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Role of Neuroimaging in Alzheimer's Disease, with Emphasis on Brain Perfusion SPECT^*

Department of Nuclear Medicine, Saitama Medical University Hospital, Saitama, Japan

Correspondence: For correspondence or reprints contact: Hiroshi Matsuda, Department of Nuclear Medicine, Saitama Medical University Hospital, 38 Morohongo, Moroyama-machi, Iruma-gun, Saitama 350-0495, Japan. E-mail: matsudah{at}saitama-med.ac.jp

Structural MRI and functional imaging by SPECT as well as ¹⁸F-FDG PET are widely used in the diagnosis of Alzheimer's disease (AD). Metabolic and perfusion reductions in the parietotemporal association cortex are recognized as a diagnostic pattern for AD. Outstanding progress in the diagnostic accuracy of these modalities has been achieved with statistical analysis on a voxel-by-voxel basis after anatomic standardization of individual scans to a standardized brain volume template instead of visual inspection or a volume-of-interest technique. In a very early stage of AD, this statistical approach revealed losses of gray matter in the entorhinal and hippocampal areas and hypometabolism or hypoperfusion in the posterior cingulate cortex and precuneus. This statistical approach also offers a prediction of the conversion from mild cognitive impairment (MCI) to AD. The presence of hypometabolism or hypoperfusion in parietal association areas and entorhinal atrophy at the MCI stage have been reported to predict a rapid conversion to AD. A recent advance in voxel-based statistical analysis has markedly enhanced the value of brain perfusion SPECT in diagnosing early AD at the stage of MCI.

Key Words: Alzheimer's disease • SPECT • PET • MRI • statistical image analysis

^* NOTE: FOR CE CREDIT, YOU CAN ACCESS THIS ACTIVITY THROUGH THE SNM WEB SITE (http://www.snm.org/ce_online) THROUGH AUGUST 2008.

No potential conflict of interest relevant to this article was reported.

COPYRIGHT © 2007 by the Society of Nuclear Medicine, Inc.

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