Discrimination between Alzheimer dementia and controls by automated analysis of multicenter FDG PET
Discrimination between Alzheimer dementia and controls by automated analysis of multicenter FDG PET
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DOI：
10.1006/nimg.2002.1208
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发表时间：
2002-09-01
期刊：
影响因子：
5.7
通讯作者：
Heiss, WD
中科院分区：
文献类型：
--
作者：
Herholz, K;Salmon, E;Heiss, WD
FDG PET扫描异常的一个新的诊断指标，基于年龄调整的t统计和自动化的基于体素的程序，提出并验证了一个大的数据集，包括110个正常对照组和395例可能阿尔茨海默病（AD），在8个参与中心进行了研究。通过滤波和掩蔽，有效地最小化PET扫描仪的空间分辨率差异的影响。在对照组中，前扣带回和额外侧裂周皮质的FDG摄取随年龄的增长而显著下降。在可能的AD患者中，后扣带回、颞顶和前额叶联合皮质的FDG摄取下降与痴呆的严重程度有关。这些效应明显不同于对照组中的年龄效应，表明AD的疾病过程与正常衰老无关。可能患有AD的女性比男性有更多的额叶代谢障碍。AD相关区域代谢异常的新指标为区分轻度至中度可能AD与正常人提供了93%的灵敏度和特异性，为检测非常轻度可能AD（由Mini Mental Score 24或更高定义）提供了84%的灵敏度和93%的特异性。与AD严重程度相关的所有区域在非常轻微的AD中已经受到影响，这表明所有易受影响的区域在疾病发作时已经受到类似程度的影响。腹内侧额叶皮质也异常。总之，多中心FDG PET的自动化分析是可行的，提供了对AD病理生理学的见解，并且可以潜在地用作早期AD诊断的敏感生物标志物。(C)2002 Elsevier Science（美国）。
A new diagnostic indicator of FDG PET scan abnormality, based on age-adjusted t statistics and an automated voxel-based procedure, is presented and validated in a large data set comprising 110 normal controls and 395 patients with probable Alzheimer's disease (AD) that were studied in eight participating centers. The effect of differences in spatial resolution of PET scanners was minimized effectively by filtering and masking. In controls FDG uptake declined significantly with age in anterior cingulate and frontolateral perisylvian cortex. In patients with probable AD decline of FDG uptake in posterior cingulate, temporoparietal, and prefrontal association cortex was related to dementia severity. These effects were clearly distinct from age effects in controls, suggesting that the disease process of AD is not related to normal aging. Women with probable AD had significantly more frontal metabolic impairment than men. The new indicator of metabolic abnormality in AD-related regions provided 93% sensitivity and specificity for distinction of mild to moderate probable AD from normals, and 84% sensitivity at 93% specificity for detection of very mild probable AD (defined by Mini Mental Score 24 or better). All regions related to AD severity were already affected in very mild AD, suggesting that all vulnerable areas are affected to a similar degree already at disease onset. Ventromedial frontal cortex was also abnormal. In conclusion, automated analysis of multicenter FDG PET is feasible, provides insights into AD pathophysiology, and can be used potentially as a sensitive biomarker for early AD diagnosis. (C) 2002 Elsevier Science (USA).