A diagnostic approach in Alzheimer's disease using three-dimensional stereotactic surface projections of fluorine-18-FDG PET.
A diagnostic approach in Alzheimer's disease using three-dimensional stereotactic surface projections of fluorine-18-FDG PET.
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发表时间：
1995-07
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通讯作者：
S. Minoshima;K. Frey;K. Frey;R. Koeppe;N. Foster;David E. Kuhl
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作者：
S. Minoshima;K. Frey;K. Frey;R. Koeppe;N. Foster;David E. Kuhl
无标签 为提高正电子发射断层扫描（PET）在辅助评估疑似阿尔茨海默病患者时的诊断效能，我们开发了一种全自动方法，该方法可生成全面的图像展示和客观的诊断指标。
方法 收集了37例可能患有阿尔茨海默病（包括可疑和轻度痴呆）患者、22名正常受试者以及5例脑血管疾病患者的氟 - 18 - 氟脱氧葡萄糖PET图像组。在立体定向解剖标准化之后，将个体PET图像组上的代谢活动提取到一组预定义的表面像素（三维立体定向表面投影，3D - SSP）中，用于后续分析。通过对正常受试者提取的数据集求平均来创建一个正常数据库。通过逐个像素计算Z分数，将患者的数据集与正常数据库进行单独比较，并以3D - SSP视图显示以供目视检查。然后基于联合皮质的平均Z分数生成诊断指标。
结果 在提取的原始数据和统计Z分数的标准3D - SSP视图中，可以看到可能患有阿尔茨海默病患者的代谢降低模式和严重程度。在区分可能患有阿尔茨海默病的患者与正常受试者时，顶叶联合皮质和单侧平均的顶 - 颞 - 额叶皮质的诊断指标的敏感度分别为95%和97%，特异性为100%。这两个指标对于脑血管疾病均未产生假阳性结果。
结论 3D - SSP能够通过立体定向坐标进行定量数据提取和代谢异常的可靠定位。所提出的方法是一种有前景的解读功能性脑PET扫描的方法。
UNLABELLED To improve the diagnostic performance of PET as an aid in evaluating patients suspected of having Alzheimer's disease, we developed a fully automated method which generates comprehensive image presentations and objective diagnostic indices. METHODS Fluorine-18-fluorodeoxyglucose PET image sets were collected from 37 patients with probable Alzheimer's disease (including questionable and mild dementia), 22 normal subjects and 5 patients with cerebrovascular disease. Following stereotactic anatomic standardization, metabolic activity on an individual's PET image set was extracted to a set of predefined surface pixels (three-dimensional stereotactic surface projection, 3D-SSP), which was used in the subsequent analysis. A normal database was created by averaging extracted datasets of the normal subjects. Patients' datasets were compared individually with the normal database by calculating a Z-score on a pixel-by-pixel basis and were displayed in 3D-SSP views for visual inspections. Diagnostic indices were then generated based on averaged Z-scores for the association cortices. RESULTS Patterns and severities of metabolic reduction in patients with probable Alzheimer's disease were seen in the standard 3D-SSP views of extracted raw data and statistical Z-scores. When discriminating patients with probable Alzheimer's disease from normal subjects, diagnostic indices of the parietal association cortex and unilaterally averaged parietal-temporal-frontal cortex showed sensitivities of 95% and 97%, respectively, with a specificity of 100%. Neither index yielded false-positive results for cerebrovascular disease. CONCLUSION 3D-SSP enables quantitative data extraction and reliable localization of metabolic abnormalities by means of stereotactic coordinates. The proposed method is a promising approach for interpreting functional brain PET scans.