Comparison of the diagnostic performance of FDG-PET and VBM-MRI in very mild Alzheimer's disease
Comparison of the diagnostic performance of FDG-PET and VBM-MRI in very mild Alzheimer's disease
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DOI：
10.1007/s00259-005-0050-x
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发表时间：
2006-07-01
影响因子：
9.1
通讯作者：
Mori, Etsuro
中科院分区：
文献类型：
--
作者：
Kawachi, Takashi;Ishii, Kazunari;Mori, Etsuro
目的：本研究的目的是比较F-18-氟脱氧葡萄糖（FDG）正电子发射断层扫描（PET）和基于体素的形态测量（VBM）在磁共振成像（MRI）上对极轻度阿尔茨海默病（AD）患者的诊断性能。（年龄67.0 +/-5.8岁; MMSE评分25.5 ± 1.2，范围24 - 28），32例轻度AD患者（年龄67.0 ± 4.5岁，MMSE评分22.1 ± 0.8，范围21 - 23）和60名年龄和性别匹配的正常志愿者进行FDG-PET和三维扰相梯度回波MRI。使用统计参数映射进行逐体素分析和Z评分映射。首先，在轻度AD患者中定义葡萄糖代谢和灰质密度显著降低的感兴趣区域（ROI）图。其次，对区分极轻度AD患者和正常对照者的ROI图中Z分数的受试者工作特征（ROC）曲线进行分析。在轻度AD患者中，FDG-PET显示双侧后扣带回和右侧顶颞区的葡萄糖代谢显著降低，VBM分析显示双侧杏仁核/海马复合体灰质体积密度较正常对照组显著降低。ROC曲线分析表明，在极轻度AD患者中，FDG-PET诊断准确率为89%，VBM-MRI诊断准确率为83%。结论：对于极轻度AD，FDG-PET和VBM-MRI均具有较高的诊断准确性，但FDG-PET的诊断准确性略高于VBM-MRI。两种技术的结合，将产生更高的诊断准确性，在非常轻微的AD，充分利用功能和形态学图像。
Purpose: The aim of this study was to compare the diagnostic performance of F-18-fluorodeoxyglucose (FDG) positron emission tomography (PET) and voxel-based morphometry (VBM) on magnetic resonance imaging (MRI) in the same group of patients with very mild Alzheimer's disease (AD).Methods: Thirty patients with very mild AD (age 67.0 +/- 5.8 years; MMSE score 25.5 +/- 1.2, range 24-28), 32 patients with mild AD (age 67.0 +/- 4.5 years, MMSE score 22.1 +/- 0.8, range 21-23) and 60 age- and sex-matched normal volunteers underwent both FDG-PET and three-dimensional spoiled gradient echo MRI. Statistical parametric mapping was used to conduct voxel by voxel analysis and Z score mapping. First, the region of interest (ROI) maps of significant reductions in glucose metabolism and grey matter density in the mild AD patients were defined. Secondly, analysis of receiver operating characteristic (ROC) curves for Z scores in the ROI maps discriminating very mild AD patients and normal controls was performed.Results: In mild AD patients, FDG-PET indicated significant reductions in glucose metabolism in the bilateral posterior cingulate gyri and the right parietotemporal area, while VBM analysis showed a significant decrease in grey matter volume density in the bilateral amygdala/hippocampus complex, compared with the normal control group. ROC analysis showed that in very mild AD patients the accuracy of FDG-PET diagnosis was 89% and that of VBM-MRI diagnosis was 83%. The accuracy of the combination of FDG-PET and VBM-MRI diagnosis was 94%.Conclusion: In very mild AD, both FDG-PET and VBM-MRI had high accuracy for diagnosis, but FDG-PET showed slightly higher accuracy than VBM-MRI. Combination of the two techniques will yield a higher diagnostic accuracy in very mild AD by making full use of functional and morphological images.