Background:Magnetic resonance imaging (MRI) provides objective information about brain structural atrophy in patients with Alzheimer’s disease (AD). This multi-structural atrophic information, when integrated as a single differential index, has the potential to further elevate the accuracy of AD identification from normal control (NC) compared to the conventional structure volumetric index. Objective:We herein investigated the performance of such an MRI-derived AD index, AD-Resemblance Atrophy Index (AD-RAI), as a neuroimaging biomarker in clinical scenario. Method:Fifty AD patients (19 with the Amyloid, Tau, Neurodegeneration (ATN) results assessed in cerebrospinal fluid) and 50 age- and gender-matched NC (19 with ATN results assessed using positron emission tomography) were recruited in this study. MRI-based imaging biomarkers, i.e., AD-RAI, were quantified using AccuBrain®. The accuracy, sensitivity, specificity, and area under the ROC curve (AUC) of these MRI-based imaging biomarkers were evaluated with the diagnosis result according to clinical criteria for all subjects and ATN biological markers for the subgroup. Results:In the whole groups of AD and NC subjects, the accuracy of AD-RAI was 91%, sensitivity and specificity were 88% and 96%, respectively, and the AUC was 92%. In the subgroup of 19 AD and 19 NC with ATN results, AD-RAI results matched completely with ATN classification. AD-RAI outperforms the volume of any single brain structure measured. Conclusion:The finding supports the hypothesis that MRI-derived composite AD-RAI is a more accurate imaging biomarker than individual brain structure volumetry in the identification of AD from NC in the clinical scenario.

中文翻译：

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AD 相似性萎缩指数作为阿尔茨海默病诊断生物标志物：回顾性临床和生物学验证

背景：磁共振成像 (MRI) 提供有关阿尔茨海默病 (AD) 患者脑结构萎缩的客观信息。与传统的结构体积指数相比，这种多结构萎缩信息当作为单个差异指数整合时，有可能进一步提高正常对照 (NC) 识别 AD 的准确性。目的：我们在此研究了这种 MRI 衍生的 AD 指数、AD 相似性萎缩指数（AD-RAI）作为临床场景中的神经影像生物标志物的性能。方法：本研究招募了 50 名 AD 患者（19 名在脑脊液中评估了淀粉样蛋白、Tau、神经变性 (ATN) 结果）和 50 名年龄和性别匹配的 NC（19 名使用正电子发射断层扫描评估了 ATN 结果）。基于 MRI 的成像生物标志物，即 AD-RAI，使用 AccuBrain® 进行量化。根据所有受试者的临床标准和亚组的ATN生物标志物，根据诊断结果评估这些基于MRI的成像生物标志物的准确性、敏感性、特异性和ROC曲线下面积（AUC）。结果：在全组AD和NC受试者中，AD-RAI的准确率为91%，敏感性和特异性分别为88%和96%，AUC为92%。在有 ATN 结果的 19 AD 和 19 NC 亚组中，AD-RAI 结果与 ATN 分类完全匹配。AD-RAI 优于测量的任何单个大脑结构的体积。结论：该发现支持这样的假设，即 MRI 衍生的复合 AD-RAI 是比个体脑结构体积测量更准确的成像生物标志物，用于在临床场景中从 NC 中识别 AD。