RT Journal Article SR Electronic T1 Classification of Mild Cognitive Impairment and Alzheimer Disease Using Model-Based MR and Magnetization Transfer Imaging JF American Journal of Neuroradiology JO Am. J. Neuroradiol. FD American Society of Neuroradiology SP 740 OP 746 DO 10.3174/ajnr.A3307 VO 34 IS 4 A1 R. Wiest A1 Y. Burren A1 M. Hauf A1 G. Schroth A1 J. Pruessner A1 M. Zbinden A1 K. Cattapan-Ludewig A1 C. Kiefer YR 2013 UL http://www.ajnr.org/content/34/4/740.abstract AB BACKGROUND AND PURPOSE: Early stratification of degenerative processes is a prerequisite to warrant therapeutic options in prodromal Alzheimer disease. Our aim was to investigate differences in cerebral macromolecular tissue composition between patients with AD, mild cognitive impairment, and age- and sex-matched healthy controls by using model-based magnetization transfer with a binary spin-bath magnetization transfer model and magnetization transfer ratio at 1.5T. MATERIALS AND METHODS: We investigated patients with de novo AD (n = 18), MCI (n = 18), and CTRLs (n = 18). A region-of-interest analysis of the entorhinal cortex, hippocampal head and body, insula, and temporal neocortex was performed with fuzzy clustering to associate every subregion to a cluster representative for each group. RESULTS: Cluster analysis achieved a concordance of 0.92 (50 of 54 subjects) between a combination of the calculated mMT parameters (kf,kr,T2r,F,T2f) in the entorhinal cortex and the neuropsychological diagnosis. The sensitivity and specificity for the discrimination of AD from MCI reached 1 and 0.94, with a positive predictive value of 0.95 and a negative predictive value of 1. Compared with mMT, the concordance for MTR was 0.83 (45 of 54 subjects) with a lower specificity of 0.5 and positive predictive value of 0.67 to discriminate patients with AD and MCI. CONCLUSIONS: mMT imaging detects macromolecule-related alterations and allows an improved classification of patients with early AD and MCI compared with MTR. ADAlzheimer diseaseCERAD-NABGerman Version of the Consortium to Establish a Registry on Alzheimer's Disease–Neuropsychological Assessment BatteryCIconfidence intervalCTRLshealthy controlsMCImild cognitive impairmentmMTmodel-based magnetization transferMTRmagnetization transfer ratio