Multicenter standardized 18F-FDG PET diagnosis of mild cognitive impairment, Alzheimer's disease, and other dementias.
This multicenter study examined (18)F-FDG PET measures in the differential diagnosis of Alzheimer's disease (AD), frontotemporal dementia (FTD), and dementia with Lewy bodies (DLB) from normal aging and from each other and the relation of disease-specific patterns to mild cognitive impairment (MCI).


METHODS
We examined the (18)F-FDG PET scans of 548 subjects, including 110 healthy elderly individuals ("normals" or NLs), 114 MCI, 199 AD, 98 FTD, and 27 DLB patients, collected at 7 participating centers. Individual PET scans were Z scored using automated voxel-based comparison with generation of disease-specific patterns of cortical and hippocampal (18)F-FDG uptake that were then applied to characterize MCI.


RESULTS
Standardized disease-specific PET patterns were developed that correctly classified 95% AD, 92% DLB, 94% FTD, and 94% NL. MCI patients showed primarily posterior cingulate cortex and hippocampal hypometabolism (81%), whereas neocortical abnormalities varied according to neuropsychological profiles. An AD PET pattern was observed in 79% MCI with deficits in multiple cognitive domains and 31% amnesic MCI. (18)F-FDG PET heterogeneity in MCI with nonmemory deficits ranged from absent hypometabolism to FTD and DLB PET patterns.


CONCLUSIONS
Standardized automated analysis of (18)F-FDG PET scans may provide an objective and sensitive support to the clinical diagnosis in early dementia.
Mosconi
Lisa
L
Center for Brain Health, New York University School of Medicine, New York, New York 10016, USA. lisa.mosconi@med.nyu.edu
Tsui
Wai H
WH
Herholz
Karl
K
Pupi
Alberto
A
Drzezga
Alexander
A
Lucignani
Giovanni
G
Reiman
Eric M
EM
Holthoff
Vjera
V
Kalbe
Elke
E
Sorbi
Sandro
S
Diehl-Schmid
Janine
J
Perneczky
Robert
R
Clerici
Francesca
F
Caselli
Richard
R
Beuthien-Baumann
Bettina
B
Kurz
Alexander
A
Minoshima
Satoshi
S
de Leon
Mony J
MJ
D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000000981:diagnostic imaging / Q000453:epidemiology; D003072:Cognition Disorders / Q000000981:diagnostic imaging* / Q000453:epidemiology*; D003704:Dementia / Q000000981:diagnostic imaging* / Q000453:epidemiology*; D005060:Europe / Q000453:epidemiology; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D008297:Male; D008875:Middle Aged; D049268:Positron-Emission Tomography / Q000592:standards* / Q000706:statistics & numerical data*; D015995:Prevalence; D019275:Radiopharmaceuticals; D012015:Reference Standards; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D014481:United States / Q000453:epidemiology
D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18