Featured publications

Theme: Diagnosis and prognosis

The impact of regional Tc-HMPAO single-photon-emission computed tomography (SPECT) imaging on clinician diagnostic confidence in a mixed cognitive impairment sample

Prosser AMJ, Tossici-Bolt L and Kipps CM

Aim: To assess the clinical impact of regional cerebral blood flow (rCBF) single-photon-emission computed tomography (SPECT) imaging on diagnosis and clinician diagnostic confidence in a cohort of individuals with cognitive impairment.

Materials and methods: Forty-one clinicians who referred 79 patients for a [99mTc]-hexamethylpropyleneamine oxime (HMPAO) SPECT for cognitive complaints completed a two-part questionnaire to determine the diagnosis and diagnostic confidence (using a 0-100 visual analogue scale [VAS]) before and after imaging. SPECT images were analysed using statistical parametric mapping and interpreted semi-quantitatively. Clinicians were also asked directly for their opinion on whether the imaging contributed to their diagnostic process.

Results: Diagnosis changed after imaging in 44% of cases, and confidence was significantly improved (VAS score change= +26.3±22.2) after imaging in cases where the pre-imaging confidence was low (p<0.001). Clinician confidence was not significantly different (VAS score change=-6.6±25.5) after imaging when pre-imaging confidence was moderate to high. Interestingly, a proportion of clinicians with the highest confidence levels became less certain about their diagnosis following imaging results. When asked directly, 96% of clinicians stated that the imaging contributed to the diagnostic process.

Conclusions: In a mixed clinical cognitive impairment cohort, perfusion SPECT is valued by referring clinicians and contributes to diagnostic decision making. Imaging is of particular value when diagnostic confidence is low prior to imaging.


Portrait image of Chris Kipps

Professor Chris Kipps

Role: Consultant Neurologist

Chris is a Consultant Neurologist with subspecialty interest in behavioural neurology and cognitive disorders, and Professor of Clinical Neurology and Dementia at University Hospital Southampton and the University of Southampton. He leads the Cognitive Disorders service at the Wessex Neurological Centre.

Chris is Clinical Director for Research and Development at...

Portrait image of Angus Prosser

Dr Angus Prosser

Role: Senior Research Fellow

Angus is a Senior Research Fellow within the Faculty of Medicine at the University of Southampton and Innovation Project Manager for the Southampton Emerging Therapies and Technologies (SETT) Centre.

Angus’s research interests include the optimisation of neuroimaging and other biomarkers to improve diagnosis and prognosis for those living with dementia...