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Receiver Operating Characteristic Analysis of Regional Cerebral Blood Flow in Alzheimer's Disease

Altschul Laboratory for Dementia Research, Burke Rehabilitation Center, Cornell University Medical College, White Plains, New York
Department of Radiology, The University of Chicago, Chicago, Illinois

Correspondence: For reprints contact: Alexander Zemcov, ScD, The Burke Rehabilitation Center, 785 Mamaroneck Ave., White Plains, NY 10605.

ABSTRACT

Receiver operating characteristic (ROC) curves were used to quantitatively assess the ability of individual detectors in a 32-detector ¹³³Xe inhalation system to discriminate between two populations over the range of regional cerebral blood flow (rCBF) values. These populations were clinically evaluated as 1)) normal (age 63.1 ± 13.1, n = 23) and 2) presumed Alzheimer's disease (age 72.7 ± 7.0, n = 82). Summary statistics showed that for homologous detectors the average value of blood flow in the normal group was greater than the flow value in the group of subjects with Alzheimer's disease. Conclusions drawn from single values of flow or mean hemispheric flow can lead to erroneous conclusions about hemisphere asymmetries. However, the dynamic relationship between the correct identifications (true positives) compared with incorrect identifications (false positives) of Alzhelmer's disease at each detector varies over the range of blood flow values, and quantitative characterization of this relationship in terms of an ROC curve provides more insight into the structure of the data. Detectors approximating the speech, auditory and association cortex were most effective in discriminating between groups. Frontal detectors were marginally useful diagnostically.