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¹⁸F-FDG PET Database of Longitudinally Confirmed Healthy Elderly Individuals Improves Detection of Mild Cognitive Impairment and Alzheimer's Disease

¹ New York University School of Medicine, New York, New York; ² Nathan Kline Institute, New York, New York; ³ University of Florence, Florence, Italy; ⁴ University of Munich, Munich, Germany; and ⁵ University of Washington, Seattle, Washington

Correspondence: For correspondence contact: Lisa Mosconi, PhD, Center for Brain Health of the Silberstein Institute, Department of Psychiatry, NYU School of Medicine, 560 First Ave., New York NY, 10016. E-mail: lisa.mosconi{at}med.nyu.edu

The normative reference sample is crucial for the diagnosis of Alzheimer's disease (AD) with automated ¹⁸F-FDG PET analysis. We tested whether an ¹⁸F-FDG PET database of longitudinally confirmed healthy elderly individuals ("normals," or NLs) would improve diagnosis of AD and mild cognitive impairment (MCI). Methods: Two ¹⁸F-FDG PET databases of 55 NLs with 4-y clinical follow-up examinations were created: one of NLs who remained NL, and the other including a fraction of NLs who declined to MCI at follow-up. Each ¹⁸F-FDG PET scan of 19 NLs, 37 MCI patients, and 33 AD patients was z scored using automated voxel-based comparison to both databases and examined for AD-related abnormalities. Results: Our database of longitudinally confirmed NLs yielded 1.4- to 2-fold higher z scores than did the mixed database in detecting ¹⁸F-FDG PET abnormalities in both the MCI and the AD groups. ¹⁸F-FDG PET diagnosis using the longitudinal NL database identified 100% NLs, 100% MCI patients, and 100% AD patients, which was significantly more accurate for MCI patients than with the mixed database (100% NLs, 68% MCI patients, and 94% AD patients identified). Conclusion: Our longitudinally confirmed NL database constitutes reliable ¹⁸F-FDG PET normative values for MCI and AD.

Key Words: neurology • PET • Alzheimer's disease • normative reference database • early diagnosis

COPYRIGHT © 2007 by the Society of Nuclear Medicine, Inc.

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