Visual rating versus volumetry to detect frontotemporal dementia

Dement Geriatr Cogn Disord. 2011;31(5):371-8. doi: 10.1159/000328415. Epub 2011 May 31.


Background/aims: Automated, volumetrically defined atrophy in the left anterior cingulate (LAC) and anterior temporal regions (LAT) on MRI can be used to distinguish most patients with frontotemporal dementia (FTD) from controls. FTD and Alzheimer's disease (AD) can differ in the degree of anterior temporal atrophy. We explored whether clinicians can visually detect this atrophy pattern and whether they can use it to classify the 2 groups of dementia patients with the same accuracy.

Methods: Four neurologists rated atrophy in the LAC and LAT regions on MRI slices from 21 FTD, 21 controls, and 14 AD participants. Inter-rater reliability and diagnostic accuracy were assessed.

Results: All 4 raters agreed on the presence of clinically significant atrophy, and their atrophy scoring correlated with the volumes, but without translation into high inter-rater diagnostic agreement.

Conclusions: Volumetric analyses are difficult to translate into routine clinical practice.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Aged, 80 and over
  • Alzheimer Disease / diagnosis
  • Alzheimer Disease / pathology
  • Atrophy
  • Autopsy
  • Diagnosis, Differential
  • Female
  • Frontotemporal Dementia / diagnosis*
  • Frontotemporal Dementia / pathology*
  • Gyrus Cinguli / pathology
  • Humans
  • Image Processing, Computer-Assisted
  • Magnetic Resonance Imaging
  • Male
  • Middle Aged
  • Observer Variation
  • Reproducibility of Results
  • Socioeconomic Factors
  • Temporal Lobe / pathology