Erschienen in:
30.01.2020 | Neuro
Normative brain volume reports may improve differential diagnosis of dementing neurodegenerative diseases in clinical practice
verfasst von:
Dennis M. Hedderich, Michael Dieckmeyer, Tiberiu Andrisan, Marion Ortner, Lioba Grundl, Simon Schön, Per Suppa, Tom Finck, Kornelia Kreiser, Claus Zimmer, Igor Yakushev, Timo Grimmer
Erschienen in:
European Radiology
|
Ausgabe 5/2020
Einloggen, um Zugang zu erhalten
Abstract
Objectives
Normative brain volume reports (NBVRs) are becoming more and more available for the workup of dementia patients in clinical routine. However, it is yet unknown how this information can be used in the radiological decision-making process. The present study investigates the diagnostic value of NBVRs for detection and differential diagnosis of distinct regional brain atrophy in several dementing neurodegenerative disorders.
Methods
NBVRs were obtained for 81 consecutive patients with distinct dementing neurodegenerative diseases and 13 healthy controls (HC). Forty Alzheimer’s disease (AD; 18 with dementia, 22 with mild cognitive impairment (MCI), 11 posterior cortical atrophy (PCA)), 20 frontotemporal dementia (FTD), and ten semantic dementia (SD) cases were analyzed, and reports were tested qualitatively for the representation of atrophy patterns. Gold standard diagnoses were based on the patients’ clinical course, FDG-PET imaging, and/or cerebrospinal fluid (CSF) biomarkers following established diagnostic criteria. Diagnostic accuracy of pattern representations was calculated.
Results
NBVRs improved the correct identification of patients vs. healthy controls based on structural MRI for rater 1 (p < 0.001) whereas the amount of correct classifications was rather unchanged for rater 2. Correct differential diagnosis of dementing neurodegenerative disorders was significantly improved for both rater 1 (p = 0.001) and rater 2 (p = 0.022). Furthermore, interrater reliability was improved from moderate to excellent for both detection and differential diagnosis of neurodegenerative diseases (κ = 0.556/0.894 and κ = 0.403/0.850, respectively).
Conclusion
NBVRs deliver valuable and observer-independent information, which can improve differential diagnosis of neurodegenerative diseases.
Key Points
• Normative brain volume reports increase detection of neurodegenerative atrophy patterns compared to visual reading alone.
• Differential diagnosis of regionally distinct atrophy patterns is improved.
• Agreement between radiologists is significantly improved from moderate to excellent when using normative brain volume reports.