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European Radiology
Published in: European Radiology 1/2016

Open Access 01-01-2016 | Neuro

Early-stage differentiation between presenile Alzheimer’s disease and frontotemporal dementia using arterial spin labeling MRI

Authors: Rebecca M. E. Steketee, Esther E. Bron, Rozanna Meijboom, Gavin C. Houston, Stefan Klein, Henri J. M. M. Mutsaerts, Carolina P. Mendez Orellana, Frank Jan de Jong, John C. van Swieten, Aad van der Lugt, Marion Smits

Published in: European Radiology | Issue 1/2016

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Abstract

Objective

To investigate arterial spin labeling (ASL)-MRI for the early diagnosis of and differentiation between the two most common types of presenile dementia: Alzheimer’s disease (AD) and frontotemporal dementia (FTD), and for distinguishing age-related from pathological perfusion changes.

Methods

Thirteen AD and 19 FTD patients, and 25 age-matched older and 22 younger controls underwent 3D pseudo-continuous ASL-MRI at 3 T. Gray matter (GM) volume and cerebral blood flow (CBF), corrected for partial volume effects, were quantified in the entire supratentorial cortex and in 10 GM regions. Sensitivity, specificity and diagnostic performance were evaluated in regions showing significant CBF differences between patient groups or between patients and older controls.

Results

AD compared with FTD patients had hypoperfusion in the posterior cingulate cortex, differentiating these with a diagnostic performance of 74 %. Compared to older controls, FTD patients showed hypoperfusion in the anterior cingulate cortex, whereas AD patients showed a more widespread regional hypoperfusion as well as atrophy. Regional atrophy was not different between AD and FTD. Diagnostic performance of ASL to differentiate AD or FTD from controls was good (78-85 %). Older controls showed global hypoperfusion compared to young controls.

Conclusion

ASL-MRI contributes to early diagnosis of and differentiation between presenile AD and FTD.

Key Points

• ASL-MRI facilitates differentiation of early Alzheimer’s disease and frontotemporal dementia.
• Posterior cingulate perfusion is lower in Alzheimer’s disease than frontotemporal dementia.
• Compared to controls, Alzheimer’s disease patients show hypoperfusion in multiple regions.
• Compared to controls, frontotemporal dementia patients show focal anterior cingulate hypoperfusion.
• Global decreased perfusion in older adults differs from hypoperfusion in dementia.
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Metadata
Title
Early-stage differentiation between presenile Alzheimer’s disease and frontotemporal dementia using arterial spin labeling MRI
Authors
Rebecca M. E. Steketee
Esther E. Bron
Rozanna Meijboom
Gavin C. Houston
Stefan Klein
Henri J. M. M. Mutsaerts
Carolina P. Mendez Orellana
Frank Jan de Jong
John C. van Swieten
Aad van der Lugt
Marion Smits
Publication date
01-01-2016
Publisher
Springer Berlin Heidelberg
Published in
European Radiology / Issue 1/2016
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-015-3789-x

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