Alzheimer disease: Improved visual interpretation of PET images by using three-dimensional stereotaxic surface projections

PURPOSE: To compare the diagnostic usefulness of three-dimensional (3D) stereotaxic surface projection (SSP) with that of standard transaxial display in brain positron emission tomography (PET) in Alzheimer disease (AD). MATERIALS AND METHODS: Standard transaxial section display and 3D SSP PET image sets obtained after administration of 2-deoxy-2-[fluorine-18]fluoro-D-glucose in 39 patients with probable AD (aged 53-82 years; 15 men, 24 women) and 40 subjects without AD (aged 21-78 years; 14 men, 26 women) were randomly interpreted. Receiver operating characteristic (ROC) analysis was performed. RESULTS: Diagnostic performance was superior with 3D SSP (A(z)[section] 0.94, A(z)[3D SSP] = 0.99 [A(z) = area under the ROC curve]; P =.043). With 3D SSP, diagnosis of AD was equally good in beginners and experts. The sensitivity and specificity in questionable or mild dementia were 94% and 99% with 3D SSP and 79% and 88% with standard transaxial display. CONCLUSION: Accuracy of detecting AD was improved in PET with 3D SSP.