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SPECT images were compared using SPM. The atrophy correction method was incorporated to reduce artifacts through the MRI masking procedure. Regional <jats:italic>Z<\/jats:italic>-score, percent extent, and atrophy correction rate were obtained and compared. The <jats:italic>Z<\/jats:italic>-score mapping program was structured as a single package that ran semi-automatically.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>The method significantly reduced regional <jats:italic>Z<\/jats:italic>-score in most regions, leading to improved estimates. The mean atrophy correction rate ranged from 10.4 to 12.0%. In MCI and AD, the convexities of the frontal and parietal lobes and the posterior medial cerebrum were particularly sensitive to cerebral atrophy, and the <jats:italic>Z<\/jats:italic>-scores were overestimated, whereas the posterior cingulate cortex and the cerebellum were less sensitive. The diagnostic accuracy for MCI increased from 67 to 69% and for AD from 78 to 82%.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>The proposed approach provided more precise <jats:italic>Z<\/jats:italic>-scores with less over- or underestimation, artifacts, and improved diagnostic accuracy, being recommended for clinical studies.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1007\/s11604-023-01526-8","type":"journal-article","created":{"date-parts":[[2024,2,14]],"date-time":"2024-02-14T04:26:16Z","timestamp":1707884776000},"page":"508-518","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Diagnostic approach with Z-score mapping to reduce artifacts caused by cerebral atrophy in regional CBF assessment of mild cognitive impairment (MCI) and Alzheimer's disease by [99mTc]-ECD and SPECT"],"prefix":"10.1007","volume":"42","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2702-7436","authenticated-orcid":false,"given":"Ikuo","family":"Odano","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fumio","family":"Maeyatsu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tetsuo","family":"Hosoya","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mami","family":"Asari","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kentaro","family":"Oba","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yasuyuki","family":"Taki","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2024,2,14]]},"reference":[{"issue":"12","key":"1526_CR1","doi-asserted-by":"publisher","first-page":"1447","DOI":"10.1001\/archneurol.2009.266","volume":"66","author":"RC Petersen","year":"2009","unstructured":"Petersen RC, Roberts RO, Knopman DS, Boeve BF, Geda YE, Ivnik RJ, et al. 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