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IC‐P‐013: Hippocampal texture provides volume independent information for Alzheimer's diagnosis
Author(s) -
Pai Akshai,
Sørensen Lauge,
Darkner Sune,
Suhy Joyce,
Oh Joonmi,
Chen Gennan,
Igel Christian,
Nielsen Mads
Publication year - 2012
Publication title -
alzheimer's and dementia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 6.713
H-Index - 118
eISSN - 1552-5279
pISSN - 1552-5260
DOI - 10.1016/j.jalz.2012.05.045
Subject(s) - wilcoxon signed rank test , hippocampal sclerosis , standard deviation , nuclear medicine , linear regression , hippocampal formation , texture (cosmology) , medicine , mathematics , pathology , pattern recognition (psychology) , artificial intelligence , temporal lobe , statistics , mann–whitney u test , computer science , image (mathematics) , psychiatry , epilepsy
clinical setting remains to be determined. Therefore we examined the added value of PiB-PET in cases of uncertain clinical diagnosis with regards to diagnostic classification and confidence in diagnosis in a highly specialized memory clinic.Methods:All referred patients who underwent a PiB-PET study as part of their diagnostic work-up were eligible for inclusion. The standard diagnositic evaluation program included physical and neurological examination, cognitive and functional assessment and a cranial CT or MRI. Additionally, most patients had a 18F-FDG-PET and cerebrospinal fluid sampling for measurement of beta-amyloid, total-tau and phospho-tau. Based on anonymized case reports, three experienced clinicians reached a consensus diagnosis and rated confidence in their diagnosis before and after disclosure of PiB-PET ratings. PiB-PET scans were rated as either positive or negative by a blinded rater. Results: A total of 57 patients (Gender, f/m: 27/30; Age: mean (range): 65.7 years (44.2-82.6), MMSE: mean, (range): 24.4 (13-29)) were included in the study. Twenty seven had a positive PiB scan. At the first rating 16 patients were given a clinical AD diagnosis (87,5 % PiB positive). Thirteen patients (23 %) were diagnositically reclassified after PiB-PET results were disclosed and clinicians overall confidence in their diagnosis increased in 28 cases (49 %) and remained unchanged in 27 cases (47 %) (See Figure). Moreover, there was an increase in the number of patients, that clinicians rated as clear AD (0 % to 31.6 %) as well as clear non-AD (12.3 % to 45.6 %).Conclusions:Amyloid imaging may have a significant impact on the diagnostic classification of patients referred to a memory clinic as indicated by the number of reclassifications. Moreover, increased confidence in diagnosis may be speculated to lead to more aggressive and targeted treatment.