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A visual [18F]FDG-PET rating scale for the differential diagnosis of frontotemporal lobar degeneration

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Abstract

This study presents a visual rating scale for the assessment of cerebral [18F]fluoro-2-deoxy-d-glucose positron emission tomography (FDG-PET) scans to characterize typical findings in dementias associated with frontotemporal lobar degeneration (FTLD) and to differentiate individual patients with FTLD compared to Alzheimer’s disease (AD) and mild cognitive impairment (MCI). A total of 43 cerebral PET scans from patients with FTLD (n = 16, mean age 58.4 years), AD (n = 16, 59.9 years) and MCI (n = 11, 57.9 years) were analysed. Every PET data set was visually rated for seven brain regions on each hemisphere (frontal lobe, temporal lobe, parietal lobe, occipital lobe, basal ganglia, thalamus and cerebellum). The extent of the impairment in metabolism was classified as absent, mild, medium or strong. Using this four-stage visual rating scale, characteristic profiles of metabolic impairment in FTLD, AD, MCI and the FTLD-subgroup FTD (n = 9) could be demonstrated. Patients with FTLD showed a significantly lower metabolism in the left frontal lobe and in the left basal ganglia when compared to AD and to MCI. Complementary analyses using statistical parametric mapping (SPM2) supported the findings of the visual analysis. In detecting FTLD with visual rating, sensitivity/specificity was 81/94% compared to AD and 81/64% compared to MCI. Patients with FTD were correctly attributed to a diagnosis of FTLD with a sensitivity of 89%. This visual rating scale may facilitate the differential diagnosis of FTLD in clinical routine.

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Authors and Affiliations

  1. Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University of Regensburg, Universitätsstrasse 84, 93053, Regensburg, Germany

    Stefan Poljansky, Bernd Ibach, Hans Klünemann & Göran Hajak

  2. Department of Nuclear Medicine, University of Regensburg, 93053, Regensburg, Germany

    Barbara Hirschberger, Peter Männer & Jörg Marienhagen

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  1. Stefan Poljansky
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  2. Bernd Ibach
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  3. Barbara Hirschberger
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  4. Peter Männer
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  7. Jörg Marienhagen
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Correspondence to Stefan Poljansky.

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Poljansky, S., Ibach, B., Hirschberger, B. et al. A visual [18F]FDG-PET rating scale for the differential diagnosis of frontotemporal lobar degeneration. Eur Arch Psychiatry Clin Neurosci 261, 433–446 (2011). https://doi.org/10.1007/s00406-010-0184-0

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  • DOI: https://doi.org/10.1007/s00406-010-0184-0

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