Comparison of 18F-FDG PET and optimized voxel-based morphometry for detection of Alzheimer's disease:: Aging effect on diagnostic performance
Comparison of 18F-FDG PET and optimized voxel-based morphometry for detection of Alzheimer's disease:: Aging effect on diagnostic performance
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DOI：
10.2967/jnumed.107.042820
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发表时间：
2007-12-01
影响因子：
9.3
通讯作者：
Kinuya, Seigo
中科院分区：
文献类型：
--
作者：
Matsunari, Ichiro;Samuraki, Miharu;Kinuya, Seigo
本研究的目的是比较优化的基于体素的形态测量 (VBM) 和 F-18-FDG PET，以区分阿尔茨海默病 (AD) 患者和健康受试者与年龄的关系。方法：研究人群由 2 组组成；第一组（27 名 AD 患者和 40 名对照受试者）用于使用统计参数映射确定 PET 和 VBM 显着异常的位置，第二组（34 名 AD 患者和 50 名对照受试者）用于比较 PET 和 VBM 的诊断性能。在第二组中，通过与对照受试者的 PET 或灰质 MR 图像的平均值和 SD 进行比较，获得每个受试者的 PET 或 VBM 的 z 分数图。然后进行受试者工作特征 (ROC) 曲线分析，以比较 PET 和 VBM 之间的诊断性能。此外，第2组分为早发亚组和晚发亚组，并对每个亚组进行ROC分析。结果：在第一组中，VBM 显示 AD 患者海马复合体灰质浓度显着降低，而 PET 显示后扣带回和顶颞叶 F-18-FDG 摄取显着降低。根据 ROC 曲线下面积测量，PET 的诊断性能（0.988 +/- 0.008；平均值 +/- SE）高于带调制（0.782 +/- 0.059）或不带调制（0.832 +/- 0.049）的 VBM。 PET 的敏感性、特异性和总体准确性分别为 100%、92% 和 95%，而 VBM 的敏感性、特异性和准确性分别为 74%、92% 和 85%。 VBM 调节并未改善这些值（分别为 56%、94% 和 79%）。当分别分析早发型和晚发型受试者时，18F-FDG PET 的优越性仅在早发型亚组中显着。结论：本研究表明，与 VBM 形态学方法相比，F-18-FDG PET 检测代谢改变在区分 AD 患者和健康对照受试者方面具有更好的诊断性能，特别是在早发受试者中。
The aim of this study was to compare optimized voxel-based morphometry (VBM) and F-18-FDG PET for discrimination between patients with Alzheimer's disease (AD) and healthy subjects in relation to age. Methods: The study population consisted of 2 groups; the first group (27 AD patients and 40 control subjects) was used to determine the locations of significant abnormalities for both PET and VBM using statistical parametric mapping, and the second group (34 AD patients and 50 control subjects) was used to compare the diagnostic performance of PET and VBM. In the second group, a z-score map for PET or VBM of each subject was obtained by comparison with the mean and SD of PET or gray-matter MR images of the control subjects. Receiver-operating-characteristic (ROC) curve analysis was then performed to compare the diagnostic performance between PET and VBM. Furthermore, group 2 was divided into the early- and late-onset subgroups, and ROC analysis was performed for each subgroup. Results: In the first group, VBM revealed a significant decrease in gray-matter concentration in the hippocampus complex in AD, whereas PET showed a significant reduction in F-18-FDG uptake in the posterior cingulate and parietotemporal lobe. The diagnostic performance of PET (0.988 +/- 0.008; mean +/- SE), as measured by the area under the ROC curve, was higher than that of VBM with (0.782 +/- 0.059) or without (0.832 +/- 0.049) modulation. PET yielded a sensitivity, specificity, and overall accuracy of 100%, 92%, and 95%, respectively, whereas for VBM the sensitivity, specificity, and accuracy were 74%, 92%, and 85%. Modulation for the VBM did not improve these values (56%,94%, and 79%, respectively). When the early- and late-onset subjects were analyzed separately, the superiority of 18F-FDG PET was significant only in the early-onset subgroup. Conclusion: The present study indicates that the detection of metabolic alteration by F-18-FDG PET yields abetter diagnostic performance for the discrimination between AD patients and healthy control subjects than does the morphologic approach by VBM, particularly in the early-onset subjects.