Original Article

European Journal of Nuclear Medicine and Molecular Imaging

, Volume 31, Issue 11, pp 1487-1494

First online:

Diagnosis of suspected Alzheimer’s disease is improved by automated analysis of regional cerebral blood flow

  • Bich-Ngoc-Thanh TangAffiliated withDepartment of Nuclear Medicine, Mont-Godinne University Hospital, UCL-Université Catholique de LouvainDepartment of Nuclear Medicine, Erasme Hospital, Free University of Brussels Email author 
  • , Satoshi MinoshimaAffiliated withDepartment of Radiology, University of Washington
  • , Jean GeorgeAffiliated withDepartment of Nuclear Medicine, Mont-Godinne University Hospital, UCL-Université Catholique de Louvain
  • , Annie RobertAffiliated withDepartments of PHS Epidemiology and Biostatistics, Mont-Godinne University Hospital, UCL-Université Catholique de Louvain
  • , Christian SwineAffiliated withDepartment of Geriatrics, Mont-Godinne University Hospital, UCL-Université Catholique de Louvain
  • , Patrice LalouxAffiliated withDepartment of Neurology, Mont-Godinne University Hospital, UCL-Université Catholique de Louvain
  • , Thierry Vander BorghtAffiliated withDepartment of Nuclear Medicine, Mont-Godinne University Hospital, UCL-Université Catholique de Louvain

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Abstract

Purpose

Accurate diagnosis of Alzheimer’s disease (AD), the most common form of dementia, remains difficult. In order to assess whether fully automated stereotactic surface projection (3D-SSP) presentation contributes to the diagnosis of AD by single-photon emission computed tomography (SPECT), we investigated the diagnostic accuracy of transaxial display with and without 3D-SSP analysis as well as the correlation between cerebral perfusion in different cortical areas and the mini mental score (MMS).

Methods

Seventy-two patients referred because of cognitive impairment were included in the study. According to the National Institute of Neurological and Communicative Disorders and Stroke (NINCDS) and the Alzheimer’s disease and Related Disorders Association (ADRDA) criteria, 27 patients were diagnosed as having probable AD while 45 were classified as non-AD patients. 3D-SSP was used to quantify the regional cerebral blood flow (rCBF) acquired from SPECT imaging.

Results

Compared with the transaxial section presentation alone, 3D-SSP presentation improved the area under the receiver operating curve (p<0.05) as well as intra-observer (k=0.73 vs 0.88) and inter-observer (k=0.50 vs 0.84) reproducibility. Upon normalisation of regional to thalamic activity, multiple regression analysis revealed a strong correlation between the MMS and rCBF in the right parietal cortex (p=0.002).

Conclusion

Addition of 3D-SSP to the transaxial section display of ECD-SPECT studies improves the reproducibility and the diagnostic performance in respect of AD in patients with cognitive impairment and provides a valid tool for assessment of the severity of cortical perfusion abnormalities in such patients.

Keywords

Alzheimer’s disease Semi-quantification Cerebral blood flow MMS ECD-SPECT