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Departments of Nuclear Medicine and Psychiatry, Technical University Munich, Munich, Germany; Division of Nuclear Medicine, Department of Internal Medicine, The University of Michigan, Ann Arbor, Michigan
Correspondence: For correspondence or reprints contact: Peter Bartenstein, MD, Nuklearmedizinische Klinik und Poliklinik, der Technischen Universität München, Klinikum rechts der Isar, Ismaninger Strasse 22, 81675 München, Germany.
ABSTRACT
This study evaluated an automated analysis of SPECT brain imaging in patients with Alzheimer's disease (AD). Methods: Patients [n =81; mean age, 69.9 ± 10.6 yr (mean ± s.d.)] with a clinical diagnosis of probable AD (NINCDS-Alzheimer's Disease and Related Disorders Association criteria) underwent 99mTc-ethyl cysteine dimer SPECT imaging. After imaging registration and data extraction using three-dimensional stereotactic surface projections, a pixel-wise comparison of ethyl cysteine dimer uptake was performed using a reference database of 10 cognitive intact controls of comparable age. Results: When individual cases were compared to the normal database, tempora-parietal regional cerebral blood flow (rCBF) abnormalities across different levels of dementia severity were clearly depicted on pixel-wise Z-score images. The rCBF reduction incortical association areas showed a significant correlation with an overall level of cognitive decline, as assessed by the Mini Mental State Examination and by the cognitive section of the Cambridge Mental Disorders of the Elderly Examination. In addition, there were significant region-specific correlations between left temporo perfusion deficit and language performance and between right parietal rCBF reduction and praxis. Conclusion: These results indicate that this observer-independent analysis of SPECT data enables objective and semiquantitative assessment of the magnitude and extentof cortical perfusion abnormalities in patients with AD.
Key Words: SPECT • computer-assisted image processing • Alzheimer's disease • cognitive dysfunction
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