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European Radiology
Published in: European Radiology 5/2020

01-05-2020 | Frontotemporal Dementia | Neuro

Normative brain volume reports may improve differential diagnosis of dementing neurodegenerative diseases in clinical practice

Authors: 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

Published in: European Radiology | Issue 5/2020

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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.
Appendix
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Metadata
Title
Normative brain volume reports may improve differential diagnosis of dementing neurodegenerative diseases in clinical practice
Authors
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
Publication date
01-05-2020
Publisher
Springer Berlin Heidelberg
Published in
European Radiology / Issue 5/2020
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-019-06602-0

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