# Alzheimer's disease diagnosis support for brain perfusion SPECT scans in a real-world clinical cohort

## TL;DR

This study develops AI models to help diagnose Alzheimer's disease using brain perfusion SPECT scans in real-world clinical settings.

## Contribution

The study introduces interpretable AI models trained on real-world data to support early Alzheimer's diagnosis using SPECT imaging.

## Key findings

- Model 1 achieved 89% AUROC in identifying abnormal brain perfusion patterns.
- Model 2 achieved 86% AUROC in identifying Alzheimer's disease from perfusion changes.
- The models use features from clinically relevant brain regions, improving interpretability.

## Abstract

Dementia diagnosis is challenging and often delayed. Brain imaging techniques such as single-photon emission computed tomography (SPECT) imaging can help identify subtle changes in brain perfusion. Artificial intelligence methods may support results interpretation for early diagnosis.

To develop and validate multivariate models for the early diagnosis of Alzheimer's disease (AD), using brain perfusion SPECT imaging and interpretable artificial intelligence methods in a real-world clinical setting.

Two logistic regression models were developed using a training dataset of 420 SPECT scans and tested on an independent clinical dataset of 443 scans. Model 1 was designed to identify abnormal perfusion patterns, while Model 2 identified perfusion changes associated with AD. Input features were extracted from anatomical volumes of interest, with feature selection performed using the Minimum Redundancy Maximum Relevance (MRMR) algorithm.

The models demonstrated good classification performance using real-world clinical data. Model 1 achieved an area under receiver operator characteristic (AUROC) Curve of 0.89 (Sensitivity 76%, Specificity 87%) in identifying abnormal brain perfusion. Model 2 achieved an AUROC of 0.86 (Sensitivity 87%, Specificity 72%) in identifying AD.

Multivariate logistic regression models trained on real-world clinical data show promise as clinical decision support tools for the diagnosis of AD from brain perfusion SPECT imaging. The models use features from clinically relevant brain regions, which enhances interpretability. Future research should focus on expanding model applicability to other dementia types and on prospective evaluation of their utility in improving diagnostic accuracy, consistency, and care pathways in diverse clinical environments.