Comparative diagnostic utility of different MR modalities in mild cognitive impairment and Alzheimer's disease

Kejal M Kantarci, YueCheng Xu, Maria M. Shiung, Peter C. O'Brien, Ruth H. Cha, Glenn E. Smith, Robert J. Ivnik, Bradley F Boeve, Steven D. Edland, Emre Kokmen, Eric George Tangalos, Ronald Carl Petersen, Clifford R Jr. Jack

Research output: Contribution to journalArticle

120 Citations (Scopus)

Abstract

This study compares the diagnostic accuracy of magnetic resonance (MR)-based hippocampal volumetry, single voxel 1H MR spectroscopy (1H MRS) and MR diffusion-weighted imaging (DWI) measurements in discriminating patients with amnestic mild cognitive impairment (MCI), Alzheimer's disease (AD) and normally aging elderly. Sixty-one normally aging elderly, 24 MCI and 22 AD patients underwent MR-based hippocampal volumetry, 1H MRS and DWI. 1H MRS voxels were placed over both of the posterior cingulate gyri, and N-acetyl aspartate (NAA)/creatine (Cr), myoinositol (MI)/Cr and NAA/MI ratios were obtained. Apparent diffusion coefficient (ADC) maps were derived from DWI, and hippocampal borders were traced to measure hippocampal ADC. At 80% specificity, the most sensitive single measurement to discriminate MCI (79%) and AD (86%) from controls was hippocampal volumes. The most sensitive single measurement to discriminate AD from MCI was posterior cingulate gyrus NAA/Cr (67%). At high specificity (>85-90%), combinations of MR measures had superior diagnostic sensitivity compared with any single MR measurement for the AD vs. control and control vs. MCI comparisons. The MR measures that best discriminate more from less affected individuals along the cognitive continuum from normal to AD vary with disease severity. Selection of imaging measures used for clinical assessment or monitoring efficiency of therapeutic intervention should be tailored to the clinical stage of the disease.

Original languageEnglish (US)
Pages (from-to)198-207
Number of pages10
JournalDementia and Geriatric Cognitive Disorders
Volume14
Issue number3-4
DOIs
StatePublished - 2002

Fingerprint

Alzheimer Disease
Magnetic Resonance Spectroscopy
Creatine
Gyrus Cinguli
Inositol
Diffusion Magnetic Resonance Imaging
Cognitive Dysfunction
N-acetylaspartate

Keywords

  • H MRS
  • Alzheimer's disease
  • Diffusion-weighted imaging
  • Hippocampal volumetry
  • Mild cognitive impairment
  • MRI

ASJC Scopus subject areas

  • Neuropsychology and Physiological Psychology
  • Geriatrics and Gerontology

Cite this

Comparative diagnostic utility of different MR modalities in mild cognitive impairment and Alzheimer's disease. / Kantarci, Kejal M; Xu, YueCheng; Shiung, Maria M.; O'Brien, Peter C.; Cha, Ruth H.; Smith, Glenn E.; Ivnik, Robert J.; Boeve, Bradley F; Edland, Steven D.; Kokmen, Emre; Tangalos, Eric George; Petersen, Ronald Carl; Jack, Clifford R Jr.

In: Dementia and Geriatric Cognitive Disorders, Vol. 14, No. 3-4, 2002, p. 198-207.

Research output: Contribution to journalArticle

Kantarci, Kejal M ; Xu, YueCheng ; Shiung, Maria M. ; O'Brien, Peter C. ; Cha, Ruth H. ; Smith, Glenn E. ; Ivnik, Robert J. ; Boeve, Bradley F ; Edland, Steven D. ; Kokmen, Emre ; Tangalos, Eric George ; Petersen, Ronald Carl ; Jack, Clifford R Jr. / Comparative diagnostic utility of different MR modalities in mild cognitive impairment and Alzheimer's disease. In: Dementia and Geriatric Cognitive Disorders. 2002 ; Vol. 14, No. 3-4. pp. 198-207.
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AU - Cha, Ruth H.

AU - Smith, Glenn E.

AU - Ivnik, Robert J.

AU - Boeve, Bradley F

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AU - Tangalos, Eric George

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AU - Jack, Clifford R Jr.

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AB - This study compares the diagnostic accuracy of magnetic resonance (MR)-based hippocampal volumetry, single voxel 1H MR spectroscopy (1H MRS) and MR diffusion-weighted imaging (DWI) measurements in discriminating patients with amnestic mild cognitive impairment (MCI), Alzheimer's disease (AD) and normally aging elderly. Sixty-one normally aging elderly, 24 MCI and 22 AD patients underwent MR-based hippocampal volumetry, 1H MRS and DWI. 1H MRS voxels were placed over both of the posterior cingulate gyri, and N-acetyl aspartate (NAA)/creatine (Cr), myoinositol (MI)/Cr and NAA/MI ratios were obtained. Apparent diffusion coefficient (ADC) maps were derived from DWI, and hippocampal borders were traced to measure hippocampal ADC. At 80% specificity, the most sensitive single measurement to discriminate MCI (79%) and AD (86%) from controls was hippocampal volumes. The most sensitive single measurement to discriminate AD from MCI was posterior cingulate gyrus NAA/Cr (67%). At high specificity (>85-90%), combinations of MR measures had superior diagnostic sensitivity compared with any single MR measurement for the AD vs. control and control vs. MCI comparisons. The MR measures that best discriminate more from less affected individuals along the cognitive continuum from normal to AD vary with disease severity. Selection of imaging measures used for clinical assessment or monitoring efficiency of therapeutic intervention should be tailored to the clinical stage of the disease.

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