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Computer-assisted diagnostic system for neurodegenerative dementia using brain SPECT and 3D-SSP

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European Journal of Nuclear Medicine and Molecular Imaging Aims and scope Submit manuscript

Abstract

Purpose

To develop a computer-assisted automated diagnostic system to distinguish among Alzheimer disease (AD), dementia with Lewy bodies (DLB), and other degenerative disorders in patients with mild dementia.

Methods

Single photon emission computed tomography (SPECT) images with injection of N-Isopropyl-p-[123I]iodoamphetamine (IMP) were obtained from patients with mild degenerative dementia. First, datasets from 20 patients mild AD, 15 patients with dementia with DLB, and 17 healthy controls were used to develop an automated diagnosing system based on three-dimensional stereotactic surface projections (3D-SSP). AD- and DLB-specific regional templates were created using 3D-SSP, and critical Z scores in the templates were established. Datasets from 50 AD patients, 8 DLB patients, and 10 patients with non-AD/DLB type degenerative dementia (5 with frontotemporal dementia and 5 with progressive supranuclear palsy) were then used to test the diagnostic accuracy of the optimized automated system in comparison to the diagnostic interpretation of conventional IMP-SPECT images. These comparisons were performed to differentiate AD and DLB from non-AD/DLB and to distinguish AD from DLB. A receiver operating characteristic (ROC) analysis was performed.

Results

The area under the ROC curve (Az) and the accuracy of the automated diagnosis system were 0.89 and 82%, respectively, for AD/DLB vs. non-AD/DLB patients, and 0.70 and 65%, respectively, for AD vs. DLB patients. The mean Az and the accuracy of the visual inspection were 0.84 and 77%, respectively, for AD/DLB vs. non-AD/DLB patients, and 0.70 and 65%, respectively, for AD vs. DLB patients. The mean Az and the accuracy of the combination of visual inspection and this system were 0.96 and 91%, respectively, for AD/DLB vs. non-AD/DLB patients, and 0.70 and 66%, respectively, for AD vs. DLB patients.

Conclusion

The system developed in the present study achieved as good discrimination of AD, DLB, and other degenerative disorders in patients with mild dementia as the commonly performed visual inspection of conventional SPECT images. A combination of visual inspection and this system is helpful in the differential diagnosis of patients with mild dementia.

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Acknowledgments

The authors thank Mr. Shuya Miki (Nihon Medi-Physics, Tokyo, Japan) for providing and improving the iSSP program, which uses the 3D-SSP program and was dedicated to this automated method.

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Authors and Affiliations

  1. Department of Radiology and Nuclear Medicine, Hyogo Brain and Heart Center, 520 Saisho-Ko, Himeji, Hyogo, 670–0981, Japan

    Kazunari Ishii, Tomonori Kanda, Takafumi Uemura, Naokazu Miyamoto & Toshiki Yoshikawa

  2. Institute for Aging Brain and Cognitive Disorders, Hyogo Brain and Heart Center, Himeji, Hyogo, Japan

    Kenichi Shimada & Shingo Ohkawa

  3. Radiology and Bioengineering, Department of Radiology, University of Washington, Seattle, WA, USA

    Satoshi Minoshima

Authors
  1. Kazunari Ishii
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  2. Tomonori Kanda
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  3. Takafumi Uemura
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  4. Naokazu Miyamoto
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  5. Toshiki Yoshikawa
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  6. Kenichi Shimada
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  7. Shingo Ohkawa
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  8. Satoshi Minoshima
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Correspondence to Kazunari Ishii.

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Ishii, K., Kanda, T., Uemura, T. et al. Computer-assisted diagnostic system for neurodegenerative dementia using brain SPECT and 3D-SSP. Eur J Nucl Med Mol Imaging 36, 831–840 (2009). https://doi.org/10.1007/s00259-008-1051-3

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  • DOI: https://doi.org/10.1007/s00259-008-1051-3

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