: de Jong
authors.affiliation: Department of Neurology, Erasmus MC - University Medical Center, PO Box 2040, 3000 CA, Rotterdam, The Netherlands.
authors.forename: John C
authors.initials: JC
authors.lastname: van Swieten
authors.affiliation: Department of Radiology, Erasmus MC - University Medical Center, PO Box 2040, 3000 CA, Rotterdam, The Netherlands.
authors.forename: Aad
authors.initials: A
authors.lastname: van der Lugt
authors.affiliation: Department of Radiology, Erasmus MC - University Medical Center, PO Box 2040, 3000 CA, Rotterdam, The Netherlands. marion.smits@erasmusmc.nl.
authors.forename: Marion
authors.initials: M
authors.lastname: Smits
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000544:Alzheimer Disease / Q000175:diagnosis*; D001284:Atrophy / Q000473:pathology; D002540:Cerebral Cortex / Q000473:pathology*; D002560:Cerebrovascular Circulation; D003937:Diagnosis, Differential; D017352:Echo-Planar Imaging / Q000379:methods*; D005260:Female; D057180:Frontotemporal Dementia / Q000175:diagnosis*; D066128:Gray Matter / Q000473:pathology*; D006801:Humans; D021621:Imaging, Three-Dimensional / Q000379:methods*; D008297:Male; D008875:Middle Aged; D013997:Time Factors; D055815:Young Adult
keywords: Alzheimer’s disease; Arterial spin labeling MRI; Frontotemporal dementia; Sensitivity; Specificity