The value of FDG combined with PiB PET in the diagnosis of patients with cognitive impairment in a memory clinic

IF 4.8 1区医学 Q1 NEUROSCIENCES

CNS Neuroscience & Therapeutics Pub Date : 2023-08-21 DOI:10.1111/cns.14418

Fang Liu, Yudi Shi, Qiuyan Wu, Huifeng Chen, Ying Wang, Li Cai, Nan Zhang

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Abstract

Aims

To analyze the value of ¹⁸F-fluorodeoxyglucose (FDG) positron emission tomography (PET) combined with amyloid PET in cognitive impairment diagnosis.

Methods

A total of 187 patients with dementia or mild cognitive impairment (MCI) who underwent ¹¹C-Pittsburgh compound B (PiB) and FDG PET scans in a memory clinic were included in the final analysis.

Results

Amyloid-positive and amyloid-negative dementia patient groups showed a significant difference in the proportion of individuals presenting temporoparietal cortex (p < 0.001) and posterior cingulate/precuneus cortex (p < 0.001) hypometabolism. The sensitivity and specificity of this hypometabolic pattern for identifying amyloid pathology were 72.61% and 77.97%, respectively, in patients clinically diagnosed with AD and 60.87% and 76.19%, respectively, in patients with MCI. The initial diagnosis was changed in 32.17% of patients with dementia after considering both PiB and FDG results. There was a significant difference in both the proportion of patients showing the hypometabolic pattern and PiB positivity between dementia conversion patients and patients with a stable diagnosis of MCI (p < 0.05).

Conclusion

Temporoparietal and posterior cingulate/precuneus cortex hypometabolism on FDG PET suggested amyloid pathology in patients with cognitive impairment and is helpful in diagnostic decision-making and predicting AD dementia conversion from MCI, particularly when combined with amyloid PET.

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FDG 联合 PiB PET 在记忆诊所诊断认知障碍患者中的价值

目的分析18F-氟脱氧葡萄糖（FDG）正电子发射断层扫描（PET）联合淀粉样蛋白PET在认知障碍诊断中的价值。方法共有187名痴呆症或轻度认知障碍（MCI）患者在一家记忆诊所接受了11C-匹兹堡化合物B（PiB）和FDG正电子发射断层扫描，并纳入最终分析。结果淀粉样蛋白阳性和淀粉样蛋白阴性痴呆患者组在颞顶叶皮层（p <0.001）和扣带回后/楔前皮层（p <0.001）代谢减低的比例上存在显著差异。在临床诊断为AD的患者中，这种低代谢模式鉴定淀粉样病理的敏感性和特异性分别为72.61%和77.97%，在MCI患者中分别为60.87%和76.19%。32.17%的痴呆症患者在同时考虑了 PiB 和 FDG 结果后改变了最初的诊断。痴呆症转化患者和 MCI 诊断稳定患者中出现低代谢模式和 PiB 阳性的患者比例存在明显差异（p < 0.05）。结论 FDG PET显示的颞顶叶和后扣带回/楔前皮层代谢减低提示认知障碍患者存在淀粉样病变，有助于诊断决策和预测从MCI转化而来的AD痴呆，尤其是与淀粉样蛋白PET结合使用时。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

CNS Neuroscience & Therapeutics 医学-神经科学

CiteScore

7.30

自引率

12.70%

发文量

240

审稿时长

2 months

期刊介绍： CNS Neuroscience & Therapeutics provides a medium for rapid publication of original clinical, experimental, and translational research papers, timely reviews and reports of novel findings of therapeutic relevance to the central nervous system, as well as papers related to clinical pharmacology, drug development and novel methodologies for drug evaluation. The journal focuses on neurological and psychiatric diseases such as stroke, Parkinson’s disease, Alzheimer’s disease, depression, schizophrenia, epilepsy, and drug abuse.