Mahla Radmard, Mona Gad, Ali Sheikhy, Richard Dagher, Vivek Yedavalli, Licia P. Luna
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Seven studies met criteria for meta-analysis based on interreader agreement and area under the curve (AUC) data. Meta-analysis was performed using the R “Mada” package, with study heterogeneity assessed via the Zhou and Dendukuri approach.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>Meta-analysis of seven studies showed FDG-PET had a slightly higher AUC (0.864, sensitivity 0.81, specificity 0.80) compared to ASL-MRI (AUC 0.836, sensitivity 0.73, specificity 0.80), but no statistically significant difference. Low heterogeneity was observed (<i>I</i><sup>2</sup>: 9.4% for FDG-PET, 6.5% for ASL-MRI). In MCI subgroup analysis, FDG-PET outperformed ASL-MRI with significantly higher sensitivity (0.90 vs. 0.75), specificity (0.91 vs. 0.73), and AUC (0.92 vs. 0.80, <i>p</i> < 0.001).</p>\n </section>\n \n <section>\n \n <h3> Conclusion</h3>\n \n <p>FDG-PET and ASL-MRI demonstrate comparable diagnostic accuracy for AD and MCI. Selection between modalities may depend on availability, cost, and safety considerations.</p>\n </section>\n \n <section>\n \n <h3> Clinical Relevance/Application</h3>\n \n <p>Both FDG-PET and MRI-ASL are effective at identifying MCI and AD, enabling accurate diagnosis. The choice of which modality to use may be addressed by cost, availability, and consideration of other potential diagnoses.</p>\n </section>\n </div>","PeriodicalId":16399,"journal":{"name":"Journal of Neuroimaging","volume":"35 5","pages":""},"PeriodicalIF":2.3000,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Functional Imaging in Alzheimer's Disease: A Systematic Review and Meta-Analysis of ASL-MRI and FDG-PET\",\"authors\":\"Mahla Radmard, Mona Gad, Ali Sheikhy, Richard Dagher, Vivek Yedavalli, Licia P. 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引用次数: 0
摘要
阿尔茨海默病(AD)和轻度认知障碍(MCI)是两种与认知能力下降相关的常见疾病。随着全球痴呆症病例的增加,确定最准确的诊断成像方法至关重要。方法根据系统评价和荟萃分析方案的首选报告项目,我们系统地回顾了利用动脉自旋标记磁共振成像(ASL-MRI)和[18F]-2-氟-2-脱氧-d -葡萄糖正电子发射断层扫描(FDG-PET)治疗神经退行性疾病的研究。在PubMed/MEDLINE、Scopus和Embase中搜索,有17项研究直接比较了这些模式对MCI/AD的诊断。7项研究符合基于解读者一致性和曲线下面积(AUC)数据的meta分析标准。采用R“Mada”软件包进行meta分析,通过Zhou和Dendukuri方法评估研究异质性。结果7项研究荟萃分析显示,FDG-PET的AUC(0.864,敏感性0.81,特异性0.80)略高于ASL-MRI (AUC 0.836,敏感性0.73,特异性0.80),但差异无统计学意义。观察到低异质性(I2: FDG-PET为9.4%,ASL-MRI为6.5%)。在MCI亚组分析中,FDG-PET的灵敏度(0.90 vs. 0.75)、特异性(0.91 vs. 0.73)和AUC (0.92 vs. 0.80, p < 0.001)明显优于ASL-MRI。结论FDG-PET和ASL-MRI对AD和MCI的诊断准确性相当。模式之间的选择可能取决于可用性、成本和安全性考虑。FDG-PET和MRI-ASL均能有效识别MCI和AD,实现准确诊断。使用哪种方式的选择可以根据成本、可获得性和其他潜在诊断的考虑来解决。
Functional Imaging in Alzheimer's Disease: A Systematic Review and Meta-Analysis of ASL-MRI and FDG-PET
Background
Alzheimer's disease (AD) and mild cognitive impairment (MCI) are two common conditions associated with cognitive decline. With global dementia cases rising, identifying the most accurate imaging method for diagnosis is essential.
Methods
Following Preferred Reporting Items for Systematic review and Meta-Analysis Protocols, we systematically reviewed studies utilizing arterial spin labeling magnetic resonance imaging (ASL-MRI) and [18F]-2-fluoro-2-deoxy-D-glucose positron emission tomography (FDG-PET) for neurodegenerative disorders. Searches in PubMed/MEDLINE, Scopus, and Embase led to 17 studies directly comparing these modalities for MCI/AD diagnosis. Seven studies met criteria for meta-analysis based on interreader agreement and area under the curve (AUC) data. Meta-analysis was performed using the R “Mada” package, with study heterogeneity assessed via the Zhou and Dendukuri approach.
Results
Meta-analysis of seven studies showed FDG-PET had a slightly higher AUC (0.864, sensitivity 0.81, specificity 0.80) compared to ASL-MRI (AUC 0.836, sensitivity 0.73, specificity 0.80), but no statistically significant difference. Low heterogeneity was observed (I2: 9.4% for FDG-PET, 6.5% for ASL-MRI). In MCI subgroup analysis, FDG-PET outperformed ASL-MRI with significantly higher sensitivity (0.90 vs. 0.75), specificity (0.91 vs. 0.73), and AUC (0.92 vs. 0.80, p < 0.001).
Conclusion
FDG-PET and ASL-MRI demonstrate comparable diagnostic accuracy for AD and MCI. Selection between modalities may depend on availability, cost, and safety considerations.
Clinical Relevance/Application
Both FDG-PET and MRI-ASL are effective at identifying MCI and AD, enabling accurate diagnosis. The choice of which modality to use may be addressed by cost, availability, and consideration of other potential diagnoses.
期刊介绍:
Start reading the Journal of Neuroimaging to learn the latest neurological imaging techniques. The peer-reviewed research is written in a practical clinical context, giving you the information you need on:
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and other new and upcoming neuroscientific modalities.The Journal of Neuroimaging addresses the full spectrum of human nervous system disease, including stroke, neoplasia, degenerating and demyelinating disease, epilepsy, tumors, lesions, infectious disease, cerebral vascular arterial diseases, toxic-metabolic disease, psychoses, dementias, heredo-familial disease, and trauma.Offering original research, review articles, case reports, neuroimaging CPCs, and evaluations of instruments and technology relevant to the nervous system, the Journal of Neuroimaging focuses on useful clinical developments and applications, tested techniques and interpretations, patient care, diagnostics, and therapeutics. Start reading today!