Dementia Japan 23: 6-13, 2009

Early diagnosis of Alzheimer's disease using MRI

Hiroshi Matsuda

Department of Nuclear Medicine, Saitama Medical University International Medical Center

    Main objectives of neuroimaging in Alzheimer's disease (AD) have moved from diagnosis of advanced AD to diagnosis of very early AD at a prodromal stage of mild cognitive impairment (MCI), prediction of conversion from MCI to AD, and differential diagnosis from other diseases causing dementia. Remarkable progress in diagnostic accuracy of early AD using MRI has been achieved using statistical analysis on a voxel-by-voxel basis after anatomical standardization of individual scans to a standardized brain template instead of visual inspection or a conventional region of interest technique. In a very early stage of AD, this statistical approach has revealed gray matter loss mainly in the entorhinal and hippocampal areas. More advanced atrophy in these structures would predict rapid conversion from MCI to AD. Moreover, brain MRI has potential to evaluate not only structures but also function in AD. Recent advance in high-field MRI enables us to observe brain perfusion without administration of contrast media with shorter acquisition time than SPECT.

Address correspondence to Dr. Hiroshi Matsuda, Department of Nuclear Medicine, Saitama Medical University International Medical Center (1397-1 Yamane, Hidaka-city, Saitama 350-1298, Japan)