title: Usefulness of 3-dimensional stereotactic surface projection FDG PET images for the diagnosis of dementia.
abstract: To compare diagnostic performance and confidence of a standard visual reading and combined 3-dimensional stereotactic surface projection (3D-SSP) results to discriminate between Alzheimer disease (AD)/mild cognitive impairment (MCI), dementia with Lewy bodies (DLB), and frontotemporal dementia (FTD).[F]fluorodeoxyglucose (FDG) PET brain images were obtained from 120 patients (64 AD/MCI, 38 DLB, and 18 FTD) who were clinically confirmed over 2 years follow-up. Three nuclear medicine physicians performed the diagnosis and rated diagnostic confidence twice; once by standard visual methods, and once by adding of 3D-SSP. Diagnostic performance and confidence were compared between the 2 methods.3D-SSP showed higher sensitivity, specificity, accuracy, positive, and negative predictive values to discriminate different types of dementia compared with the visual method alone, except for AD/MCI specificity and FTD sensitivity. Correction of misdiagnosis after adding 3D-SSP images was greatest for AD/MCI (56%), followed by DLB (13%) and FTD (11%). Diagnostic confidence also increased in DLB (visual: 3.2; 3D-SSP: 4.1; P < 0.001), followed by AD/MCI (visual: 3.1; 3D-SSP: 3.8; P = 0.002) and FTD (visual: 3.5; 3D-SSP: 4.2; P = 0.022). Overall, 154/360 (43%) cases had a corrected misdiagnosis or improved diagnostic confidence for the correct diagnosis.The addition of 3D-SSP images to visual analysis helped to discriminate different types of dementia in FDG PET scans, by correcting misdiagnoses and enhancing diagnostic confidence in the correct diagnosis. Improvement of diagnostic accuracy and confidence by 3D-SSP images might help to determine the cause of dementia and appropriate treatment.
authors.affiliation: Department of Nuclear Medicine Department of Neurology, Chonnam National University Hospital, Donggu, Gwangju, Republic of Korea.
authors.forename: Jahae
authors.initials: J
authors.lastname: Kim
authors.forename: Sang-Geon
authors.initials: SG
authors.lastname: Cho
authors.forename: Minchul
authors.initials: M
authors.lastname: Song
authors.forename: Sae-Ryung
authors.initials: SR
authors.lastname: Kang
authors.forename: Seong Young
authors.initials: SY
authors.lastname: Kwon
authors.forename: Kang-Ho
authors.initials: KH
authors.lastname: Choi
authors.forename: Seong-Min
authors.initials: SM
authors.lastname: Choi
authors.forename: Byeong-Chae
authors.initials: BC
authors.lastname: Kim
authors.forename: Ho-Chun
authors.initials: HC
authors.lastname: Song
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000000981:diagnostic imaging*; D000704:Analysis of Variance; D016009:Chi-Square Distribution; D015331:Cohort Studies; D003704:Dementia / Q000000981:diagnostic imaging*; D003937:Diagnosis, Differential; D019788:Fluorodeoxyglucose F18; D006801:Humans; D007091:Image Processing, Computer-Assisted; D021621:Imaging, Three-Dimensional; D020961:Lewy Body Disease / Q000000981:diagnostic imaging*; D049268:Positron-Emission Tomography / Q000379:methods*; D012372:ROC Curve; D056910:Republic of Korea; D012189:Retrospective Studies
chemical_list: D019788:Fluorodeoxyglucose F18