Semiquantitative ^99mTc-HMPAO-SPECT bei Demenz vom Alzheimer-Typ: Auswirkungen der Wahl von Rekonstruktionsfilter und Referenzregion

 

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Zusammenfassung

Ziel der Studie war es, zu klären, ob die Wahl der Referenzregion und/oder des Rekonstruktionsfilters einen Einfluß auf das Ergebnis der semiquantitativen Analyse einer zur Diagnose der Demenz vom Alzheimer-Typ (DAT) durchgeführten ^99mTc-HMPAO-SPECT ausübt. Methoden: Untersucht wurden 19 DAT-Patienten gemäß der Kriterien des NINCDS-ADRDA sowie des DSM-III-R und eine Vergleichsgruppe (n = 14) mit normaler zerebraler Perfusion. Es wurden drei Referenzregionen (Zerebellum, Gesamtschicht, Okzipitalregion) und vier Rekonstruktionsfilter (Hanning f_c = 0,7 und 1,0 Nyquist; Butterworth (n = 8) mit f_c = 0,5 und 0,9 Nyquist) auf jeweils 12 standardisierte ROI (pro Patient) angewendet. Die Datenauswertung erfolgte mit Hilfe einer ROC-Analyse. Ergebnisse: Es zeigte sich eine Abhängigkeit der bei DAT als charakteristisch beschriebenen bilateralen parieto-temporalen Perfusionsreduktion von den verwendeten Filtern und Referenzregionen. Ein Butterworth-Filter (n = 8; f_c = 0,5) kombiniert mit dem Zerebellum als Referenzregion ermöglichte die sicherste Trennung beider Patientengruppen. Schlußfolgerung: Die Wahl der Referenzregion und des Rekonstruktionsfilters hat einen großen Einfluß auf die Ergebnisse einer Semiquantifizierung. Es bedarf daher einer Standardisierung in Abhängigkeit von der jeweiligen Fragestellung.

Summary

Aim: The aim of the study was to clarify, whether the selection of the reference-region and/or the reconstruction-filter influences the result of the semiquantitative analysis of a ^99mTc-HMPAO-SPECT that was conducted to diagnose the dementia of the Alzheimer type (DAT). Methods: A group of 19 DAT-patients according to the criteria of NINCDS-ADRDA and DSM-III-R was examined together with a comparison group (n = 14) with normal cerebral perfusion. Three reference-regions (cerebellum, whole slice, occipital cortex) and four reconstruction-filters (Hanning f_c = 0.7 and 1.0 Nyquist; Butterworth (n = 8); f_c = 0.5 and 0.9 Nyquist) were applied to twelve standardized regions of interest (per patient) respectively. The data was evaluated through a ROC-analysis. Results: It has been showed, that the bilateral parieto-temporal perfusion reduction as a characteristic of DAT depends on the filters and reference-regions used. The most secure separation of both groups of patients was obtained through a Butterworth-filter (n = 8; f_c = 0.5) in combination with the cerebellum as reference-region. Conclusion: The selection of the reference-region and the reconstruction-filter has an important influence on the results of a semiquantitative analysis. Therefore standardisation in dependency on the actual questioning is necessary.

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