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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
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.
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.
A definitive, quantitative differential diagnosis delivered with NeuroQ color-coded JPEGs attached to your PET report is very important to the physician treating dementia.
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 shows abnormal clusters along with SUVr calculations(using ROIs from Clark et al, 2012 validated for amyloid imaging with florbetapir) and Centiloids. The table on the right shows statistics for abnormal clusters, including z-scores.
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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.
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.
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.
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 older study is displayed in the top row, the newer study in the middle row, and the %difference in the bottom row. The table shows cluster changes. The image pane in the lower right shows the difference images for the slices that comprise the cluster highlighted in either the images above or the cluster table to the left. All 3 image panes have interoperability (when you click in one, the display for the others updates).
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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