Purpose: We evaluate the ability of Artificial Intelligence with automatic classification methods applied to semi-quantitative data from brain 18F-FDG PET/CT to improve the differential diagnosis between Alzheimer Disease (AD) and Mild Cognitive Impairment (MCI). Procedures: We retrospectively analyzed a total of 150 consecutive patients who underwent diagnostic evaluation for suspected AD (n = 67) or MCI (n = 83). All patients received brain 18F-FDG PET/CT according to the international guidelines, and images were analyzed both Qualitatively (QL) and Quantitatively (QN), the latter by a fully automated post-processing software that produced a z score metabolic map of 25 anatomically different cortical regions. A subset of n = 122 cases with a confirmed diagnosis of AD (n = 53) or MDI (n = 69) by 18–24-month clinical follow-up was finally included in the study. Univariate analysis and three automated classification models (classification tree –ClT-, ridge classifier –RC- and linear Support Vector Machine –lSVM-) were considered to estimate the ability of the z scores to discriminate between AD and MCI cases in. Results: The univariate analysis returned 14 areas where the z scores were significantly different between AD and MCI groups, and the classification accuracy ranged between 74.59% and 76.23%, with ClT and RC providing the best results. The best classification strategy consisted of one single split with a cut-off value of ≈ −2.0 on the z score from temporal lateral left area: cases below this threshold were classified as AD and those above the threshold as MCI. Conclusions: Our findings confirm the usefulness of brain 18F-FDG PET/CT QL and QN analyses in differentiating AD from MCI. Moreover, the combined use of automated classifications models can improve the diagnostic process since its use allows identification of a specific hypometabolic area involved in AD cases in respect to MCI. This data improves the traditional 18F-FDG PET/CT image interpretation and the diagnostic assessment of cognitive disorders.

Differential Diagnosis of Alzheimer Disease vs. Mild Cognitive Impairment Based on Left Temporal Lateral Lobe Hypomethabolism on 18F-FDG PET/CT and Automated Classifiers / Nuvoli, S.; Bianconi, F.; Rondini, M.; Lazzarato, A.; Marongiu, A.; Fravolini, M. L.; Cascianelli, S.; Amici, S.; Filippi, L.; Spanu, A.; Palumbo, B.. - In: DIAGNOSTICS. - ISSN 2075-4418. - 12:10(2022), p. 2425. [10.3390/diagnostics12102425]

Differential Diagnosis of Alzheimer Disease vs. Mild Cognitive Impairment Based on Left Temporal Lateral Lobe Hypomethabolism on 18F-FDG PET/CT and Automated Classifiers

Nuvoli S.;Rondini M.;Lazzarato A.;Marongiu A.;Spanu A.;Palumbo B.
2022-01-01

Abstract

Purpose: We evaluate the ability of Artificial Intelligence with automatic classification methods applied to semi-quantitative data from brain 18F-FDG PET/CT to improve the differential diagnosis between Alzheimer Disease (AD) and Mild Cognitive Impairment (MCI). Procedures: We retrospectively analyzed a total of 150 consecutive patients who underwent diagnostic evaluation for suspected AD (n = 67) or MCI (n = 83). All patients received brain 18F-FDG PET/CT according to the international guidelines, and images were analyzed both Qualitatively (QL) and Quantitatively (QN), the latter by a fully automated post-processing software that produced a z score metabolic map of 25 anatomically different cortical regions. A subset of n = 122 cases with a confirmed diagnosis of AD (n = 53) or MDI (n = 69) by 18–24-month clinical follow-up was finally included in the study. Univariate analysis and three automated classification models (classification tree –ClT-, ridge classifier –RC- and linear Support Vector Machine –lSVM-) were considered to estimate the ability of the z scores to discriminate between AD and MCI cases in. Results: The univariate analysis returned 14 areas where the z scores were significantly different between AD and MCI groups, and the classification accuracy ranged between 74.59% and 76.23%, with ClT and RC providing the best results. The best classification strategy consisted of one single split with a cut-off value of ≈ −2.0 on the z score from temporal lateral left area: cases below this threshold were classified as AD and those above the threshold as MCI. Conclusions: Our findings confirm the usefulness of brain 18F-FDG PET/CT QL and QN analyses in differentiating AD from MCI. Moreover, the combined use of automated classifications models can improve the diagnostic process since its use allows identification of a specific hypometabolic area involved in AD cases in respect to MCI. This data improves the traditional 18F-FDG PET/CT image interpretation and the diagnostic assessment of cognitive disorders.
2022
Differential Diagnosis of Alzheimer Disease vs. Mild Cognitive Impairment Based on Left Temporal Lateral Lobe Hypomethabolism on 18F-FDG PET/CT and Automated Classifiers / Nuvoli, S.; Bianconi, F.; Rondini, M.; Lazzarato, A.; Marongiu, A.; Fravolini, M. L.; Cascianelli, S.; Amici, S.; Filippi, L.; Spanu, A.; Palumbo, B.. - In: DIAGNOSTICS. - ISSN 2075-4418. - 12:10(2022), p. 2425. [10.3390/diagnostics12102425]
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11388/297685
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