Differential effects of global and cerebellar normalization on detection and differentiation of dementia in FDG-PET studies
Differential effects of global and cerebellar normalization on detection and differentiation of dementia in FDG-PET studies
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DOI：
10.1016/j.neuroimage.2009.09.017
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发表时间：
2010-01-15
期刊：
影响因子：
5.7
通讯作者：
Schroeter, Matthias L.
中科院分区：
文献类型：
--
作者：
Dukart, Juergen;Mueller, Karsten;Schroeter, Matthias L.
FDG-PET（[18F]氟脱氧葡萄糖正电子发射断层扫描）经常用于改善痴呆症的鉴别诊断。然而，强度归一化程序参考区域的基本方法问题仍未解决。在这里，我们系统地比较了两种最常用的大脑和小脑葡萄糖代谢率标准化方法，以检测和区分痴呆综合征。对 19 名患有早期阿尔茨海默病的受试者、13 名患有早期额颞叶变性的受试者和 10 名抱怨记忆障碍的受试者进行了 FDG-PET 成像，但尚未得到全面的临床测试证实。将图像标准化为大脑或小脑的葡萄糖代谢率。通过体素比较评估相对区域葡萄糖代谢的差异。使用两种标准化程序的分析揭示了显着的差异效应。尽管小脑正常化在识别痴呆患者方面优于对照受试者，但大脑正常化在痴呆类型之间的鉴别诊断方面显示出更好的结果。这些效果在阿尔茨海默病和额颞叶变性中均得到体现。与对照组相比，仅使用全局标准化在两种痴呆症中检测到相对代谢亢进。结果表明，正常化对痴呆症的诊断准确性具有决定性影响。虽然小脑正常化似乎对早期诊断更敏感，但大脑整体正常化可能更适合痴呆综合征的鉴别诊断目的。 (C) 2009 Elsevier Inc. 保留所有权利。
FDG-PET ([18F]fluorodeoxyglucose positron emission tomography) is frequently used to improve the differential diagnosis of dementia. However, a fundamental methodological issue of the reference area for the intensity normalization procedure is still unsolved. Here, we systematically compared the two most commonly used normalization methods to the cerebral and to the cerebellar metabolic rate for glucose with regard to detection and differentiation of dementia syndromes. FDG-PET imaging was performed on 19 subjects with early Alzheimer's disease, 13 subjects with early frontotemporal lobar degeneration and 10 subjects complaining of memory impairment, which had not been confirmed by comprehensive clinical testing. Images were normalized to either the cerebral or the cerebellar metabolic rate for glucose. Differences in relative regional glucose metabolism were assessed by voxelwise comparison. Analysis using the two normalization procedures revealed remarkable differential effects. Whereas cerebellar normalization was superior in identifying dementia patients in comparison to control subjects, cerebral normalization showed better results for differential diagnosis between types of dementia. These effects were shown for both, Alzheimer's disease and frontotemporal lobar degeneration. Relative hypermetabolism in comparison to the control group was only detected in both kinds of dementia using global normalization. The results indicate that normalization has a decisive impact on diagnostic accuracy in dementia. While cerebellar normalization seems to be more sensitive for early diagnosis, cerebral global normalization might be superior for differential diagnostic purposes in dementia syndromes. (C) 2009 Elsevier Inc. All rights reserved.