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Improved Turnaround Times | Median time to first decision: 12 days

Research ArticleAdult Brain

Head-to-Head Visual Comparison between Brain Perfusion SPECT and Arterial Spin-Labeling MRI with Different Postlabeling Delays in Alzheimer Disease

T. Kaneta, O. Katsuse, T. Hirano, M. Ogawa, K. Yoshida, T. Odawara, Y. Hirayasu and T. Inoue
American Journal of Neuroradiology August 2017, 38 (8) 1562-1568; DOI: https://doi.org/10.3174/ajnr.A5238
T. Kaneta
aFrom the Departments of Radiology (T.K., T.H., M.O., K.Y., T.I.)
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O. Katsuse
bPsychiatry (O.K., T.O., Y.H.), Yokohama City University, Yokohama, Japan.
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T. Hirano
aFrom the Departments of Radiology (T.K., T.H., M.O., K.Y., T.I.)
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M. Ogawa
aFrom the Departments of Radiology (T.K., T.H., M.O., K.Y., T.I.)
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K. Yoshida
aFrom the Departments of Radiology (T.K., T.H., M.O., K.Y., T.I.)
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T. Odawara
bPsychiatry (O.K., T.O., Y.H.), Yokohama City University, Yokohama, Japan.
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Y. Hirayasu
bPsychiatry (O.K., T.O., Y.H.), Yokohama City University, Yokohama, Japan.
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T. Inoue
aFrom the Departments of Radiology (T.K., T.H., M.O., K.Y., T.I.)
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    Fig 1.

    The regions used for scoring brain images. We evaluated 22 regions located at the levels of the vertex, lateral ventricle, basal ganglia, and cerebellum. The raters scored each region with a 4-point scale, where 0 is a normal CBF, 1 is a mild decrease, 2 is a moderate decease, and 3 is a severe decrease.

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    Fig 2.

    The comparisons of the total scores of the 2 raters for PLD1.5, PLD2.5, and SPECT images. The Friedman analysis of variance showed a significant difference among all 3 groups (P < .01), and the Wilcoxon test showed a significant difference between the 2 raters for the PLD1.5, PLD2.5, and SPECT total scores (P < .01).

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    Fig 3.

    An 86-year-old woman with AD. The patient had an MMSE score of 14. Axial images of T2-weighted MR imaging (A), ASL-MR imaging with PLD1.5 in a color-scale fused with T1-weighted MR imaging (B), ASL-MR imaging with PLD2.5 in a color-scale fused with T1-weighted MR imaging (C), and brain perfusion SPECT at the level of the parietal lobe, corona radiata, basal ganglia, and cerebellum (D). Both raters indicated a score of 4 (definitely AD) for PLD1.5 and SPECT and 1 (probably not AD) for PLD2.5.

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    Fig 4.

    An 83-year-old woman with AD. The patient had an MMSE score of 19. Axial images of T2-weighted MR imaging (A), fused T1-weighted and PLD1.5 ASL-MR imaging (B), fused T1-weighted and PLD2.5 ASL-MR imaging (C), and brain perfusion SPECT (D). Both raters indicated a score of 4 for PLD1.5 and 2 (undetermined) for PLD2.5. One rater indicated a score of 3 (probably AD) and another rater indicated a score of 4 for SPECT.

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    Fig 5.

    A 73-year-old woman with MCI. The patient had an MMSE score of 23. Axial images of T2-weighted MR imaging (A), fused T1-weighted and PLD1.5 ASL-MR imaging (B), fused T1-weighted and PLD2.5 ASL-MR imaging (C), and brain perfusion SPECT (D). Both raters scored 4 for PLD1.5. However, 1 rater indicated a score of 1 (probably not AD) for PLD2.5 and 2 for SPECT, while another rater indicated a score of 0 (definitely not AD) for PLD2.5, and 1 for SPECT.

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    Table 1:

    Demographic and neuropsychological summary of the participantsa

    ADMCI due to AD
    Age (yr)77.1 (7.7)78.2 (5.6)
    No. of patients1419
    Sex (M/F)3:118:11
    MMSE score16.9 (3.0)b25.2 (2.6)b
    • ↵a Data are presented as mean (±SD).

    • ↵b There was a significant difference in the MMSE score (P < .01) between AD and patients with AD-induced MCI.

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    Table 2:

    The results of visual assessments for the diagnosis of AD

    Overall Positive Rate (%)Positive Rate in AD (%)Positive Rate in MCI (%)
    PLD1.5PLD2.5SPECTPLD1.5PLD2.5SPECTPLD1.5PLD2.5SPECT
    Rater 187.99.169.792.914.392.984.228.652.6
    Rater 297.012.190.110028.692.994.7089.5
    Agreement84.83.066.792.97.185.784.2052.6
    • View popup
    Table 3:

    Interrater agreement

    κ Statistic
    5-Point ScoringPositive or Negative for AD Diagnosis
    PLD1.50.0330.3694
    PLD2.50.1410.203
    SPECT0.0100.195
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American Journal of Neuroradiology: 38 (8)
American Journal of Neuroradiology
Vol. 38, Issue 8
1 Aug 2017
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Cite this article
T. Kaneta, O. Katsuse, T. Hirano, M. Ogawa, K. Yoshida, T. Odawara, Y. Hirayasu, T. Inoue
Head-to-Head Visual Comparison between Brain Perfusion SPECT and Arterial Spin-Labeling MRI with Different Postlabeling Delays in Alzheimer Disease
American Journal of Neuroradiology Aug 2017, 38 (8) 1562-1568; DOI: 10.3174/ajnr.A5238

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Head-to-Head Visual Comparison between Brain Perfusion SPECT and Arterial Spin-Labeling MRI with Different Postlabeling Delays in Alzheimer Disease
T. Kaneta, O. Katsuse, T. Hirano, M. Ogawa, K. Yoshida, T. Odawara, Y. Hirayasu, T. Inoue
American Journal of Neuroradiology Aug 2017, 38 (8) 1562-1568; DOI: 10.3174/ajnr.A5238
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