Heterogeneity of cerebral blood flow in frontotemporal lobar degeneration and Alzheimer’s disease

  • Michinobu NagaoEmail author
  • Yoshifumi Sugawara
  • Manabu Ikeda
  • Ryuji Fukuhara
  • Kazuhiko Hokoishi
  • Kenya Murase
  • Teruhito Mochizuki
  • Hitoshi Miki
  • Takanori Kikuchi
Original Article


This study was designed to quantify the heterogeneity on cerebral blood flow single-photon emission tomography (SPET) images in frontotemporal lobar degeneration (FTLD) and Alzheimer’s disease (AD) using a three-dimensional fractal analysis. Twenty-one FTLD patients, 21 AD patients and 11 healthy controls underwent technetium-99m hexamethylpropylene amine oxime SPET scanning. Patients with FTLD and AD matched for sex, age and the severity of dementia as estimated with the Clinical Dementia Rating and were determined to be in the early stage of illness. We delineated the SPET images using a 35% cut-off and a 50% cut-off of the maximal voxel radioactivity and measured the number of voxels included in the contours of two different cut-offs. The fractal dimension (FD) was calculated by relating the logarithms of the cut-offs and the numbers of voxels, and it was defined as the heterogeneity of the cerebral perfusion. We divided the SPET images into two sets, anterior and posterior, with equal numbers of coronal SPET slices. We calculated total FD, anterior FD and posterior FD for total, anterior and posterior SPET images. Anterior FDs for FTLD and AD were 1.55±0.34 and 1.24±0.19 (P=0.0002). The ratios of anterior to posterior FD for FTLD and AD were 1.81±0.41 and 1.32±0.14 (P<0.0001). Use of the anterior FD and the ratio of anterior to posterior FD separated FTLD patients from AD patients and controls with a sensitivity of 85.7% and a specificity of 93.8%. Anterior FD and the ratio of anterior to posterior FD may be useful in distinguishing FTLD from AD.


Frontotemporal lobar degeneration Alzheimer’s disease SPET Fractal analysis 



The authors wish to thank Professor Junpei Ikezoe of the Department of Radiology and Professor Hirotaka Tanabe of the Department of Neuropsychiatry at Ehime University for their continuous encouragement and valuable suggestions, and also Dr. Shozo Nakano for proofreading this manuscript.


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Copyright information

© Springer-Verlag 2004

Authors and Affiliations

  • Michinobu Nagao
    • 1
    Email author
  • Yoshifumi Sugawara
    • 2
  • Manabu Ikeda
    • 3
  • Ryuji Fukuhara
    • 3
  • Kazuhiko Hokoishi
    • 3
  • Kenya Murase
    • 4
  • Teruhito Mochizuki
    • 2
  • Hitoshi Miki
    • 2
  • Takanori Kikuchi
    • 2
  1. 1.Department of RadiologyMatsuyama Medical Center for Cancer and Cardiovascular DiseaseMatsuyama-City, EhimeJapan
  2. 2.Department of RadiologyEhime University Medical SchoolEhimeJapan
  3. 3.Department of NeuropsychiatryEhime University Medical SchoolEhimeJapan
  4. 4.Department of Medical Engineering Division of Allied Health SciencesOsaka University Medical SchoolOsakaJapan

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