{"title":"<sup>18</sup>F-FDG PET for the differential diagnosis of Alzheimer's disease and frontotemporal lobar degeneration: A multicenter prospective study in Japan.","authors":"Kengo Ito, Yukihiko Washimi, Takashi Kato, Keisuke Suzuki, Yasuomi Ouchi, Chigusa Watanabe, Yoshihide Sunada, Yumiko Kutoku, Kazunari Ishii, Kenji Ishii, Michio Kitayama, Etsuro Matsubara, Noriyuki Kimura, Harumasa Takano, Hiroaki Adachi, Kazuhiro Hara, Takeshi Kawarabayashi, Mikio Shoji, Norio Sugimoto","doi":"10.1177/13872877251338691","DOIUrl":null,"url":null,"abstract":"<p><p>Background<sup>18</sup>F-fluoro-2-deoxy-2-D-glucose positron emission tomography (<sup>18</sup>F-FDG PET) is a biomarker of neuronal injury, according to the revised National Institute on Aging-Alzheimer's Association criteria.ObjectiveThis multicenter prospective cohort study aimed to evaluate the value of <sup>18</sup>F-FDG PET for differential diagnosis of Alzheimer's disease (AD) and frontotemporal lobar degeneration (FTLD) in comparison with phosphorylated tau protein (p-tau181) in cerebrospinal fluid (CSF).MethodsIn total, 138 patients (AD, 119; FTLD, 19) from 11 participating institutions underwent clinical and neuropsychological examinations, magnetic resonance imaging (MRI), CSF examination, and <sup>18</sup>F-FDG PET at baseline. The cases were visually classified into predefined dementia patterns using <sup>18</sup>F-FDG PET by three experts. A region-of-interest (ROI)-based automated analysis of <sup>18</sup>F-FDG PET was also performed. The participants were followed up for 12 months, and the clinical diagnosis of dementia was re-evaluated.ResultsThe sensitivity, specificity, and accuracy of the visual reading of<sup>18</sup> F-FDG PET for differentiating AD from FTLD were 94%, 78%, and 92%, respectively. In contrast, those of p-tau181 in CSF were 62%, 79%, and 65%, respectively. The sensitivity, the primary endpoint, was 32% higher for <sup>18</sup>F-FDG PET than for p-tau181 in CSF. Additionally, the accuracy, the secondary endpoint, was 27% higher for <sup>18</sup>F-FDG PET than for p-tau181 in CSF. In addition to the visual reading of <sup>18</sup>F-FDG PET, the ROI-based automated analysis showed sensitivity, specificity, and accuracy of 81%, 79%, and 81%, respectively.ConclusionsThis study showed that the diagnostic performance of <sup>18</sup>F-FDG PET in differential diagnosis of AD and FTLD was higher than that of p-tau181 in CSF.Trial registrationUMIN-CTR (UMIN 000016427, https://www.umin.ac.jp/ctr/) and Japan Registry of Clinical Trials (jRCTs041180098, https://jrct.mhlw.go.jp/).</p>","PeriodicalId":14929,"journal":{"name":"Journal of Alzheimer's Disease","volume":" ","pages":"13872877251338691"},"PeriodicalIF":3.4000,"publicationDate":"2025-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Alzheimer's Disease","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1177/13872877251338691","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"NEUROSCIENCES","Score":null,"Total":0}
引用次数: 0
Abstract
Background18F-fluoro-2-deoxy-2-D-glucose positron emission tomography (18F-FDG PET) is a biomarker of neuronal injury, according to the revised National Institute on Aging-Alzheimer's Association criteria.ObjectiveThis multicenter prospective cohort study aimed to evaluate the value of 18F-FDG PET for differential diagnosis of Alzheimer's disease (AD) and frontotemporal lobar degeneration (FTLD) in comparison with phosphorylated tau protein (p-tau181) in cerebrospinal fluid (CSF).MethodsIn total, 138 patients (AD, 119; FTLD, 19) from 11 participating institutions underwent clinical and neuropsychological examinations, magnetic resonance imaging (MRI), CSF examination, and 18F-FDG PET at baseline. The cases were visually classified into predefined dementia patterns using 18F-FDG PET by three experts. A region-of-interest (ROI)-based automated analysis of 18F-FDG PET was also performed. The participants were followed up for 12 months, and the clinical diagnosis of dementia was re-evaluated.ResultsThe sensitivity, specificity, and accuracy of the visual reading of18 F-FDG PET for differentiating AD from FTLD were 94%, 78%, and 92%, respectively. In contrast, those of p-tau181 in CSF were 62%, 79%, and 65%, respectively. The sensitivity, the primary endpoint, was 32% higher for 18F-FDG PET than for p-tau181 in CSF. Additionally, the accuracy, the secondary endpoint, was 27% higher for 18F-FDG PET than for p-tau181 in CSF. In addition to the visual reading of 18F-FDG PET, the ROI-based automated analysis showed sensitivity, specificity, and accuracy of 81%, 79%, and 81%, respectively.ConclusionsThis study showed that the diagnostic performance of 18F-FDG PET in differential diagnosis of AD and FTLD was higher than that of p-tau181 in CSF.Trial registrationUMIN-CTR (UMIN 000016427, https://www.umin.ac.jp/ctr/) and Japan Registry of Clinical Trials (jRCTs041180098, https://jrct.mhlw.go.jp/).
期刊介绍：
The Journal of Alzheimer''s Disease (JAD) is an international multidisciplinary journal to facilitate progress in understanding the etiology, pathogenesis, epidemiology, genetics, behavior, treatment and psychology of Alzheimer''s disease. The journal publishes research reports, reviews, short communications, hypotheses, ethics reviews, book reviews, and letters-to-the-editor. The journal is dedicated to providing an open forum for original research that will expedite our fundamental understanding of Alzheimer''s disease.
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