99Tcm-HMPAO SPECT in suspected dementia

Launes, Jyrki; Sulkava, Raimo; Erkinjuntti, Timo; Nikkinen, P.; Lindroth, L.; Liewendahl, K.; Iivanainen, Matti

doi:10.1097/00006231-199109000-00002

Cited by 46 publications

(23 citation statements)

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“…This is in agreement with the fact that the number of abnormal scans increased with the severity of the disorder [36]. Thus, our results confirm that SPECT is not a very sensitive tool, although longitudinal studies show excellent agreement between rCBF regional cerebral blood flow and the pattern of cortical degenera tion [44], C on clu sio n s SPECT visual rating is reliable.…”

Section: Spect In Memory Clinicsupporting

confidence: 88%

“…In a Japanese study, bilateral parietal abnormalities were ob served in 15/21 (71%) AD patients with l23I IMP SPECT imaging [6] but no details are provided on the severity of AD. At the Memory Disorder Clinic of Helsinki Universi ty Hospital [36], the typical AD pattern of HMPAO-SPECT imaging (bilateral posterior parietotemporal or parictotemporo-occipital hypoperfusion) was observed in 23/36 (64%) of AD patients. The authors admit that the sensibility and specificity of HMPAO-SPECT were not particularly high for any patient category studied (total number of patients n = 160; AD n = 36; multi-infarct dementia n = 33; frontal lobe type dementia n = 5; vascu lar disorder n = 33; miscellaneous specific causes for dementia n = 32, psychiatric disorders -depression or anxiety -n = 21).…”

Section: Discussionmentioning

confidence: 99%

“…Greene et al [42] also noted the fact that 39% of their AD patients had nor mal SPECT scans. SPECT scans were normal in 13% of patients with mild dementia of the Helsinki Memory Dis order Clinic [36], and in 15% in the Dundee Memory Clinic [37], This gives a sensitivity of HMPAO-SPECT scanning for the diagnosis of AD of 58% in the population of the latter study. SPECT was normal in 2/5 histological ly confirmed aspecific DFT [14].…”

Section: Spect In Memory Clinicmentioning

confidence: 99%

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The Use of SPECT in a Multidisciplinary Memory Clinic

Pasquier¹,

Lavenu²,

Lebert³

et al. 1997

Dement Geriatr Cogn Disord

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We tested the interobserver reliability of visual rating of HMPAO-SPECT imaging in 271 outpatients referred to a memory clinic, and followed over 1 year. The clinical diagnoses were Alzheimer''s disease (n = 156), frontotemporal dementia (n = 47), vascular dementia (n = 21), senile dementia of Lewy body type (n = 12), anxiety/depressive disorders (n = 14) and miscellaneous memory disorders (n = 21). The interobserver agreement was good (k = 0.68). However, the heterogeneity of the patterns – independent from demographic data, age at onset and duration of the disease – and their lack of sensibility and specificity limited the contribution of SPECT for diagnostic purposes in routine practice.

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Section: Spect In Memory Clinicsupporting

confidence: 88%

Section: Discussionmentioning

confidence: 99%

Section: Spect In Memory Clinicmentioning

confidence: 99%

See 1 more Smart Citation

The Use of SPECT in a Multidisciplinary Memory Clinic

Pasquier¹,

Lavenu²,

Lebert³

et al. 1997

Dement Geriatr Cogn Disord

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“…The diagnostic accuracy of the OINN automated approach (94% correct for control vs. demented and 83% for AD vs. VD). This compares favorably to the diagnostic classification on this set of cases by the SPECT diagnostician and previous reports using SPECT (17). These results suggest that neural network algorithms have a clinical use in interpreting SPECT and presumably other modalities that can reliably reproduce the image patterns of a subject studied under the same conditions.…”

Section: Discussionsupporting

confidence: 70%

“…Although there are a number of studies comparing SPECT HMPAO-99Tc activity patterns in elderly controls and AD and VD subjects (16)(17)(18)(19), there are few studies that independently diagnosed them with SPECT (17) and no studies using artificial neural networks to automate the SPECT diagnosis. The diagnostic accuracy of the OINN automated approach (94% correct for control vs. demented and 83% for AD vs. VD).…”

Section: Discussionmentioning

confidence: 99%

Neural-network-based classification of cognitively normal, demented, Alzheimer disease and vascular dementia from single photon emission with computed tomography image data from brain.

deFigueiredo

Shankle

Maccato

et al. 1995

Proc. Natl. Acad. Sci. U.S.A.

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Single photon emission with computed tomography (SPECT) hexamethylphenylethyleneamineoxime technetium-99 images were analyzed by an optimal interpolative neural network (OINN) algorithm to determine whether the network could discriminate among clinically diagnosed groups of elderly normal, Alzheimer disease (AD), and vascular dementia (VD) subjects. After initial image preprocessing and registration, image features were obtained that were representative of the mean regional tissue uptake. These features were extracted from a given image by averaging the intensities over various regions defined by suitable masks. After training, the network classified independent trials of patients whose clinical diagnoses conformed to published criteria for probable AD or probable/possible VD. For the SPECT data used in the current tests, the OINN agreement was 80 and 86% for probable AD and probable/possible VD, respectively. These results suggest that artificial neural network methods offer potential in diagnoses from brain images and possibly in other areas of scientific research where complex patterns of data may have scientifically meaningful groupings that are not easily identifiable by the researcher.Alzheimer disease (AD), vascular dementia (VD), or both occur in 70-90% of all dementias and are often clinically difficult to distinguish. Brain imaging is an important part of the diagnostic evaluation (1-4). However, the brain image may be qualitatively difficult to distinguish between normal and demented persons, and more so between different dementia types such as AD and VD. Since disturbances of brain metabolism may precede structural changes, metabolic images can detect more subtle patterns of change earlier than anatomical ones. We chose single photon emission with computed tomography (SPECT) because (i) it provides measures of regional tissue uptake (hexamethylphenylethyleneamineoxime technetium-99 or HMPAO-99Tc) that show complex patterns of brain activity and because (ii) it is widely available. Improvements in the recognition, quantification, and classification of these image patterns could increase diagnostic sensitivity between normal and abnormal as well as between different subtypes of dementia.The need for better methods of diagnostic interpretation of brain images is illustrated by the large variability in their diagnostic interpretation by even well-trained neuroradiologists using standardized criteria. For example, the Consortium to Establish a Registry for Alzheimer's Disease (CERAD) conducted an interrater reliability study among 14 participating CERAD neuroradiologists for interpreting specific mag-The publication costs of this article were defrayed in part by page charge payment. This article must therefore be hereby marked "advertisement" in accordance with 18 U.S.C. §1734 solely to indicate this fact. netic resonance imaging features and found within-feature correlations ranging from 0.64 (for detecting cerebral sulcal dilatation) to 0.79 (for rating the size of the lateral and third ventricl...

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Regional Cerebral Blood Flow Single Photon Emission Computed Tomography for detection of Frontotemporal dementia in people with suspected dementia

Archer

Smailagic

John

et al. 2015

Cochrane Database of Systematic Reviews

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At present, we would not recommend the routine use of rCBF SPECT in clinical practice because there is insufficient evidence from the available literature to support this.Further research into the use of rCBF SPECT for differentiating FTD from other dementias is required. In particular, protocols should be standardised, study populations should be well described, the threshold for 'abnormal' scans predefined and clear details given on how scans are analysed. More prospective cohort studies that verify the presence or absence of FTD during a period of follow up should be undertaken.

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99Tcm-HMPAO SPECT in suspected dementia

Cited by 46 publications

References 0 publications

The Use of SPECT in a Multidisciplinary Memory Clinic

The Use of SPECT in a Multidisciplinary Memory Clinic

Neural-network-based classification of cognitively normal, demented, Alzheimer disease and vascular dementia from single photon emission with computed tomography image data from brain.

Regional Cerebral Blood Flow Single Photon Emission Computed Tomography for detection of Frontotemporal dementia in people with suspected dementia

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