Fluorodeoxyglucose positron emission tomography of mild cognitive impairment with clinical follow-up at 3 years.
BACKGROUND
Alzheimer's disease (AD) is the most common dementing illness. Development of effective treatments directed at AD requires an early diagnosis. Mild cognitive impairment (MCI) often heralds AD. Thus, characterizing MCI is fundamental to the early diagnosis of AD.


METHODS
19 MCI patients referred from a memory loss clinic and 27 healthy subjects, all followed up for 3 years. Metabolism scans (MCI minus controls) were compared voxel-wise after anatomic normalization and were examined both visually and with a computerized classifier.


RESULTS
Agreement between raters as to whether the individual scans were normal or abnormal was high. Agreement between raters of the eventual clinical diagnosis and baseline metabolic pattern was poor. A computerized classifier was unsuccessful at classifying MCI from normal; however, its performance improved when using only prototypic AD-like MCI scans, indicating the classifier worked well when shared patterns existed in the data. Outcomes on follow-up were nine of 19 AD, five of 19 remained MCI, and five of 19 developed dementias other than AD. Both MCI cases of early Lewy body dementia (LBD) showed an AD-like metabolic pattern.


CONCLUSIONS
Visual inspection proved reliable in determining normal from abnormal scans, but it proved unreliable at predicting diagnosis on follow-up. Computerized classification of MCI by using an AD-like metabolic template (such as derived from the averaged MCI images) showed potential to identify patients who will develop AD. However, the metabolic pattern in early LBD did not differ from that in AD.
Pardo
José V
JV
Cognitive Neuroimaging Unit, Minneapolis Veterans Affairs Medical Center, University of Minnesota, Minneapolis, MN, USA. jvpardo@umn.edu
Lee
Joel T
JT
Kuskowski
Michael A
MA
Munch
Kristin R
KR
Carlis
John V
JV
Sheikh
Sohail A
SA
Surerus
Christa
C
Lewis
Scott M
SM
McCarten
J Riley
JR
Fink
Howard
H
McPherson
Susan
S
Shah
Hemant H
HH
Rottunda
Susan
S
Dysken
Maurice W
MW
D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000000981:diagnostic imaging / Q000523:psychology; D003072:Cognition Disorders / Q000000981:diagnostic imaging* / Q000523:psychology; D018450:Disease Progression; D005260:Female; D019788:Fluorodeoxyglucose F18; D005500:Follow-Up Studies; D006801:Humans; D007091:Image Processing, Computer-Assisted; D020961:Lewy Body Disease / Q000000981:diagnostic imaging / Q000523:psychology; D008297:Male; D009483:Neuropsychological Tests; D049268:Positron-Emission Tomography; D019275:Radiopharmaceuticals; D015203:Reproducibility of Results
D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18
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