This manuscript is an original research paperWord count: 3015
Advances in Knowledge:-Automated machine learning methods can be trained to distinguish between subjects with subjective cognitive decline (SCD), patients with mild cognitive impairment (MCI), and patients with Alzheimer's disease (AD) based on arterial spin labeling (ASL) images with high classification training accuracy (range, 83.8% -89.0% , p < .01).-Classifiers based on these trainings can predict the diagnosis of single subjects with high diagnostic accuracy (area under the receiver operating curve range, .89 -.96, p < .001).
Implications for Patient Care:-Automated classification of 3D pseudo-continuous ASL scans that detects AD patients with high accuracy (> 82%) may support image-based diagnosis, especially in centres without experienced (neuro)radiologists.-Automated classification of 3D pseudo-continuous ASL scans may be used for AD screening purposes without compromising diagnostic accuracy.Summary statement: Automated classification of perfusion maps enable distinguishing patients with various stages of Alzheimer's disease with high accuracy.ABSTRACT Purpose: This current study investigates whether multivariate pattern recognition analysis of arterial spin labeling (ASL) perfusion maps can be used for classification and single-subject prediction of patients withAlzheimer's disease (AD), mild cognitive impairment (MCI), and subjective cognitive decline (SCD), after using the W-score method to remove confounding effects of gender and age.
Materials and Methods:The local institutional review board approved the study. Subjects classifier used diagnostic status and perfusion maps. Discrimination maps were extracted and used for single-subject classification in the prediction-set. Prediction performance was assessed by means of a ROC analysis, generating an area under the curve (AUC) and sensitivity/specificity distribution.Results: Single-subject diagnosis in the prediction-set using the discrimination maps yielded excellent performance for AD vs. SCD (AUC .96, p < .01), good performance for AD vs. MCI (AUC = 0.89, p < .01), and poor performance for MCI vs. SCD (AUC = 0.63, p = .06).Application of the AD vs. SCD discrimination map for prediction of MCI subgroups resulted in good performance for MCIc vs. SCD (AUC = .84, p < .01) and fair performance for MCIc vs.MCIs (AUC = .71, p > .05).
Conclusion:Using automated methods, age-and gender adjusted ASL perfusion maps can be used to classify and predict diagnoses of AD, MCI-converters, stable MCI patients and SCD subjects with good to excellent accuracy and AUC values.