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Visual rating of medial temporal lobe metabolism in mild cognitive impairment and Alzheimer’s disease using FDG-PET

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European Journal of Nuclear Medicine and Molecular Imaging Aims and scope Submit manuscript

Abstract

Purpose

This study was designed to examine the utility of visual inspection of medial temporal lobe (MTL) metabolism in the diagnosis of mild cognitive impairment (MCI) and Alzheimer’s disease (AD) using FDG-PET scans.

Methods

Seventy-five subjects [27 normal controls (NL), 26 MCI, and 22 AD] with FDG-PET and MRI scans were included in this study. We developed a four-point visual rating scale to evaluate the presence and severity of MTL hypometabolism on FDG-PET scans. The visual MTL ratings were compared with quantitative glucose metabolic rate (MRglc) data extracted using regions of interest (ROIs) from the MRI-coregistered PET scans of all subjects. A standard rating evaluation of neocortical hypometabolism was also completed. Logistic regressions were used to determine and compare the diagnostic accuracy of the MTL and cortical ratings.

Results

For both MTL and cortical ratings, high intra- and inter-rater reliabilities were found (p values <0.001). The MTL rating was highly correlated with and yielded a diagnostic accuracy equivalent to the ROI MRglc measures (p values <0.001). The combination of MTL and cortical ratings significantly improved the diagnostic accuracy over the cortical rating alone, with 100% of AD, 77% of MCI, and 85% of NL cases being correctly identified.

Conclusion

This study shows that the visual rating of MTL hypometabolism on PET is reliable, yields a diagnostic accuracy equal to the quantitative ROI measures, and is clinically useful and more sensitive than cortical ratings for patients with MCI. We suggest this method be further evaluated for its potential in the early diagnosis of AD.

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Acknowledgements

We thank the NIH–NIA for support of AG12101, AG13613, and AG08051. We thank Joanna Fowler, David Schlyer, and Gene-Jack Wang for support of the PET studies, and Schantel Williams and Ronit Notkin for study coordination and psychometric testing.

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Authors and Affiliations

  1. Department of Psychiatry, New York University School of Medicine, New York, NY, 10016, USA

    Lisa Mosconi, Susan De Santi, Yi Li, Juan Li, Jiong Zhan, Wai Hon Tsui, Madhu Boppana & Mony J. de Leon

  2. Department of Clinical Pathophysiology, Nuclear Medicine Unit, University of Florence, Florence, Italy

    Lisa Mosconi & Alberto Pupi

  3. Nathan Kline Institute, Orangeburg, NY, 10962, USA

    Wai Hon Tsui & Mony J. de Leon

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  1. Lisa Mosconi
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  2. Susan De Santi
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Correspondence to Mony J. de Leon.

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Mosconi, L., De Santi, S., Li, Y. et al. Visual rating of medial temporal lobe metabolism in mild cognitive impairment and Alzheimer’s disease using FDG-PET. Eur J Nucl Med Mol Imaging 33, 210–221 (2006). https://doi.org/10.1007/s00259-005-1956-z

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