A comparison of the diagnostic sensitivity of MRI, CBF-SPECT, FDG-PET and cerebrospinal fluid biomarkers for detecting Alzheimer's disease in a memory clinic.
OBJECTIVE
Magnetic resonance imaging (MRI), cerebral blood flow single photon emission computed tomography (CBF-SPECT), fluorodeoxyglucose-positron emission tomography (FDG-PET) and cerebrospinal fluid (CSF) biomarkers are used for the diagnosis of Alzheimer's disease (AD). We aimed to reveal the relative sensitivity of these tools in a memory clinic setting.


METHODS
In 207 patients with probable AD in our memory clinic, medial temporal lobe atrophy on MRI, hypoperfusion/hypometabolism of the parietotemporal lobe and posterior cingulate gyrus in ethylcysteinate dimer-CBF-SPECT/FDG-PET, and abnormalities of CSF amyloid β-protein 1-42, total tau and phosphorylated tau were evaluated as findings characteristic of AD.


RESULTS
The AD findings were observed in 77.4% of all AD patients with MRI, 81.6% with CBF-SPECT, 93.1% with FDG-PET and 94.0% with CSF biomarkers. At the stage of Clinical Dementia Rating (CDR) 0.5, CSF biomarkers were the most sensitive (90.0%); at the stage of CDR 1, FDG-PET (96.7%) and CSF biomarkers (95.5%) were highly sensitive. At the stage of CDR 2, all tools showed high positive percentages.


CONCLUSIONS
The diagnosis of AD was most often supported by CSF biomarkers and FDG-PET at the early stage of dementia (CDR 1) and by CSF biomarkers at the earlier stage (CDR 0.5).
Morinaga
Akiyoshi
A
Department of Neurology and Neurobiology of Aging, Kanazawa University Graduate School of Medical Science, Japan.
Ono
Kenjiro
K
Ikeda
Tokuhei
T
Ikeda
Yoshihisa
Y
Shima
Keisuke
K
Noguchi-Shinohara
Moeko
M
Samuraki
Miharu
M
Yanase
Daisuke
D
Yoshita
Mitsuhiro
M
Iwasa
Kazuo
K
Mastunari
Ichiro
I
Yamada
Masahito
M
D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000134:cerebrospinal fluid / Q000175:diagnosis* / Q000473:pathology; D016229:Amyloid beta-Peptides / Q000134:cerebrospinal fluid*; D001284:Atrophy / Q000000981:diagnostic imaging / Q000473:pathology; D015415:Biomarkers / Q000378:metabolism; D002555:Cerebrospinal Fluid / Q000000981:diagnostic imaging / Q000378:metabolism; D042241:Early Diagnosis; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D010446:Peptide Fragments / Q000134:cerebrospinal fluid*; D049268:Positron-Emission Tomography; D011859:Radiography; D019275:Radiopharmaceuticals; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D016037:Single-Blind Method; D013702:Temporal Lobe / Q000000981:diagnostic imaging / Q000473:pathology*; D015899:Tomography, Emission-Computed, Single-Photon; D016875:tau Proteins / Q000134:cerebrospinal fluid*
D016229:Amyloid beta-Peptides; D015415:Biomarkers; D010446:Peptide Fragments; D019275:Radiopharmaceuticals; C075222:amyloid beta-protein (1-42); D016875:tau Proteins; D019788:Fluorodeoxyglucose F18