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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.