title: [Molecular neuroimaging in the study of cognitive impairment: contribution of the cerebral blood flow SPECT with 99mTc-HMPAO and 18F-FDG PET/CT scan].
abstract: OBJECTIVE
  The aim of this study was to analyze cerebral perfusion and glucose metabolism in patients with cognitive impairment using cerebral blood flow (99m)Tc-HMPAO SPECT and (18)F-FDG PET/CT scans.
  
  
  METHODS
  Twenty-two patients with cognitive impairment were included: 4 subjective memory complaints (SMC), 8 amnestic mild cognitive impairment (MCI), 5 prodromic Alzheimer's disease (AD) and 5 AD. In each clinical group, (99m)Tc-HMPAO SPECT and (18)F-FDG PET/CT scans were performed.
  
  
  RESULTS
  (99m)Tc-HMPAO SPECT showed regions of cerebral hypoperfusion in 15 patients and was normal in 7 of the 22 patients. (18)F-FDG PET/CT scan showed cerebral regional hypometabolism in 19 patients and was normal in the other 3 patients. The distribution of abnormalities on (99m)Tc-HMPAO SPECT and (18)F-FDG PET/CT scans was similar in 9 patients (2 SMC, 2 amnestic MCI, 2 prodromic AD, and 3 AD). In 6 patients (1 amnestic MCI, 2 prodromic AD, and 3 AD), FDG hypometabolism was more extensive than the cerebral hypoperfusion. Four patients (1SMC, 3 amnestic MCI) had an abnormal (18)F-FDG PET/CT scan and normal (99m)Tc-HMPAO SPECT. There were 3 patients (1 SMC 2, amnestic MCI) with normal (99m)Tc-HMPAO SPECT and (18)F-FDG PET/CT scans.
  
  
  CONCLUSIONS
  (99m)Tc-HMPAO SPECT and (18)F-FDG PET/CT scans showed cerebral hypoperfusion and hypometabolism in patients with cognitive impairment, even in patients with clinical diagnosis of SMC. In patients with a normal cerebral blood flow SPECT, brain glucose cerebral hypometabolism can be detected. In some patients, the extension of FDG hypometabolism is more pronounced than that corresponding to the hypoperfusion area.
authors.affiliation: Servicio de Medicina Nuclear, Hospital Universitario Marqués de Valdecilla, Universidad de Cantabria, Santander, España. mnubmj@humv.es
authors.forename: I
authors.initials: I
authors.lastname: Banzo
authors.forename: R
authors.initials: R
authors.lastname: Quirce
authors.forename: I
authors.initials: I
authors.lastname: Martínez-Rodríguez
authors.forename: J
authors.initials: J
authors.lastname: Jiménez-Bonilla
authors.forename: H
authors.initials: H
authors.lastname: Portilla-Quattrociocchi
authors.forename: P
authors.initials: P
authors.lastname: Medina-Quiroz
authors.forename: F
authors.initials: F
authors.lastname: Ortega
authors.forename: E
authors.initials: E
authors.lastname: Rodríguez
authors.forename: I
authors.initials: I
authors.lastname: Mateo
authors.forename: J L
authors.initials: JL
authors.lastname: Vázquez-Higuera
authors.forename: M
authors.initials: M
authors.lastname: de Arcocha
authors.forename: J M
authors.initials: JM
authors.lastname: Carril
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000000981:diagnostic imaging / Q000378:metabolism; D001921:Brain / Q000378:metabolism; D002560:Cerebrovascular Circulation; D003072:Cognition Disorders / Q000000981:diagnostic imaging* / Q000378:metabolism; D005260:Female; D005462:Fluorine Radioisotopes; D019788:Fluorodeoxyglucose F18; D006801:Humans; D008297:Male; D008569:Memory Disorders / Q000000981:diagnostic imaging / Q000378:metabolism; D008875:Middle Aged; D064847:Multimodal Imaging; D049268:Positron-Emission Tomography; D011237:Predictive Value of Tests; D019275:Radiopharmaceuticals; D012680:Sensitivity and Specificity; D019690:Technetium Tc 99m Exametazime; D015899:Tomography, Emission-Computed, Single-Photon; D014057:Tomography, X-Ray Computed
chemical_list: D005462:Fluorine Radioisotopes; D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18; D019690:Technetium Tc 99m Exametazime