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AJNR - American Journal of Neuroradiology

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American Journal of Neuroradiology 28:731-736, April 2007
© 2007 American Society of Neuroradiology

BRAIN

Automated Discrimination Between Very Early Alzheimer Disease and Controls Using an Easy Z-Score Imaging System for Multicenter Brain Perfusion Single-Photon Emission Tomography

H. Matsuda^a,b, S. Mizumura^c, T. Nagao^d, T. Ota^e, T. Iizuka^f, K. Nemoto^b,g, N. Takemura^h, H. Arai^e and A. Hommaⁱ

^a Department of Nuclear Medicine, Saitama Medical University Hospital
^b Department of Radiology, National Center Hospital for Mental, Nervous, and Muscular Disorders, National Center of Neurology and Psychiatry
^c Department of Radiology, Nippon Medical School
^d Department of Neurology, Tokyo Metropolitan Ebara Hospital
^e Department of Psychiatry, Juntendo University School of Medicine
^f Department of Nuclear Medicine, Fukujuji Hospital
^g Department of Neuropsychiatry, Institute of Clinical Medicine, University of Tsukuba
^h Daiichi Radioisotope Laboratory, Tokyo Metropolitan Institute of Gerontology
ⁱ Department of Psychiatry, Tokyo Metropolitan Institute of Gerontology

Please address correspondence to Hiroshi Matsuda, MD, Department of Nuclear Medicine, Saitama Medical University Hospital, 38, Morohongo, Moroyama-machi, Iruma-gun, Saitama, 350-0495, Japan; e-mail: matsudah{at}saitama-med.ac.jp

BACKGROUND AND PURPOSE: In Alzheimer disease (AD), a peculiar regional cerebral blood flow (rCBF) abnormality has been reported in the posterior cingulate gyri and precunei, even at a very early stage. We performed a multicenter brain perfusion single-photon emission tomography (SPECT) study to evaluate the discrimination ability of an easy Z-score imaging system (eZIS) with a common normal data base between patients with very early AD at the stage of mild cognitive impairment and age-matched healthy controls.

MATERIALS AND METHODS: For a multicenter study, SPECT images of 40 patients with AD and 40 healthy volunteers were acquired from 4 gamma camera systems in 4 different institutions. Systematic differences of SPECT images between gamma cameras were corrected by using conversion maps calculated from the SPECT images of the same brain phantom. Receiver operating characteristic (ROC) analysis was performed to discriminate patients and controls by using a Z-score in the volume of interest (VOI), which had been defined as a region related to AD in subjects other than those in a multicenter study.

RESULTS: Bilateral posterior cingulate gyri, precunei, and parietal cortices were defined as a VOI showing rCBF reduction in very early AD. A new indicator of rCBF abnormality in the VOI provided 86% accuracy for distinction of AD and healthy controls in the multicenter study. The area under the ROC curve was 0.934.

CONCLUSION: Because an eZIS can use a common normal data base by converting site-specific SPECT data to the core data, the eZIS was useful for automated diagnosis of very early AD in routine studies in multiple institutions.

This article has been cited by other articles:

				A. Cho, M. Sugimura, S. Nakano, and T. Yamada The Japanese MCI Screen for Early Detection of Alzheimer's Disease and Related Disorders American Journal of Alzheimer's Disease and Other Dementias, May 1, 2008; 23(2): 162 - 166. [Abstract] [PDF]

				H. Matsuda Role of Neuroimaging in Alzheimer's Disease, with Emphasis on Brain Perfusion SPECT J. Nucl. Med., August 1, 2007; 48(8): 1289 - 1300. [Abstract] [Full Text] [PDF]