In Differential Diagnosis of Dementia Application of Easy Z-score Imaging System in Single Photon Emission Computed Tomography Brain Perfusion Scan
American Journal of Psychiatry and Neuroscience
Volume 7, Issue 4, December 2019, Pages: 100-107
Received: Oct. 20, 2019;
Accepted: Nov. 6, 2019;
Published: Nov. 12, 2019
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Nasreen Sultana, National Institute of Nuclear Medicine and Allied Sciences (NINMAS), BSMMU Campus Dhaka, Bangladesh
Hiroshi Matsuda, Integrative Brain Imaging Center, National Center of Neurology and Psychiatry, Tokyo, Japan
Azmal Kabir Sarker, Institute of Nuclear Medicine and Allied Sciences, Mitford, SSMC Campus, Dhaka, Bangladesh
Jasmine Ara Haque, National Institute of Nuclear Medicine and Allied Sciences (NINMAS), BSMMU Campus Dhaka, Bangladesh
Rafiqul Islam, Neurology, BSM Medical University, Dhaka, Bangladesh
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Application of easy Z score imaging system (eZIS) on brain perfusion SPECT images for quantitative evaluation of rCBF has attempted to explore the differential diagnosis of dementia with various degenerative diseases and to evaluate discrimination of early Alzheimer’s disease (AD) from other types of dementia. This retrospective study was done with various degenerative diseases that underwent brain perfusion SPECT using 99mTc ethyl cysteinate dimer were included. Brain perfusion SPECT was performed in 58 patients (M/F = 48/10) with mean age of 61.2±10.4 years (41-90). Decreased rCBF was observed in the area suspected early AD in 20 cases (34%) and in the frontal gyrus and insula in 10 cases (17%). And decreased rCBF was observed in occipital lobe and, precuneus, gyrus and posterior cingulate cortex in 8 cases (14%). Discrete areas of decreased rCBF were seen in 14 cases (24%) and the rest of 6 cases (11%) showed normal rCBF. Clinically suspected AD patients were divided into two groups on basis of MMSE score (group A, mild stage of AD, MMSE =20-26 and group B, moderate to severe stage of AD, MMSE=10-19). Mean MMSE and mean Z scores were 22.9±1.11 and 1.01±0.35 in group A (n = 12) while 17.56±0.96 and 2.62±0.59 in group B (n= 8). There was negative correlation between MMSE and eZIS score; r = - 0.69 in group A (p = 0.002); r = - 0.58 in group B (p = 0.019) and r = - 0.93 overall (p = 0.000). Quantification of rCBF with eZIS score was well associated with clinical MMSE scoring in this study group with clinical likelihood of having AD. In rest of the cases, SPECT findings and surface view analysis by eZIS, the affected area of decreased rCBF were consistent with clinically suspected different types of degenerative disease manifesting dementia.
eZIS, Alzheimer's Disease, Brain Perfusion, SPECT
To cite this article
Azmal Kabir Sarker,
Jasmine Ara Haque,
In Differential Diagnosis of Dementia Application of Easy Z-score Imaging System in Single Photon Emission Computed Tomography Brain Perfusion Scan, American Journal of Psychiatry and Neuroscience.
Vol. 7, No. 4,
2019, pp. 100-107.
Copyright © 2019 Authors retain the copyright of this article.
This article is an open access article distributed under the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/
) which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Ashburner J, Friston KJ: Voxel-based morphometry– the methods. Neuroimage 2000; 11: 805–821.
Frith CD, Friston KJ, Ashburner J, et al: Principlesand methods; in Frackowiak RSJ, Friston KJ, Frith CD, Dolan RJ, Mazziotta JC (eds): Human Brain Function, ed 1. San Diego, Academic Press, 1997, pp 3–159.
Minoshima S, Berger KL, Lee KS, et al: Anautomated method for rotational correction and centering of three-dimensional functional brain images. J Nucl Med 1992; 33: 1579–1585.
Minoshima S, Koeppe RA, Mintun MA, etal: Automated detection of the intercommissural line for stereotactic localization of functional brain images. J Nucl Med 1993; 34: 322–329.
Minoshima S, Koeppe RA, Frey KA, et al: Anatomic standardization: linear scaling and nonlinear warping of functional brainimages. J Nucl Med 1994; 35: 1528–1537.
Matsuda H, Mizumura S, Soma T, et al: Conversionof brain SPECT images between different collimators and reconstruction processes for analysis using statistical parametric mapping. Nucl Med Commun 2004; 25: 67–74.
Kanetaka H, Matsuda H, Asada T, et al: Effects of partial volume correction on discrimination between very early Alzheimer’s dementia and controls using brain perfusion SPECT. Eur J Nucl Med Mol Imaging 2004; 31: 975–980.
Matsuda H, Mizumura S, Nagao T, et al: Automated discrimination between very early Alzheimer’s disease and controls using an easy Z-score imaging system for multicenter brain perfusion SPECT. AJNR Am J Neuroradiol 2007; 28: 731–736.
Matsuda H: Role of neuroimaging in Alzheimer’s disease, with emphasis on brain perfusion SPECT. J Nucl Med 2007; 48: 1289–1300.
Waragai M, Yamada T, Matsuda H: Evaluation of brain perfusion SPECT using an easy Z-score imaging system (eZIS) as an adjunct to early diagnosis of neurodegenerative diseases. J Neurol Sci 2007; 260: 57–64.
McKeith IG, Boeve BF, Dickson DW, Halliday G, Taylor JP, Weintraub D, et al. Diagnosis and management of dementia with Lewy bodies: Fourth consensus report of the DLB Consortium. Neurology 2017; 89: 88-100.
Minoshima S, Foster NL, Sima AA, et al: Alzheimer’s disease versus dementia with Lewy bodies: cerebral metabolic distinction with autopsy confirmation. Ann Neurol 2001; 50: 358–365.
Rosen HJ, Hartikainen KM, Jagust W, et al: Utility of clinical criteria in differentiating frontotemporal lobar degeneration (FTLD) from AD. Neurology 2002; 58: 1608–1615.
Charpentier P, Lavenu I, Defebvre L, et al: Alzheimer’s disease and frontotemporal dementia are differentiated by discriminant analysis applied to 99mTc HmPAO SPECT data. J Neurol Neurosurg Psychiatry 2000; 69: 661–663.
Nakano S, Asada T, Yamashita F, et al: Relationship between antisocial behavior and regional cerebral blood flow in frontotemporal dementia. Neuroimage 2006; 32: 301–306.
Bonte FJ, Harris TS, Roney CA, et al: Differential diagnosis between Alzheimer’s and frontotemporal disease by the posterior cingulatesign. J Nucl Med 2004; 45: 771–774.