NeuroQ was developed in collaboration with Daniel Silverman, M.D. PhD, head of the Neuronuclear Imaging section, David Geffen School of Medicine at UCLA. In 2009, Dr. Silverman authored a valuable resource for BrainPET diagnosticians, the book titled "PET in the Evaluation of Alzheimer’s Disease and Related Disorders", which details when and why to add PET to the clinical evaluation of dementia.
NeuroQ™ is one of the most powerful and widely used quantitative tools for the differential diagnosis of dementia. Radiologists, nuclear physicians, and other professional Brain PET interpreters use NeuroQ to gain a higher level of decision support and confidence from NeuroQ for PET-FDG brain imaging studies.
Alzheimer's vs. Dementia:
What's the difference?
Dr. Daniel H.S. Silverman
A definitive, quantitative differential diagnosis delivered with NeuroQ color-coded JPEGs attached to your PET report is very important to the physician treating dementia.
Treatment is specific to each type of dementia, so accurate diagnosis is critical. NeuroQ goes beyond the eye to discern a very subtle grey-scale. That's why so many radiologists, nuclear physicians and and other professional Brain PET interpreters worldwide rely on NeuroQ.
NeuroQ has been developed to aid in the assessment of human brain scans through quantification of mean pixel values lying within standardized regions of interest, and to provide quantified comparisons with brain scans derived from PET studies of defined groups having no identified neuropsychiatric disease or symptoms, i.e., asymptomatic controls (AC). The Program provides automated analysis of brain PET scans, with output that includes quantification of relative activity in 240 different brain regions, as well as measures of the magnitude and statistical significance with which activity in each region differs from mean activity values of brain regions in the AC database.
The SPECT extension provides quantified comparisons with brain scans derived from technetium-99m ECD and technetium-99m HMPAO SPECT agents
The Amyloid extension provides quantified comparisons with brain scans derived from Amyloid agents including Amyvid (Lilly), NeuraCeq (Piramal), and Vizamyl (GE). All agents have been validated in accordance with agent vendor requirements.
Display output of Amyvid™ analysis in the NeuroQ application is shown. The left insert image shows the regions used to calculate cortex-to-whole cerebellum ratios (using ROIs from Clark et al, 2012 validated for amyloid imaging with florbetapir). The images on the right side of the screen demonstrate application of the standardized volume-of-interest (sVOI or “cluster”) NeuroQ display-and-analysis algorithms, tailored to amyloid-PET template space.
EQuAL is useful for assessing maximal temporal asymmetry over a specified proportion of the temporal lobe which may help to predict whether patients will likely be free of seizueres during the years after neurosurgical resection of epileptogenic tissue.
EQuAL (Extent-specified Quantified Asymmetry-of-Lobe analysis) is a unique tool integrated into NeuroQ, based on work by Lin et al. from the Department of Molecular and Medical Pharmacology, David Geffen School of Medicine, UCLA Los Angeles and published in the Journal of Nuclear Medicine.
Conventional visual analysis of brain F18-PET FDG scans is useful for predicting post-surgical improvement for TLE patients, but prognostic value for identifying patients who will achieve seizure-free status is considerably lower.
Tina W. Lin, Michelle A. Kung de Aburto, Magnus Dahlbom, Lynn L. Huang, Michael M. Marvi, Michael Tang, Johannes Czernin, Michael E. Phelps, and Daniel H.S. Silverman. Predicting Seizure-Free Status for Temporal Lobe Epilepsy Patients Undergoing Surgery: Prognostic Value of Quantifying Maximal Metabolic Asymmetry Extending over a Specified Proportion of the Temporal Lobe. J Nucl Med. 2007 48(5): 776-782.
By providing a Difference Image between the two studies, NeuroQ is able to show how much each region has changed in metabolic activity over time.
The oldest study is displayed in the top row, the most recent in the middle row, and the difference image is displayed in the bottom image to the right. The middle slider bar in the middle row is used to step through the planes. All images with the exception of the patient’s images in the left hand column will move when the slider bar is moved left or right. The difference image shows the regions in which there is at least a 1 standard deviation difference between the original and recent study. This analysis is helpful to monitor the progression of dementia over a period of time.
The DaTscan extension provides quantified comparisons with brain scans derived from Ioflupane I-123 (DaTscan) injections. Although DaTscan does not diagnose a Parkinsonian Syndrome (PS) or Essential Tremor (ET), the findings of SPECT imaging with DaTscan may be used, in addition to other clinical tests, to help make a diagnosis.
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