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Visual Assessment of Brain Perfusion MRI Scans in Dementia: A Pilot Study
Author(s) -
Fällmar David,
Lilja Johan,
Velickaite Vilma,
Danfors Torsten,
Lubberink Mark,
Ahlgren André,
Osch Matthias J.P.,
Kilander Lena,
Larsson ElnaMarie
Publication year - 2015
Publication title -
journal of neuroimaging
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.822
H-Index - 64
eISSN - 1552-6569
pISSN - 1051-2284
DOI - 10.1111/jon.12296
Subject(s) - medicine , nuclear medicine , positron emission tomography , dementia , intraclass correlation , arterial spin labeling , perfusion , smoothing , radiology , psychometrics , disease , clinical psychology , computer science , computer vision
PURPOSE Functional imaging is becoming increasingly important for the detection of neurodegenerative disorders. Perfusion MRI with arterial spin labeling (ASL) has been reported to provide promising diagnostic possibilities but is not yet widely used in routine clinical work. The aim of this study was to compare, in a clinical setting, the visual assessment of subtracted ASL CBF maps with and without additional smoothing, to FDG‐PET data. METHODS Ten patients with a clinical diagnosis of dementia and 11 age‐matched cognitively healthy controls were examined with pseudo‐continuous ASL (pCASL) and 18F‐Fluorodeoxyglucose positron emission tomography (FDG‐PET). Three diagnostic physicians visually assessed the pCASL maps after subtraction only, and after postprocessing using Gaussian smoothing and GLM‐based beta estimate functions. The assessment scores were compared to FDG PET values. Furthermore, the ability to discriminate patients from healthy elderly controls was assessed. RESULTS Smoothing improved the correlation between visually assessed regional ASL perfusion scores and the FDG PET SUV‐r values from the corresponding regions. However, subtracted pCASL maps discriminated patients from healthy controls better than smoothed maps. Smoothing increased the number of false‐positive patient identifications. Application of beta estimate functions had only a marginal effect. CONCLUSION Spatial smoothing of ASL images increased false positive results in the discrimination of hypoperfusion conditions from healthy elderly. It also decreased interreader agreement. However, regional characterization and subjective perception of image quality was improved.