Mizumura S, Kumita S, Cho K, Ishihara M, Nakajo H, Toba M, Kumazaki TDevelopment of quantitative analysis method for stereotactic brain image: assessment of reduced accumulation in extent and severity using anatomical segmentation. Ann Nucl Med 17:289-295

Department of Radiology, Nippon Medical School, Tokyo, Japan.
Annals of Nuclear Medicine (Impact Factor: 1.68). 07/2003; 17(4):289-95. DOI: 10.1007/BF02988523
Source: PubMed


Through visual assessment by three-dimensional (3D) brain image analysis methods using stereotactic brain coordinates system, such as three-dimensional stereotactic surface projections and statistical parametric mapping, it is difficult to quantitatively assess anatomical information and the range of extent of an abnormal region. In this study, we devised a method to quantitatively assess local abnormal findings by segmenting a brain map according to anatomical structure. Through quantitative local abnormality assessment using this method, we studied the characteristics of distribution of reduced blood flow in cases with dementia of the Alzheimer type (DAT). Using twenty-five cases with DAT (mean age, 68.9 years old), all of whom were diagnosed as probable Alzheimer's disease based on NINCDS-ADRDA, we collected I-123 iodoamphetamine SPECT data. A 3D brain map using the 3D-SSP program was compared with the data of 20 cases in the control group, who age-matched the subject cases. To study local abnormalities on the 3D images, we divided the whole brain into 24 segments based on anatomical classification. We assessed the extent of an abnormal region in each segment (rate of the coordinates with a Z-value that exceeds the threshold value, in all coordinates within a segment), and severity (average Z-value of the coordinates with a Z-value that exceeds the threshold value). This method clarified orientation and expansion of reduced accumulation, through classifying stereotactic brain coordinates according to the anatomical structure. This method was considered useful for quantitatively grasping distribution abnormalities in the brain and changes in abnormality distribution.

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    • "The difference in CMRglc between each patient and this database was expressed as a Z-score (normal mean individual value / normal SD) and superimposed onto 3D-SSP maps (Minoshima et al., 1995). The regional Z-score was examined using the stereotactic extraction estimation (SEE) method developed by (Mizumura et al., 2003) an analytical method for measuring regional Z-scores using a stereotactic region of interest template from the Talairach Daemon database. Using the SEE method, we calculated the extent ratio, which was the percentage of voxels that showed Z-score > 0 in a specific brain area, and we calculated the severity, which was the average of Z-scores of these voxels. "
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    ABSTRACT: Objectives It is well known that Alzheimer's disease (AD)-type pathology is commonly present in dementia with Lewy bodies (DLB) brains and that the degree of AD-type pathology has an influence on the clinical characteristics of DLB. Although significant hypometabolism in the temporoparietal/precuneus on [18F]fluoro-d-glucose (18F-FDG) positron emission tomography (PET) scans is considered to support a diagnosis of AD, some DLB patients also exhibit this metabolic pattern. The clinical significance of the metabolic pattern on DLB remains unknown.Methods Twenty-three DLB patients, 10 AD patients, and 11 controls underwent 18F-FDG PET scans. According to the degree of hypometabolism in the parietal/precuneus regions, representing the AD-like metabolic pattern, 12 patients were placed in the DLB-AD(+) group and 11 patients were placed in the DLB-AD(−) group. The demographics and clinical variables were compared among the four groups.ResultsIn addition to the parietal/precuneus regions, the DLB-AD(+) group exhibited significantly greater posterior cingulate hypometabolism than the DLB-AD(−) group, although occipital metabolism did not differ. The prevalence of visual hallucinations and extracampine hallucinations, and the Bender-Gestalt test score were significantly higher in the DLB-AD(+) group than the DLB-AD(−) group, although there were no differences in the demographics and other examined clinical variables between the two DLB groups. These clinical differences were absent in the DLB-AD(−) group, AD group, and controls.Conclusions Parietal/precuneus hypometabolism may be associated with clinical characteristics in DLB patients. Further multiple imaging modalities that are sensitive to AD-type pathology are needed to reveal the neurobiological basis of the AD-like metabolic pattern. Copyright © 2014 John Wiley & Sons, Ltd.
    Full-text · Article · Mar 2015 · International Journal of Geriatric Psychiatry
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    • "In order to evaluate the decrease in the regional cerebral metabolic rate of glucose (CMRglc) in all patients, the CMRglc for each patient was compared using three-dimensional stereotactic surface projection (3D-SSP) analysis with an age-matched normative database consisting of data from 77 normal healthy volunteers between 41 and 84 years of age (36 men and 41 women) [19]. The difference in CMRglc between each patient and this database was expressed as a Z-score (normal mean-individual value/normal SD) and superimposed onto 3D-SSP maps [20] [21]. Hypometabolism in the PVC was measured based on the average extent of CMRglc reduction in each primary visual cortex on the [ 18 F]-FDG PET scans at a Z-score of N1.0. "
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    ABSTRACT: We previously reported non-demented patients with glucose hypometabolism in the primary visual cortex (PVC), which is the preferentially affected region in patients with dementia with Lewy bodies (DLB). It remains unknown, however, whether these patients represent a prodromal DLB state. Eleven non-demented patients who attended our memory clinic for more than three years (mean follow-up period: 44±5months) were examined. All the patients had glucose hypometabolism in the PVC on [(18)F]-fluoro-d-glucose (FDG) positron emission tomography (PET) scans at baseline. Four patients, including one with a clinical history of occipital bleeding, exhibited no core or suggestive features of DLB. Seven patients reported recurrent nocturnal dream-enactment behavior, which is consistent with probable rapid eye movement (REM) sleep behavior disorder (RBD). The condition of the patient with occipital bleeding was stable, which is consistent with an underlying non-neurodegenerative disorder. Of the remaining 10 patients, 5 had stable cognitive conditions (non-converters) and 5 exhibited progression to dementia (converters). The clinical diagnoses of 4 patients with probable RBD were changed to probable DLB. Despite no differences in psychological profiles at baseline between non-converters and converters, the initial pattern of cortical metabolism differed: converters had lower glucose hypometabolism in the parietal and the lateral occipital cortex compared to non-converters. The metabolic reduction in the PVC is present in patients with prodromal DLB. Moreover, the spatial profiles of reduced glucose metabolism at baseline could help to define the distinct prognostic subgroup that has a greater risk of conversion to DLB.
    Full-text · Article · Jul 2013 · Journal of the neurological sciences
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    • "We analyzed the results of 99mTc-ECD SPECT using two related voxel-based statistical programs, namely the Easy Z-score Imaging System (eZIS) [23] and the voxel-based Stereotactic Extraction Estimation Program (vbSEE) [24]. The eZIS program processes the original SPECT data so that the brain morphology is anatomically remodeled and brain areas were defined according to Talairach and Tournoux normal brain. "
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    ABSTRACT: The aim of this study was to investigate onset patterns and initial symptoms in patients with dementia with Lewy bodies (DLB) and their association with SPECT findings. We studied 29 probable and 12 possible DLB patients. Onset was defined as 'acute' when symptoms (in various combinations) present within a few weeks or 'chronic' when a few symptoms present and progress during a longer period of time. Initial symptoms were dichotomized into 'cognitive' and 'non-cognitive'. We conducted voxel-to-voxel statistical analyses of SPECT, and uptake deviations from age-matched controls were depicted with Z-scores. In acute patients, decreases were more apparent in the bilateral frontal and temporal lobes, whereas chronic patients showed decreases in the bilateral occipital, posterior cingulate and precuneal regions. Differences in the left frontal and left posterior cingulate were significant and those in the left temporal region showed a tendency toward significance. Patients with cognitive symptoms demonstrated more marked decreases in the bilateral temporal, parietal, occipital, cingulate and precuneal regions. Differences in the left parietal area reached significance and the total decreases were larger in patients with cognitive than non-cognitive symptoms, with a trend toward significance. The multiplicity of onset patterns and initial symptoms may possibly be based on pathophysiological diversities in DLB.
    Full-text · Article · Aug 2011
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