Multicenter standardized 18F-FDG PET diagnosis of mild cognitive impairment, Alzheimer's disease, and other dementias
Multicenter standardized 18F-FDG PET diagnosis of mild cognitive impairment, Alzheimer's disease, and other dementias
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DOI：
10.2967/jnumed.107.045385
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发表时间：
2008-03-01
影响因子：
9.3
通讯作者：
de Leon, Mony J.
中科院分区：
文献类型：
--
作者：
Mosconi, Lisa;Tsui, Wai H.;de Leon, Mony J.
这项多中心研究检查了F-18-FDG PET测量在阿尔茨海默病(AD)、额颞痴呆(FTD)和路易体痴呆(DLB)与正常年龄和彼此之间的鉴别诊断中的作用，以及疾病特定模式与轻度认知障碍(MCI)的关系。方法：我们对来自7个参与中心的548名受试者进行了F-18-FDG PET扫描，其中包括110名健康老年人(“正常人”或NLS)、114名MCI、199名AD、98名FTD和27名DLB患者。单独的正电子发射计算机断层扫描采用基于自动体素的比较法与产生的皮质和海马区F-18-FDG摄取的疾病特异性模式进行Z评分，然后应用这些模式来表征MCI。结果：建立了标准化的疾病特异性PET模式，正确区分了95%的AD、92%的DLB、94%的FTD和94%的NIL。MCI患者主要表现为后扣带回皮质和海马低代谢(81%)，而新皮质异常则因神经心理特征而异。79%的MCI有多个认知领域的缺陷，31%的遗忘性MCI出现AD-PET模式。无记忆障碍的MCI患者的F-18-FDG PET异质性从缺乏代谢异常到FTD和DLB型。结论：F-18-FDG PET标准化自动分析可为早期痴呆的临床诊断提供客观、灵敏的支持。关键词：F-18-FDG PET；阿尔茨海默病；额颞叶痴呆；路易体痴呆；轻度认知障碍；正常衰老；海马区。
This multicenter study examined F-18-FDG PET measures in the differential diagnosis of Alzheimer's disease (AD), frontotemporal dementia (FTD), and dementia with Lewy bodies (DLB) from normal aging and from each other and the relation of disease-specific patterns to mild cognitive impairment (MCI). Methods: We examined the F-18-FDG PET scans of 548 subjects, including 110 healthy elderly individuals ("normals" or NLs), 114 MCI, 199 AD, 98 FTD, and 27 DLB patients, collected at 7 participating centers. Individual PET scans were Z scored using automated voxel-based comparison with generation of disease-specific patterns of cortical and hippocampal F-18-FDG uptake that were then applied to characterize MCI. Results: Standardized disease-specific PET patterns were developed that correctly classified 95% AD, 92% DLB, 94% FTD, and 94% NIL. MCI patients showed primarily posterior cingulate cortex and hippocampal hypometabolism (81%), whereas neocortical abnormalities varied according to neuropsychological profiles. An AD PET pattern was observed in 79% MCI with deficits in multiple cognitive domains and 31% amnesic MCI. F-18-FDG PET heterogeneity in MCI with non-memory deficits ranged from absent hypometabolism to FTD and DLB PET patterns. Conclusion: Standardized automated analysis of F-18-FDG PET scans may provide an objective and sensitive support to the clinical diagnosis in early dementia. Key Words: F-18-FDG PET; Alzheimer's disease; frontotemporal dementia; Lewy body dementia; mild cognitive impairment; normal aging; hippocampus.