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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. Matsudaa,b, S. Mizumurac, T. Nagaod, T. Otae, T. Iizukaf, K. Nemotob,g, N. Takemurah, H. Araie 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


Figure 1
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  		Fig 1. Maximum intensity projections of SPM2 results from group comparison of rCBF between patients with very early AD and age-matched healthy volunteers. Patients with very early AD showed significant decline of rCBF in bilateral posterior cingulate gyri, precunei, and inferior parietal cortices. Height threshold is <0.001, corrected for multiple comparisons.


Figure 2
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  		Fig 2. ROC curves with data conversion to the core SPECT data for discrimination between patients with probable AD at the very early stage of MCI and age-matched healthy volunteers in a multicenter study by using the 3 indicators of severity, extent, and ratio.


Figure 3
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  		Fig 3. Automated voxel-by-voxel Z-score analysis by comparison of a brain perfusion SPECT image of a 78-year-old man with probable AD and an MMSE score of 24 with the mean and SD of SPECT images of healthy volunteers after normalization to global mean cerebral blood flow values. Color-scaled Z-score maps ranging from 2.0 to 5.0 with extent threshold of 300 voxels are displayed by overlaying on transaxial sections and surface rendering of the spatially normalized MR imaging template. Red lines enclose a VOI with the most significant decline of rCBF in very early AD obtained from group comparison with healthy volunteers by SPM2. The severity, extent, and ratio are 2.18, 77.2%, and 3.56, respectively.





Copyright © 2008 by the American Society of Neuroradiology. Print ISSN: 0195-6108 Online ISSN: 1936-959X