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Quantification of functional deficit in Alzheimer's disease using a computer-assisted mapping program for 99mTc-HMPAO
1Lawson Research Institute, Department of Neurology, University of Western Ontario, London, Canada.
Neuroradiology
|January 1, 1994
Summary
A new computer-assisted mapping program using SPECT and 99mTc-HMPAO accurately detects Alzheimer's disease (AD). Regional/cerebellar flow values, especially in the left parietal lobe, show high diagnostic accuracy for identifying cortical impairment.
Area of Science:
- Neurology
- Medical Imaging
- Gerontology
Background:
- Aging is associated with changes in cerebral perfusion.
- Alzheimer's disease (AD) significantly impacts cognitive function and brain activity.
- Accurate assessment of cerebral perfusion is crucial for diagnosing and monitoring neurodegenerative conditions.
Purpose of the Study:
- To develop and validate a computer-assisted mapping program for assessing cerebral perfusion changes in normal and pathological aging.
- To evaluate the diagnostic accuracy of single photon emission computer tomography (SPECT) with 99mTc-hexamethylpropyleneamine oxime (HMPAO) in differentiating Alzheimer's disease patients from normal controls.
- To correlate regional cerebral blood flow values with cognitive status as measured by the Dementia Rating Scale (DRS).
Main Methods:
- Development of a computer-assisted mapping software to outline the cortex and define regions of interest on SPECT brain slices.
- Calculation of regional/global and regional/cerebellar relative flow values in 27 Alzheimer's disease patients and 10 normal controls.
- Assessment of cognitive function using the Dementia Rating Scale (DRS) and correlation with SPECT-derived flow values using multiple regression analysis.
Main Results:
- Multiple regression analysis revealed a significant correlation between relative flow values and DRS scores.
- Regional/cerebellar relative flow values (R = 0.88) were more indicative of cortical impairment than regional/global values (R = 0.68).
- Left parietal flow values showed the strongest correlation with DRS scores (r = 0.83), with a cutoff of 77 accurately classifying 80% of normals and 100% of AD patients.
Conclusions:
- Computer-assisted mapping of SPECT provides semiquantitative cerebral perfusion values with high diagnostic accuracy.
- This technique is effective in differentiating patients with Alzheimer's disease from normal aging.
- Regional/cerebellar and specifically left parietal flow values are valuable biomarkers for assessing cognitive impairment in aging and AD.