Multicenter standardized 18F-FDG PET diagnosis of mild cognitive impairment, Alzheimer's disease, and other dementias

Lisa Mosconi, Wai H. Tsui, Karl Herholz, Alberto Pupi, Alexander Drzezga, Giovanni Lucignani, Eric M. Reiman, Vjera Holthoff, Elke Kalbe, Sandro Sorbi, Janine Diehl-Schmid, Robert Perneczky, Francesca Clerici, Richard John Caselli, Bettina Beuthien-Baumann, Alexander Kurz, Satoshi Minoshima, Mony J. De Leon

Research output: Contribution to journalArticle

420 Citations (Scopus)

Abstract

This multicenter study examined 18F-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 18F-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 18F-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% NL. 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. 18F-FDG PET heterogeneity in MCI with non-memory deficits ranged from absent hypometabolism to FTD and DLB PET patterns. Conclusion: Standardized automated analysis of 18F-FDG PET scans may provide an objective and sensitive support to the clinical diagnosis in early dementia.

Original languageEnglish (US)
Pages (from-to)390-398
Number of pages9
JournalJournal of Nuclear Medicine
Volume49
Issue number3
DOIs
StatePublished - Mar 1 2008
Externally publishedYes

Fingerprint

Fluorodeoxyglucose F18
Dementia
Alzheimer Disease
Lewy Body Disease
Frontotemporal Dementia
Positron-Emission Tomography
Gyrus Cinguli
Cognitive Dysfunction
Multicenter Studies
Differential Diagnosis

Keywords

  • F-FDG PET
  • Alzheimer's disease
  • Frontotemporal dementia
  • Hippocampus
  • Lewy body dementia
  • Mild cognitive impairment
  • Normal aging

ASJC Scopus subject areas

  • Radiological and Ultrasound Technology

Cite this

Mosconi, L., Tsui, W. H., Herholz, K., Pupi, A., Drzezga, A., Lucignani, G., ... De Leon, M. J. (2008). Multicenter standardized 18F-FDG PET diagnosis of mild cognitive impairment, Alzheimer's disease, and other dementias. Journal of Nuclear Medicine, 49(3), 390-398. https://doi.org/10.2967/jnumed.107.045385

Multicenter standardized 18F-FDG PET diagnosis of mild cognitive impairment, Alzheimer's disease, and other dementias. / Mosconi, Lisa; Tsui, Wai H.; Herholz, Karl; Pupi, Alberto; Drzezga, Alexander; Lucignani, Giovanni; Reiman, Eric M.; Holthoff, Vjera; Kalbe, Elke; Sorbi, Sandro; Diehl-Schmid, Janine; Perneczky, Robert; Clerici, Francesca; Caselli, Richard John; Beuthien-Baumann, Bettina; Kurz, Alexander; Minoshima, Satoshi; De Leon, Mony J.

In: Journal of Nuclear Medicine, Vol. 49, No. 3, 01.03.2008, p. 390-398.

Research output: Contribution to journalArticle

Mosconi, L, Tsui, WH, Herholz, K, Pupi, A, Drzezga, A, Lucignani, G, Reiman, EM, Holthoff, V, Kalbe, E, Sorbi, S, Diehl-Schmid, J, Perneczky, R, Clerici, F, Caselli, RJ, Beuthien-Baumann, B, Kurz, A, Minoshima, S & De Leon, MJ 2008, 'Multicenter standardized 18F-FDG PET diagnosis of mild cognitive impairment, Alzheimer's disease, and other dementias', Journal of Nuclear Medicine, vol. 49, no. 3, pp. 390-398. https://doi.org/10.2967/jnumed.107.045385
Mosconi, Lisa ; Tsui, Wai H. ; Herholz, Karl ; Pupi, Alberto ; Drzezga, Alexander ; Lucignani, Giovanni ; Reiman, Eric M. ; Holthoff, Vjera ; Kalbe, Elke ; Sorbi, Sandro ; Diehl-Schmid, Janine ; Perneczky, Robert ; Clerici, Francesca ; Caselli, Richard John ; Beuthien-Baumann, Bettina ; Kurz, Alexander ; Minoshima, Satoshi ; De Leon, Mony J. / Multicenter standardized 18F-FDG PET diagnosis of mild cognitive impairment, Alzheimer's disease, and other dementias. In: Journal of Nuclear Medicine. 2008 ; Vol. 49, No. 3. pp. 390-398.
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AU - Pupi, Alberto

AU - Drzezga, Alexander

AU - Lucignani, Giovanni

AU - Reiman, Eric M.

AU - Holthoff, Vjera

AU - Kalbe, Elke

AU - Sorbi, Sandro

AU - Diehl-Schmid, Janine

AU - Perneczky, Robert

AU - Clerici, Francesca

AU - Caselli, Richard John

AU - Beuthien-Baumann, Bettina

AU - Kurz, Alexander

AU - Minoshima, Satoshi

AU - De Leon, Mony J.

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N2 - This multicenter study examined 18F-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 18F-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 18F-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% NL. 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. 18F-FDG PET heterogeneity in MCI with non-memory deficits ranged from absent hypometabolism to FTD and DLB PET patterns. Conclusion: Standardized automated analysis of 18F-FDG PET scans may provide an objective and sensitive support to the clinical diagnosis in early dementia.

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KW - Alzheimer's disease

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