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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

View larger version (17K): [in this window] [in a new window]   FIGURE 1.  Standardized ROIs. Predefined anatomic surface ROIs (in red) are superimposed onto (from left to right) right and left lateral and right and left medial views of standardized brain template showing surface projection maps of statistical abnormalities in AD patients as compared with NLs. z scores are represented on color-coded scale ranging from 0 (black) to 5 (red). Typical AD-related CMRglc reductions in parietotemporal and posterior cingulate cortices are evident in ROIs.

View larger version (28K): [in this window] [in a new window]   FIGURE 2.  Database effects on 18F-FDG PET diagnostic accuracy. (A and B) Effects in AD-affected brain regions discriminating AD patients (A) and MCI patients (B) from NLs using DB– (white bars) and DB+ (hatched bars). (C and D) Effects of using DB– (top row) and DB+ (bottom row) to create 3D-SSP maps are depicted in 2 representative AD (C) and MCI (D) patients. 3D-SSP maps showing CMRglc reductions in AD and MCI patients are displayed on same color-coded z score scale. IPL = inferior parietal lobe; L = left hemisphere; LTL = lateral temporal lobe; PCC = posterior cingulate cortex; R = right hemisphere.

View larger version (15K): [in this window] [in a new window]   FIGURE 3.  18F-FDG PET diagnostic accuracy. Percentage of NLs (n = 19), MCI patients (n = 37), patients with mild AD (n = 15), and patients with moderate to severe (mod-to-sev) AD (n = 18) correctly identified using DB– (white bars) and DB+ (hatched bars).

View larger version (18K): [in this window] [in a new window]   FIGURE 4.  Comparison between NL-MCI patients and NL-NLs. Brain regions showing baseline CMRglc reductions in 22 NL-MCI patients and 22 age-matched NL-NLs are displayed on standardized T1-weighted MRI template in axial view (from left to right: z = 29 to z = 64 mm, every 5 mm, relative to anterior commissure–posterior commissure line). Voxelwise group comparison of spatially normalized 18F-FDG PET scans was performed with t test for independent samples accounting for global CMRglc (3,5). CMRglc reductions in NL-MCI patients compared with NL-NLs were evident mainly in temporal, posterior cingulate, and parietal cortices. Color scale indicate P values corresponding to significance of CMRglc reductions, ranging from P = 0.05 to P = 0.01, uncorrected for multiple comparisons. PCC = posterior cingulate cortex; P Cx = parietal cortex; T Cx = temporal cortex.