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dc.contributor.authorSoonawala, Dariusen_UK
dc.contributor.authorAmin, Taniaen_UK
dc.contributor.authorEbmeier, Klaus Pen_UK
dc.contributor.authorSteele, J Douglasen_UK
dc.contributor.authorDougall, Nadineen_UK
dc.contributor.authorBest, Jonathan J Ken_UK
dc.contributor.authorMigneco, Octaveen_UK
dc.contributor.authorNobili, Flavioen_UK
dc.contributor.authorScheidhauer, Klemensen_UK
dc.description.abstractBackground: For a quantitative comparison of images obtained during 99mTc-hexamethylpropylene amine oxime (HMPAO) single-photon emission computed tomography (SPECT), brain activity values are usually normalized to a reference region. In studies of Alzheimer-type dementia (ATD), the cerebellum is often used as a reference region, assuming that it is spared any major pathological involvement. Statistical parametric mapping (SPM) may enhance the evaluation of SPECT scans in ATD patients. However, current SPM software only allows scaling to average whole brain activity (i.e., global normalization). The aim of this study was to develop an easily applied, objective, and reproducible method for determining average cerebellar tracer uptake so that images can be scaled specifically to cerebellar activity prior to the performance of SPM analysis. We also investigated whether cerebellar normalization increases the sensitivity and specificity of SPM analysis of ATD patients compared with global normalization. Methods: Image files were taken from a parallel study investigating the use of SPECT as a diagnostic tool for early onset of ATD. Two methods for determining cerebellar activity were developed: one manually, using templates, the other automated, using specified coordinates entered into a Matlab routine. Group comparison of ATD patients versus controls (= healthy volunteers and depressed patients) was performed on a voxel-by-voxel basis using SPM 96 on Windows 95. Receiver operator characteristics (ROC) were computed for 20 student raters examining patient and control scans with and without single-subject SPMs. Results: The reduction of cerebral blood flow in the group of ATD patients appeared 1.7 times greater in spatial extent when the tracer uptake was normalized to cerebellum rather than to average whole brain activity. Computing the reverse contrast (reductions in the control group compared with ATD patients) produced clusters of significance in globally normalized images which were not manifest after normalizing to cerebellum. This is consistent with the notion that the cerebellum is spared in ATD. Analysis of the area under the ROC curve showed that cerebellar-normalized SPM produced significantly improved accuracy over perfusion scans alone. Conclusion: An easily applied, objective, reproducible method was developed for normalizing images to cerebellum prior to the performance of SPM analysis. Cerebellar normalization produced more extensive abnormalities in SPM analyses of ATD patients than global normalization. Furthermore, cerebellar normalization produced marginally more accurate diagnostic results in single-scan SPM analysis of ATD patients than did global normalization.en_UK
dc.relationSoonawala D, Amin T, Ebmeier KP, Steele JD, Dougall N, Best JJK, Migneco O, Nobili F & Scheidhauer K (2002) Statistical parametric mapping of Tc-99m-HMPAO-SPECT images for the diagnosis of Alzheimer's disease: Normalizing to cerebellar tracer uptake. NeuroImage, 17 (3), pp. 1193-1202.
dc.rightsThe publisher does not allow this work to be made publicly available in this Repository. Please use the Request a Copy feature at the foot of the Repository record to request a copy directly from the author. You can only request a copy if you wish to use this work for your own research or private study.en_UK
dc.subjectAlzheimer's diseaseen_UK
dc.subjectreference regionen_UK
dc.subjectDementia diagnosisen_UK
dc.subjectAlzheimer Disease diagnosisen_UK
dc.titleStatistical parametric mapping of Tc-99m-HMPAO-SPECT images for the diagnosis of Alzheimer's disease: Normalizing to cerebellar tracer uptakeen_UK
dc.typeJournal Articleen_UK
dc.rights.embargoreason[statistical parametric mapping.pdf] The publisher does not allow this work to be made publicly available in this Repository therefore there is an embargo on the full text of the work.en_UK
dc.type.statusVoR - Version of Recorden_UK
dc.contributor.affiliationUniversity of Edinburghen_UK
dc.contributor.affiliationUniversity of Edinburghen_UK
dc.contributor.affiliationUniversity of Edinburghen_UK
dc.contributor.affiliationUniversity of Edinburghen_UK
dc.contributor.affiliationUniversity of Edinburghen_UK
dc.contributor.affiliationUniversity of Nice Sophia-Antipolis, Franceen_UK
dc.contributor.affiliationUniversity of Genoaen_UK
dc.contributor.affiliationUniversity of Cologneen_UK
rioxxterms.typeJournal Article/Reviewen_UK
local.rioxx.authorSoonawala, Darius|en_UK
local.rioxx.authorAmin, Tania|en_UK
local.rioxx.authorEbmeier, Klaus P|en_UK
local.rioxx.authorSteele, J Douglas|en_UK
local.rioxx.authorDougall, Nadine|0000-0003-3462-6960en_UK
local.rioxx.authorBest, Jonathan J K|en_UK
local.rioxx.authorMigneco, Octave|en_UK
local.rioxx.authorNobili, Flavio|en_UK
local.rioxx.authorScheidhauer, Klemens|en_UK
local.rioxx.projectInternal Project|University of Stirling|
local.rioxx.filenamestatistical parametric mapping.pdfen_UK
Appears in Collections:Faculty of Health Sciences and Sport Journal Articles

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