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Diagnostic performance of the medial temporal lobe atrophy scale in patients with Alzheimer’s disease: a systematic review and meta-analysis

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Abstract

Objective

To evaluate the diagnostic performance and reliability of the medial temporal lobe atrophy (MTA) scale in patients with Alzheimer’s disease.

Methods

A systematic literature search of MEDLINE and EMBASE databases was performed to select studies that evaluated the diagnostic performance or reliability of MTA scale, published up to January 21, 2021. Pooled estimates of sensitivity and specificity were calculated using a bivariate random-effects model. Pooled correlation coefficients for intra- and interobserver agreements were calculated using the random-effects model based on Fisher’s Z transformation of correlations. Meta-regression was performed to explain the study heterogeneity. Subgroup analysis was performed to compare the diagnostic performance of the MTA scale and hippocampal volumetry.

Results

Twenty-one original articles were included. The pooled sensitivity and specificity of the MTA scale in differentiating Alzheimer’s disease from healthy control were 74% (95% CI, 68–79%) and 88% (95% CI, 83–91%), respectively. The area under the curve of the MTA scale was 0.88 (95% CI, 0.84–0.90). Meta-regression demonstrated that the difference in the method of rating the MTA scale was significantly associated with study heterogeneity (p = 0.04). No significant difference was observed in five studies regarding the diagnostic performance between MTA scale and hippocampal volumetry (p = 0.40). The pooled correlation coefficients for intra- and interobserver agreements were 0.85 (95% CI, 0.69–0.93) and 0.83 (95% CI, 0.66–0.92), respectively.

Conclusions

Our meta-analysis demonstrated a good diagnostic performance and reliability of the MTA scale in Alzheimer’s disease.

Key Points

• The pooled sensitivity and specificity of the MTA scale in differentiating Alzheimer’s disease from healthy control were 74% and 88%, respectively.

• There was no significant difference in the diagnostic performance between MTA scale and hippocampal volumetry.

• The reliability of MTA scale was excellent based on the pooled correlation coefficient for intra- and interobserver agreements.

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Abbreviations

AD:

Alzheimer’s disease

CI:

Confidence interval

DLB:

Dementia with Lewy bodies

ESNR:

European Society of Neuroradiology

FTLD:

Frontotemporal lobar dementia

HC:

Healthy controls

HSROC:

Hierarchical summary receiver operating characteristics

MCI:

Mild cognitive impairment

MTA:

Medial temporal lobe atrophy

NIA-AA :

National Institute on Aging and Alzheimer's Association

SCD:

Subjective cognitive decline

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Funding

This work was supported by the National Research Foundation of Korea (NRF-2021R1C1C1014413 to Chong Hyun Suh).

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Author notes

  1. Ho Young Park and Chae Ri Park contributed equally to this work.

Authors and Affiliations

  1. Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea

    Ho Young Park, Chong Hyun Suh, Woo Hyun Shim & Sang Joon Kim

  2. Department of Medical Science, Asan Medical Institute of Convergence Science and Technology, University of Ulsan College of Medicine, Seoul, Republic of Korea

    Chae Ri Park

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  1. Ho Young Park
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Correspondence to Chong Hyun Suh.

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The scientific guarantor of this publication is Chong Hyun Suh, M.D.

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The authors of this manuscript declare no relationships with any companies whose products or services may be related to the subject matter of the article.

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Written informed consent was not required because the article type of this study is a systematic review and meta-analysis.

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Some study subjects or cohorts have been previously reported in previously published articles which were included in this study.

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Park, H.Y., Park, C.R., Suh, C.H. et al. Diagnostic performance of the medial temporal lobe atrophy scale in patients with Alzheimer’s disease: a systematic review and meta-analysis. Eur Radiol 31, 9060–9072 (2021). https://doi.org/10.1007/s00330-021-08227-8

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