Perfusion CT imaging as a diagnostic and prognostic tool for dementia: prospective case-control study

Area of Science:

• Neurology
• Radiology
• Medical Imaging

Background:

• Functional brain changes precede structural alterations in dementia.
• Early diagnosis and differentiation of dementia subtypes are clinically significant.
• Cerebral Perfusion CT (PCT) may reveal early functional changes.

Purpose of the Study:

• To evaluate PCT for early dementia diagnosis.
• To differentiate Alzheimer's disease (AD) from vascular dementia (VaD).
• To assess the correlation between PCT parameters and cognitive function (Montreal Cognitive Assessment - MOCA score).

Main Methods:

• Prospective case-control study with 25 dementia patients (15 VaD, 10 AD) and 25 controls.
• Utilized a 256-slice CT scanner for PCT acquisition.
• Analyzed quantitative perfusion parameters (CBF, CBV, MTT, TTP) in specific brain regions.

Main Results:

• VaD cases showed infarcts and white matter changes; global reduction in CBF and CBV.
• AD cases exhibited reduced CBF and CBV primarily in temporoparietal regions and hippocampi.
• Significant positive correlation found between MOCA scores and PCT parameters in both dementia types.

Conclusions:

• PCT is a reliable tool for early dementia detection and distinguishing VaD from AD.
• PCT-derived perfusion parameters correlate with cognitive status.
• Perfusion parameters can serve as surrogate markers for cognitive function in dementia patients.