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Mapping Pathological 99mTc-d,l-Hexamethylpropylene Amine Oxime Uptake in Alzheimer’s Disease and Frontal Lobe Dementia with SPECT

Seventeen patients with probable Alzheimer’s disease (AD), 7 patients with frontal lobe dementia (FLD) and 19 control subjects (NOR) were examined by 99mTc-d,l- hexamethylpropylene amine oxime (99mTc-HMPAO) SPECT. Images were standardised in the same 3D space and averaged within each group. After normalisation, the three sets of images were analysed in all cerebral lobes, hippocampus, thalamus and basal ganglia. In AD, the 99mTc-HMPAO uptake values were significantly reduced, as compared to NOR, in the parietal, temporal and insular lobes. In patients with FLD, the uptake was altered in all lobes with the exception of the parietal lobe. The uptake in the nucleus caudatus decreased significantly in both AD and FLD as compared to NOR. The uptake in the anterior cingulate cortex was significantly reduced in FLD. Subtraction images highlighted all significantly decreased areas. In conclusion, standardising SPECT in a common space and subtracting data from a control group improves the visual interpretation of images. In this study, the typical temporo-parietal and fronto-parietal 99mTc-HMPAO uptake reductions were found in AD and FLD, respectively. The uptake in the nucleus caudatus was found to decrease significantly in AD and FLD and the one in the anterior cingulate cortex was reduced in FLD.