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Single‐Photon Emission Computed Tomographic Perfusion Imaging in Autopsy‐Diagnosed Dementia
Author(s) -
Jagust William J.,
Reed Bruce R.,
Ellis William G.,
Eberling Jamie L.,
Budinger Thomas F.
Publication year - 1993
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/jon19933293
Subject(s) - medicine , dementia , perfusion , single photon emission computed tomography , nuclear medicine , emission computed tomography , perfusion scanning , cerebral blood flow , autopsy , occipital lobe , positron emission tomography , alzheimer's disease , radiology , parietal lobe , pathology , cardiology , disease , psychiatry
Physiological imaging of regional cerebral blood flow with single‐photon emission computed tomography (SPECT) has been proposed to be diagnostically useful in the evaluation of patients with dementia because of the frequent finding of temporal and parietal lobe hypoperfusion in patients with Alzheimer's disease (AD). A major limitation of SPECT to date has been the selection of patients using clinical criteria, which may be unreliable in excluding patients with non‐Alzheimer dementias from study. SPECT with the perfusion tracer 123 l‐N‐isopropyl‐ p ‐iodoamphetamine was used to study 16 dementia patients who were subsequently followed to autopsy, as well as 16 elderly control subjects. Eleven dementia patients had the diagnosis of AD confirmed by autopsy, while 5 had other, nonAD dementias. SPECT perfusion patterns were evaluated as regional ratios of lobar radioactivity counts normalized to either activity counts in the occipital lobes (occipital ratio) or activity counts in the entire tomographic slice (whole‐slice ratio). Results showed that the relative frontal perfusion differentiated non‐AD patients from control subjects and AD patients regardless of which ratio method was used, while temporal and parietal relative perfusion ratios were more effective at differentiating AD from non‐AD patients when the whole‐slice ratio was used, although the ratio used did not affect the differentiation of AD patients from control subjects. Scatterplots of the whole‐slice ratio in the right parietal and left temporal lobes showed no overlap between AD and non‐AD patients and control subjects. These results support the diagnostic utility of SPECT in the clinical evaluation of dementia patients, particularly in distinguishing AD from non‐AD dementias during life.