Comparative insights into mild cognitive impairment: A clinical case study with 18F-FDG and amyloid PET imaging.

Early detection of mild cognitive impairment (MCI) is crucial for initiating therapeutic interventions that may slow or prevent further cognitive deterioration. Mild cognitive impairment represents a transitional phase between normal cognitive aging and more severe forms of dementia, such as Alzheimer's disease (AD). Positron emission tomography (PET) can provide insight into the pathophysiology and progression of neurodegenerative processes associated with dementia and MCI using either fluorine-18 (¹⁸F)-florbetapir, which detects beta-amyloid plaque burden, or ¹⁸F-fluorodeoxyglucose (¹⁸F-FDG), which measures glucose metabolism. However, there are limited comparative studies using the two radiotracers to quantify cognitive decline. This case study presents an 83-year-old female with a clinical diagnosis of MCI and a mini-mental state examination (MMSE) score of 26, at the lower boundary for normal cognitive function; she was assessed with PET/computed tomography (CT) using both radiotracers. Although global assessments did not reveal significant abnormalities, localized findings showed hypometabolism in key brain regions, such as the posterior cingulate cortex, and beta-amyloid plaque accumulation in the anterior cingulate cortex. These results highlight the limitations of conventional cognitive assessments, like the MMSE, and underscore the potential value of PET imaging as a complementary diagnostic tool. The study supports the role of ¹⁸F-FDG as a stronger indicator of cognitive impairment due to its correlation with cognitive scores, while recognizing the need for further research to evaluate the predictive value of both PET tracers in early MCI detection and their potential to improve diagnostic accuracy.