Hiroto Takahashi, Presenter: Nothing to Disclose

Kazunari Ishii MD, Abstract Co-Author: Nothing to Disclose

Nobuo Kashiwagi, Abstract Co-Author: Nothing to Disclose

Keizou Miyakoshi RT, Abstract Co-Author: Nothing to Disclose

Kohei Hanaoka, Abstract Co-Author: Nothing to Disclose

Takamichi Murakami MD, PhD, Abstract Co-Author: Consultant, DAIICHI SANKYO Group

Ryuichiro Ashikaga MD, Abstract Co-Author: Nothing to Disclose

To evaluate the detectability of reduced regional cerebral perfusion in Alzheimer disease (AD) using 3D arterial spin labeling (ASL) in comparison to brain perfusion single-photon emission computed tomography (SPECT) and reveal the characteristics of perfusion images with 3D ASL in diagnosis of AD.

This study included 25 patients with clinically suspected AD who underwent perfusion imaging with both 3D ASL on a 1.5T clinical MR scanner and 99mTc-hexamethylpropylene amine oxime (HMPAO) SPECT. Sixteen patients were diagnosed AD and 9 patients were diagnosed non-AD. The SPECT data was evaluated with visual inspection and three-dimensional stereotactic surface projections (3D-SSP) z-score maps. The normal database for 3D-SSP of ASL perfusion images was constructed with 30 cognitively normal subjects ASL images. Then the ASL images were evaluated with visual inspection and 3D-SSP z-score maps. The SPECT images and 3D ASL images were reviewed respectively by consensus between two experienced radiologists. Receiver operating characteristic (ROC) curve analysis was used to compare the diagnostic performance of both images. In addition, the regional differences of perfusion distribution between both methods images were evaluated with voxel-based analysis using statistical parametric mapping (SPM).  

The area under the ROC curve distinguishing AD from non-AD was 0.78 for SPECT images alone, and 0.70 for ASL images alone, respectively. In the ASL image, the perisylvian and medial parieto-occipital perfusions were significantly higher and the perfusions in the watershed area and frontal white matters were significantly lower than those in the SPECT image (Figure. optional-image).

The diagnostic performance of 3D ASL on a 1.5T MR scanner and SPECT was almost equivalent for AD. Perfusion imaging with 3D ASL was more influenced by the hemodynamic factor, such as arterial blood volume, than that of SPECT.

3D ASL on a widely used 1.5T MR scanner can be used to help the diagnosis of AD, having more chance to reduce the susceptibility effects than at 3T, and needs the attention to its hemodynamics.

Takahashi, H, Ishii, K, Kashiwagi, N, Miyakoshi, K, Hanaoka, K, Murakami, T, Ashikaga, R, Brain Perfusion Imaging of Alzheimer's Disease with 3D Arterial Spin Labeling: Comparison with Brain Perfusion SPECT.  Radiological Society of North America 2012 Scientific Assembly and Annual Meeting, November 25 - November 30, 2012 ,Chicago IL. http://archive.rsna.org/2012/12027405.html