Posterior cingulate hypoperfusion in Alzheimer's disease, senile dementia of Alzheimer type, and other dementias evaluated by three-dimensional stereotactic surface projections using Tc-99m HMPAO SPECT

Clin Nucl Med. 2004 Jun;29(6):362-6. doi: 10.1097/01.rlu.0000127091.43180.92.


Hypoperfusion in the posterior cingulate cortex is thought to be useful for the early diagnosis of dementia of Alzheimer type (DAT). In the present study, we compared the incidence of posterior cingulate hypoperfusion in patients with Alzheimer's disease (AD), patients with senile dementia of Alzheimer type (SDAT), and patients with other types of dementia, as evaluated by three-dimensional stereotactic surface projection (3D-SSP) imaging. The subjects were 20 AD patients, 20 SDAT patients, 13 frontotemporal dementia patients, and 3 other types of dementia patients. A SPECT study was performed 5 minutes after the injection of 740 MBq technetium-99m hexamethylpropylene amine oxime. 3D-SSP images were obtained with global normalization to perform the statistical analysis. The normal database of 3D-SSP consisted of 15 healthy volunteers. Hypoperfusion was considered to be significant when the Z-score was over 2.5. Posterior cingulate hypoperfusion was observed in 13 of 20 AD patients (65%), in 5 of 20 SDAT patients (25%), but in none of other type of dementia patients. Posterior cingulate hypoperfusion was considered to be a finding specific to DAT, and this finding was thought to be useful to diagnose DAT patients, especially for AD patients. However, it was considered to be difficult to diagnose early-stage SDAT patients.

Publication types

  • Case Reports
  • Clinical Trial
  • Comparative Study
  • Controlled Clinical Trial
  • Validation Study

MeSH terms

  • Aged
  • Alzheimer Disease / classification
  • Alzheimer Disease / complications
  • Alzheimer Disease / diagnostic imaging
  • Brain Ischemia / complications
  • Brain Ischemia / diagnostic imaging*
  • Cerebrovascular Circulation
  • Dementia / classification
  • Dementia / complications
  • Dementia / diagnostic imaging*
  • Female
  • Gyrus Cinguli / blood supply*
  • Gyrus Cinguli / diagnostic imaging*
  • Humans
  • Image Interpretation, Computer-Assisted / methods
  • Imaging, Three-Dimensional / methods*
  • Male
  • Middle Aged
  • Radiopharmaceuticals
  • Reproducibility of Results
  • Sensitivity and Specificity
  • Severity of Illness Index
  • Statistics as Topic
  • Technetium Tc 99m Exametazime*
  • Tomography, Emission-Computed, Single-Photon / methods*


  • Radiopharmaceuticals
  • Technetium Tc 99m Exametazime