Van Gils, Aniek M;
Tolonen, Antti J;
Rhodius-Meester, Hanneke FM;
Mecocci, Patrizia;
Vanninen, Ritva;
Frederiksen, Kristian Steen;
Barkhof, Frederik;
... Alzheimer’s Disease Neuroimaging Initiative; + view all
(2024)
Separating dementia with Lewy bodies from Alzheimer’s disease dementia using a volumetric MRI classifier.
European Radiology
10.1007/s00330-024-11257-7.
(In press).
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Barkhof_Tolonen - Separating dementia with Lewy bodies from Alzheimers disease dementia using a volumetric MRI classifier_Main text_clean.pdf Access restricted to UCL open access staff until 31 December 2025. Download (499kB) |
Abstract
Objectives: Distinguishing dementia with Lewy bodies (DLB) from Alzheimer’s disease (AD) dementia, particularly in patients with DLB and concomitant AD pathology (DLB/AD+), can be challenging and there is no specific MRI signature for DLB. The aim of this study is to examine the additional value of MRI-based brain volumetry in separating patients with DLB (AD+/−) from patients with AD and controls. // Methods: We included 1518 participants from four cohorts (ADC, ADNI, PDBP and PredictND); 147 were patients with DLB (n = 76, DLB/AD+; n = 71, DLB/AD−), 668 patients with AD dementia, and 703 controls. We used an automatic segmentation tool to compute volumes of 70 brain regions, for which age, sex, and head size-dependent z-scores were calculated. We compared individual regions between the diagnostic groups and evaluated whether combining multiple regions improves differentiation. To assess the diagnostic performance, we used the area under the receiver operating characteristic curve (AUC) and sensitivity. // Results: The classifier using the combination of 70 volumetric brain regions correctly classified 60% of patients with DLB and 70% of patients with AD dementia. For DLB vs. AD, the classifier produced an AUC of 0.80 (0.77–0.83), which outperformed the best individual region, hippocampus (AUC: 0.73 [0.69–0.76], p < 0.01). For the comparison of DLB/AD+ vs. AD, the classifier increased the AUC to 0.74 (0.68–0.80), which was 0.70 (0.64–0.76) for the hippocampus, p = 0.25. // Conclusion: Using a combination of volumetric brain regions improved the classification accuracy, and thus the discrimination, of patients with DLB with and without concomitant AD pathology and AD.
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