Cyrus Raji BS, BA, Presenter: Nothing to Disclose

Charles Lee MD, Abstract Co-Author: Nothing to Disclose

Oscar Lopez MD, Abstract Co-Author: Nothing to Disclose

Jawad Tsay MD, Abstract Co-Author: Nothing to Disclose

John Fisher Boardman MD, Abstract Co-Author: Nothing to Disclose

Eric D. Schwartz MD, Abstract Co-Author: Nothing to Disclose

Owen Carmichael PhD, Abstract Co-Author: Nothing to Disclose

H. Michael Gach PhD, Abstract Co-Author: Nothing to Disclose

Hebah Hefzy MD, Abstract Co-Author: Nothing to Disclose

James T. Becker PhD, Abstract Co-Author: Nothing to Disclose

00030490-DMT et al, Abstract Co-Author: Nothing to Disclose

To test the reliability and accuracy of visual criteria in perfusion and structural MRI for early detection of Alzheimer’s disease (AD).

Every subject provided informed consent for review of de-identified data from the IRB approved Cardiovascular Health Study-Cognition Study (CHS-CS). Data were analyzed from 32 participants; 19 cognitively normal individuals and 13 with clinically adjudicated Alzheimer’s dementia. At the time of scan, no AD subjects had been identified by their primary care physician with a cognitive disorder nor were they taking any cholinesterase inhibitors. All subjects had structural T1 weighted spoiled gradient echo (SGPR) volumetric MRI and arterial spin labeled (ASL) perfusion MRI to measure regional cerebral blood flow. Four readers with different levels of experience in neuroradiology used standardized visual criteria to separately adjudicate each ASL and SPGR scan as normal or abnormal and rated confidence in their evaluation.

Inter-rater reliability was superior in ASL (κ=.7 in experienced readers) compared to SPGR (κ=.17). ASL MRI had the highest specificity (85%), highest accuracy (70%) and largest negative predictive value (86%). Five year follow up showed that 37% of ASL false positives converted to AD. Three out of the four readers had a statistically significant relationship between their confidence and correct classification when using ASL. Figure 1 shows examples of true negative (part a), true positive (part b), false negative (part c) and false positive (part d) ASL scans on a color cale of 0-100 mL blood/gram tissue/minute.

ASL MRI is able to separate very early AD from normal aging with high sensitivity but volumetric MRI was not. This initial experience suggests that ASL MRI may be a useful screening tool in persons who are early in the course of AD.

Perfusion arterial spin labeled MRI, a method that uses no radioactive or contrast agents, can be applied to detect Alzheimer’s disease in persons with very mild clinical symptoms.

Raji, C, Lee, C, Lopez, O, Tsay, J, Boardman, J, Schwartz, E, Carmichael, O, Gach, H, Hefzy, H, Becker, J, et al, 0, Use of Arterial Spin Labeled MRI for Clinical Diagnosis of Alzheimer’s Disease: Initial Experience.  Radiological Society of North America 2009 Scientific Assembly and Annual Meeting, November 29 - December 4, 2009 ,Chicago IL. http://archive.rsna.org/2009/8010067.html