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

  • Bich-Ngoc-Thanh Tang
  • Satoshi Minoshima
  • Jean George
  • Annie Robert
  • Christian Swine
  • Patrice Laloux
  • Thierry Vander Borght
Original Article

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 

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Copyright information

© Springer-Verlag 2004

Authors and Affiliations

  • Bich-Ngoc-Thanh Tang
    • 1
    • 2
  • Satoshi Minoshima
    • 3
  • Jean George
    • 1
  • Annie Robert
    • 4
  • Christian Swine
    • 5
  • Patrice Laloux
    • 6
  • Thierry Vander Borght
    • 1
  1. 1.Department of Nuclear Medicine, Mont-Godinne University HospitalUCL-Université Catholique de LouvainYvoirBelgium
  2. 2.Department of Nuclear Medicine, Erasme HospitalFree University of BrusselsBrusselsBelgium
  3. 3.Department of RadiologyUniversity of WashingtonSeattleUSA
  4. 4.Departments of PHS Epidemiology and Biostatistics, Mont-Godinne University HospitalUCL-Université Catholique de LouvainYvoirBelgium
  5. 5.Department of Geriatrics, Mont-Godinne University HospitalUCL-Université Catholique de LouvainYvoirBelgium
  6. 6.Department of Neurology, Mont-Godinne University HospitalUCL-Université Catholique de LouvainYvoirBelgium

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