Brain SPECT in patients with cognitive disorders – comparison with clinical diagnosis and significance for clinical practise – still valid possiblity?
Authors:
Renata Píchová 1; Aleš Bartoš 2,3; Otto Lang 1
Authors place of work:
Klinika nukleární medicíny
1; Neurologická klinika 3. LF UK a FN Královské Vinohrady, Praha 10
2; NÚDZ Klecany u Prahy, ČR
3
Published in the journal:
NuklMed 2022;11:42-48
Category:
Original Article
Summary
Introduction: The importance of brain perfusion examination using single photon emission computed tomography (SPECT) in the differential diagnosis of cognitive disorders is evaluated in this study.
Methods: For a period of four years a retrospective analysis of the examined patient´s data was performed in order to compare the conclusions of the brain SPECT examination with the clinical diagnosis. 68 patients with clinical diagnoses (33 patients with probable Alzheimer‘s disease (AD), 13 with mild cognitive impairment (MCI) and 22 with other diseases) were divided into 5 groups of perfusion patterns according to the second reading of their brain SPECT images without clinical information: Alzheimer‘s disease (AD – 19 patients), vascular dementia picture (VD – 17), mixed dementia picture (MIX – 18), other perfusion patterns (O – 11) and normal picture (N – 3).
Results: Thirty-three patients with probable Alzheimer’s disease were studied. 87 % of them showed typical image of AD on SPECT scan and half of them showed an image of mixed type dementia. In 13 patients with MCI was found heterogeneous blood perfusion corresponding with miscellaneous population of patients with MCI. In 25 right-handed patients with the SPECT pattern suggestive of AD or MIX, temporoparietal or temporal hypoperfusion was detected in the first examination of these patients on the left in 60 %, on the right in 8 % and bilaterally in 32 % of AD patients. The reliability of the radionuclide (RN) method was assessed by determining the inter (89%) and intrapersonal (87%) agreement of the conclusions of the brain perfusion examination using the SPECT technique.
Conclusion: In addition to supporting of the AD diagnosis, brain SPECT perfusion provides additional information about a possible combination with vascular mechanisms. Heterogeneous patterns correspond to a mixed population of individuals with MCI.
Keywords:
dementia – Alzheimer‘s disease – Cognitive impairment – Single photon emission computed tomography – 99mTc-HMPAO brain SPECT – regional brain perfusion
Zdroje
- Topinková E. Jak správně a včas diagnostikovat demence – manuál pro klinickou praxi. Praha, UCB Pharma, s. r. o., 1999
- Newberg AB, Alavi A. Functional neuroimaging in the differential diagnosis of dementia. In Fazekas F, Schmidt R, Alavi A (eds.): Neuroimaging of Normal Aging and Uncommon causes of Dementia. Dordrecht, ICG Publications, 1998, p. 201-223
- Petersen RC, Smith GE, Waring SC et al. Mild cognitive impairment: clinical characterization and outcome. Arch Neurol 1999;56:303-308
- Dubois B, Feldman HH, Jacova C et al. Research criteria for the diagnosis of Alzheimer‘s disease: revising the NINCDS-ADRDA criteria. Lancet Neurol 2007;6:734-746
- Tien RD, Felsberg GJ, Ferris NJ et al. The dementias: correlation of clinical features, pathophysiology, and neuroradiology. AJR Am J Roentgenol 1993;161:245-255
- Rubens AB, Tikofsky RS. Dementia. Cerebral SPECT Imaging 1995;Chapter 6:111-113
- Jagust WJ, Johnson KA, Holman BL. SPECT perfusion imaging in the diagnosis of dementia. J Neuroimaging 1995;5 Suppl 1:S45-52
- Ryding E. SPECT measurements of brain function in dementia; a review. Acta Neurol Scand Suppl 1996;168:54-58
- Small GW. Differential diagnosis and early detection of dementia. Am J Geriatr Psychiatry 1998;6:26-33
- Talbot PR, Lloyd JJ, Snowden JS et al. A clinical role for 99mTc-HMPAO SPECT in the investigation of dementia? J Neurol Neurosurg Psychiatry 1998;64:306-313
- Bartoš A, Rusina R, Píchová R et al. Demence v obraze SPECT vyšetření mozku. Praktický lékař 2000;11:610-613
- Ferrando R, Damian A. Brain SPECT as a Biomarker of Neurodegeneration in Dementia in the Era of Molecular Imaging: Still a Valid Option? Front. Neurol. 2021 10;12:629442. doi: 10,3389 /fneur.2021.629442
- Blennow K, de Leon MJ, Zetterberg H. Alzheimer‘s disease. Lancet 2006;368:387-403
- Shimizu S, Hirose D, Hatanaka H et al. Role of neuroimaging as a biomarker for neurodegenerative diseases. Front Neurol 2018;9:265. doi: 10.3389/fneur.2018.00265
- Carapelle E, Mundi C, Cassano T et al. Interaction between cognitive reserve and biomarkers in alzheimer disease. Int J Mol Sci 2020;21:1–12 doi: 10.3390/ijms21176279
- Dougall NJ. Systematic review of the diagostic accuracy of 99mTc-HMPAO-SPECT in dementia. Am J Geriatr Psychiatry 2004;12:554–570 doi: 10.1097 / 00019442-200411000-00002
- Read SL, Miller BL, Mena I et al. SPECT in dementia: clinical and pathological correlation. J Am Geriatr Soc 1995;43:1243–1247 doi: 10.1111 / j.1532-5415.1995.tb07400.x
- Bonte FJ, Hynan L, Harris TS et al. TC-99m HMPAO Brain Blood Flow Imaging in the Dementias with Histopathologic Correlation in 73 Patients. Int J Mol Imaging. 2011;2011:409101. doi: 10.1155/2011/409101. Epub 2010 Dec 1. PMID: 21490729; PMCID: PMC3065903.
- Dukart J, Mueller K, Villringer A et al. Relationship between imaging biomarkers, age, progression and symptom severity in Alzheimer´s disease. NeuroImage Clin 2013;3:84–94 doi: 10.1016 / j.nicl.2013.07.005
- El Fakhri G, Kijewski MF, Albert MS et al. Quantitative SPECT leads to improved performance in discrimination tasks related to prodromal Alzheimer´s disease. J Nucl Med 2004;45:2026–2031
- Perani D. FDG PET and cognitive symptoms of dementia. Clin Transl Imaging 2013;1:247–260 doi: 10,1007 / s40336-013-0029-8
- Valotassiou V, Malamitsi J, Papatriantafyllou J et al. SPECT and PET imaging in Alzheimer´s disease. Ann Nucl Med 2018;32:583–593 doi: 10,1007 / s12149-018-1292-6
- Jagust W, Thisted R, Devous MD, Sr. et al. SPECT perfusion imaging in the diagnosis of Alzheimer’s disease: a clinicalpathologic study. Neurology 2001;56:950–956
- Snowdon DA, Greiner LH, Mortimer JA et al. Brain infarction and the clinical expression of Alzheimer disease. The Nun Study. JAMA 1997;277:813-817
- Langa KM, Foster NL, Larson EB. Mixed dementia: emerging concepts and therapeutic implications. JAMA 2004;292:2901-2908
Štítky
Nuclear medicine Radiodiagnostics RadiotherapyČlánok vyšiel v časopise
Nuclear Medicine
2022 Číslo 3
Najčítanejšie v tomto čísle
- Brain SPECT in patients with cognitive disorders – comparison with clinical diagnosis and significance for clinical practise – still valid possiblity?
- Alternative testing methods of radiopharmaceuticals in Czech Pharmacopoeia 2017 – Supplement 2021
- 43. Pracovní dny Radiofarmaceutické sekce ČSNM, Strážnice
- PET pracoviště nemocnice Chomutov