Abstract
The voxel-based morphometry (VBM) technique using brain magnetic resonance imaging (MRI) objectively maps gray matter loss on a voxel-by-voxel basis after anatomic standardization. In patients with Alzheimer's disease (AD), reductions of gray matter volume, mainly in the medial temporal structures, have been reported; however, inhomogeneity and geometric distortion of the field intensity hampers the reproducibility of MRI. In the present study, we developed a novel computed tomography (CT)-based VBM method and used this technique to detect volume loss in AD patients as compared with normal controls. The results were compared with MRI-based VBM using the same subjects. Pittsburgh Compound B (11C-PIB) positron emission tomography (PET)/CT was performed and two experts in neuro-nuclear medicine judged whether regional amyloid β load was consistent with a diagnosis of AD. Before the injection of 11C-PIB, high-quality CT scans were obtained using the same PET/CT equipment. MRI was performed within a mean interval of 25.1 ± 8.2 days before the PET/CT scan. Using statistical parametric mapping 8 (SPM8), the extracted gray matter images from CT and MRI were spatially normalized using a gray matter template and smoothed using a Gaussian kernel. Group comparisons were performed using SPM8 between five 11C-PIB-positive patients with probable AD and seven 11C-PIB-negative age-matched controls with normal cognition. Gray matter volumes in the bilateral medial temporal areas were reduced in the AD group as compared with the cognitively normal group in both CT-based VBM (in the left; P < 0.0001, cluster size 2776 and in the right; P < 0.0001, cluster size 630) and MRI-based VBM (in the left; P < 0.0001, cluster size 381 and in the right, P < 0.0001, cluster size 421). This newly developed CT-based VBM technique can detect significant atrophy in the entorhinal cortex in probable AD patients as previously reported using MRI-based VBM. However, CT-VBM was more sensitive and revealed larger areas of significant atrophy than MR-VBM.
Highlights
The brain has a simple structure, despite its complex functions
We developed a novel computed tomography (CT)-based voxel-based morphometry (VBM) (CT-VBM) technique
In CT-VBM, the Alzheimer’s disease (AD) group showed a significant decrease of gray matter volume in the bilateral entorhinal cortex at Brodmann area (BA) 28, left hippocampus, in the left anterior cingulate gyri at BA 32, in the right temporopolar area, and in the right caudal head as compared to the cognitively normal group (Table 1 and Fig. 2)
Summary
The brain has a simple structure, despite its complex functions. Brain structures consist mainly of gyri and sulci, with these structures being quite common in human beings. This simplicity makes it easier to normalize the brain to an anatomically standardized space and to introduce voxel-based statistical a 2013 The Authors. Comparison Between Brain CT and MRI for VBM of AD analysis. The majority of brain tissue consists of gray matter, white matter, and cerebrospinal fluid space. Gray matter thickness reflects the number of residual neurons. Brain magnetic resonance imaging (MRI) has been used to derive anatomical and tissue volume information, especially in gray and white matter
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