Practical use of visual medial temporal lobe atrophy cut-off scores in Alzheimer’s disease: Validation in a large memory clinic populationReport as inadecuate




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European Radiology

, Volume 27, Issue 8, pp 3147–3155

First Online: 12 January 2017Received: 04 July 2016Revised: 06 December 2016Accepted: 21 December 2016

Abstract

ObjectiveTo provide age-specific medial temporal lobe atrophy MTA cut-off scores for routine clinical practice as marker for Alzheimer’s disease AD.

MethodsPatients with AD n = 832, mean age 81.8 years were compared with patients with subjective cognitive impairment n = 333, mean age 71.8 years in a large single-centre memory clinic. Mean of right and left MTA scores was determined with visual rating Scheltens scale using CT 0, no atrophy to 4, severe atrophy. Relationships between age and MTA scores were analysed with regression analysis. For various MTA cut-off scores, decade-specific sensitivity and specificity and area under the curve AUC values, computed with receiver operator characteristic curves, were determined.

ResultsMTA strongly increased with age in both groups to a similar degree. Optimal MTA cut-off values for the age ranges <65, 65–74, 75–84 and ≥85 were: ≥1.0, ≥1.5, ≥ 2.0 and ≥2.0. Corresponding values of sensitivity and specificity were 83.3% and 86.4%; 73.7% and 84.6%; 73.7% and 76.2%; and 84.0% and 62.5%.

ConclusionFrom this large unique memory clinic cohort we suggest decade-specific MTA cut-off scores for clinical use. After age 85 years, however, the practical usefulness of the MTA cut-off is limited.

Key Points• We suggest decade-specific MTA cut-off scores for AD.

• MTA cut-off after the age of 85 years has limited use.

• CT is feasible and accurate for visual MTA rating.

KeywordsAlzheimer’s disease Temporal lobe Diagnostic imaging Computed tomography Clinical practice  Download fulltext PDF



Author: Jules J. Claus - Salka S. Staekenborg - Dana C. Holl - Jelmen J. Roorda - Jacqueline Schuur - Pieter Koster - Caroline 

Source: https://link.springer.com/



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