Abstract:
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Purpose: This study was to evaluate the usefulness of three-dimensional stereotactic surface projections (3D-SSP) of 123I-isopropyl iodoamphetamine(IMP) single photon emission computed tomography (SPECT) for the differential diagnosis of dementia.
Methods and Materials: Sixty six consecutive patients with dementia were enrolled in this study (M:F 21:45(mean age 73.8 (50-87)). The clinical diagnoses of dementia were consisted of Alzheimer type dementia (ATD) (n=31), vascular dementia (VD) (n=12), frontotemporal dementia (FTD) (n=16), and dementia with Lewy bodies (DLB) (n=7). In all patients, the diagnoses were done according to clinical criteria by two experienced psychiatrists. 123I-SPECT was performed in all patients and these image data were processed in 3D-SSP, a pixel-wise comparison of IMP uptake was performed using a normal database of comparable age. On SPECT and 3D-SSP, the diagnosis was visually defined according to the characteristic distribution pattern of the regional cerebral blood flow (rCBF) in each dementia. We compared a diagnostic value between the conventional SPECT imaging and 3D-SSP.
Results: In 31 patients with ATD, 22(71.0%) patients were correctly diagnosed on conventional SPECT images. While, correct diagnosis was obtained in 28(90.3%) on 3D-SSP. In 12 patients with VD, 9(75%) patients were correctly diagnosed on SPECT and 11(91.7%) on 3D-SSP. In the diagnosis of DLB, correct diagnosis on conventional SPECT image was obtained in 4 (57.1%) of 7 patients and that on 3D-SSP in all cases(100%), respectively. In FTD, correct diagnosis was obtained in 13 of 16(81.3%) patients on the conventional SPECT images and in 14(87.5%) on 3-D SSP. Overall, collect diagnosis was obtained in 48 of 66 (72.7%) patients with dementia on SPECT imaging and in 60 (91.0%) on 3D-SSP.
Conclusion: 3D-SSP was superior to the conventional SPECT image in the differential diagnosis of dementia.
Kawanaka MD, K,
Usefulness of Three-dimensional Stereotactic Surface Projections Using 123I-IMP SPECT for Diagnosis of Dementia. Radiological Society of North America 2003 Scientific Assembly and Annual Meeting, November 30 - December 5, 2003 ,Chicago IL.
http://archive.rsna.org/2003/3102670.html
