Tc-99m ethylcysteinate dimer SPECT in the differential diagnosis of dementias

Neurol India. 2010 Nov-Dec;58(6):857-62. doi: 10.4103/0028-3886.73745.

Abstract

Background: Dementias produce deficits in perfusion, in part, reflecting decreased metabolic needs. Single photon emission computed tomography (SPECT) studies have reported characteristic anterior-to-posterior perfusion gradients that permit distinction between the various forms of dementia.

Aim: We undertook this study to evaluate the role of visual analysis of SPECT perfusion patterns for the differential diagnosis of types of degenerative dementia.

Materials and methods: Tc-99m ethylcysteinate dimer (ECD) was used with a dual-head scanner to generate perfusion images of the brain in 136 patients referred from the dementia clinic. Diagnosis was made by the nuclear physician unaware of clinical diagnosis.

Results: Sensitivity, specificity, positive predictive value and negative predictive value of perfusion studies for Alzheimer's dementia were 93.42%, 95.12%, 97.26%, and 88.63%, respectively, and for frontotemporal dementia were 96.29%, 98%, 96.29%, and 98.88%, respectively.

Conclusions: Tc-99m ECD brain perfusion SPECT is useful in the differential diagnosis of dementia with particular reference to AD as well as FTD.

MeSH terms

  • Aged
  • Cysteine / analogs & derivatives*
  • Dementia / classification
  • Dementia / diagnostic imaging*
  • Diagnosis, Differential
  • Female
  • Humans
  • Male
  • Middle Aged
  • Organotechnetium Compounds*
  • Predictive Value of Tests
  • Radiopharmaceuticals*
  • Sensitivity and Specificity
  • Tomography, Emission-Computed, Single-Photon / methods*

Substances

  • Organotechnetium Compounds
  • Radiopharmaceuticals
  • technetium Tc 99m bicisate
  • Cysteine