Tc-99m HMPAO SPECT in the Differential Diagnosis of the... : Clinical Nuclear Medicine (original) (raw)

Original Article

Tc-99m HMPAO SPECT in the Differential Diagnosis of the Dementias With Histopathologic Confirmation

Bonte, Frederick J. MD*†; Harris, Thomas S. MS*†; Hynan, Linda S. PhD‡; Bigio, Eileen H. MD∥§; White, Charles L. III MD§

From the *Nuclear Medicine Center and the Department of †Radiology, the ‡Center for Biostatistics and Clinical Sciences, and the §Division of Neuropathology, Department of Pathology, The University of Texas Southwestern Medical Center at Dallas, Dallas, Texas; ∥presently the Department of Pathology, Northwestern University School of Medicine, Chicago, Illinois.

Received for publication August 1, 2005; revision accepted January 30, 2006.

Reprints: Frederick J. Bonte, MD, Director, Nuclear Medicine Center, The University of Texas, Southwestern Medical Center, 5323 Harry Hines Blvd., Dallas, TX 75390-9061. E-mail: [email protected].

Abstract

Purpose:

The purpose of this study is to determine the value of Tc-99m HMPAO SPECT in the diagnosis of the dementias, with particular reference to Alzheimer disease.

Materials and Methods:

Tc-99m HMPAO was used with a 3-camera scanner to produce 5 sets of sectional images of the brain. Diagnosis was made by a physician blinded to the clinical diagnosis. Results in 49 subjects were ultimately compared with neuropathologic study of the brain at autopsy.

Results:

Sensitivity = 86.7% (68.4–95.6%, 95% confidence interval [CI]), specificity = 89.5% (65.5–98.2% CI), positive predictive value = 92.9% (75.0–98.8% CI), negative predictive value = 81% (57.4–93.7% CI), accuracy = 87.8% (74.5–94.9% CI), likelihood ratio = 8.23% (7.09–9.57% CI).

Conclusions:

Comparison is made with several other SPECT and PET series with histopathologic correlation. Brain blood flow SPECT is useful in the diagnosis and differential diagnosis of the dementias.