title: Complementarity of visual and voxel-based FDG-PET analysis to detect MCI-like hypometabolic pattern in elderly patients with hypertension and isolated memory complaints.
abstract: BACKGROUND
  18F-FDG PET can be used to aid in the diagnosis of Alzheimer's disease (AD) and clarify the diagnosis and prognosis of patients with mild cognitive impairment (MCI).
  
  
  OBJECTIVE
  To compare the results of a quantitative analysis of FDG-PET brain images to a standard visual analysis (SVA) with regards to the detection of MCI-like hypometabolic pattern in elderly patients with hypertension and subjective, isolated memory complaints.
  
  
  METHODS
  FDG-PET brain was performed in 71 patients (mean age, 76.4 ± 5.1 years; women, 53.5%). Images were analyzed for the presence of an MCI-like hypometabolic pattern using an SVA by 2 physicians and a voxel-based statistical procedure (statistical parametric mapping [SPM]) that compared each patient's images to normal reference samples from 19 elderly individuals obtained using the same PET camera. The reliability of these analyses was evaluated according to neuropsychological assessment results, including the Grober & Buschke Free and Cued Selective Reminding Test, and a combined analysis by a neuropsychologist.
  
  
  RESULTS
  An MCI-like hypometabolic pattern was documented in 5 patients (7%) by SVA and 7 patients (10%) by SPM analysis; however, only 2 of these patients were selected by both methods. The group characteristics of the 7 patients identified by the quantitative method were consistent with the MCI pattern, which included a higher rate of abnormal GB-FCSRT in Free Recall (57% vs. 9%, p < 0.05) or in Total Recall (29% vs. 8%, p < 0.05) when compared with other patients. In contrast, the group identified by SVA did not exhibit these characteristics.
  
  
  CONCLUSIONS
  A combined visual and quantitative analysis improves the diagnostic accuracy to detect an MCI-like hypometabolic pattern in elderly patients with hypertension and subjective, isolated memory complaints.
authors.affiliation: Department of Nuclear Medicine, CHU-Nancy, Vandoeuvre-lès-Nancy, France axel.vandergucht@gmail.com.
authors.forename: Axel
authors.initials: A
authors.lastname: Van Der Gucht
authors.affiliation: Department of Nuclear Medicine, CHU-Nancy, Vandoeuvre-lès-Nancy, France Nancyclotep Experimental Imaging Platform, Nancy, France.
authors.forename: Antoine
authors.initials: A
authors.lastname: Verger
authors.affiliation: Department of Nuclear Medicine, CHU-Nancy, Vandoeuvre-lès-Nancy, France.
authors.forename: Yalcin
authors.initials: Y
authors.lastname: Yagdigul
authors.affiliation: Department of Nuclear Medicine, CHU-Nancy, Vandoeuvre-lès-Nancy, France Nancyclotep Experimental Imaging Platform, Nancy, France.
authors.forename: Sylvain
authors.initials: S
authors.lastname: Poussier
authors.affiliation: Department of Geriatrics, CHU-Nancy, Nancy, France.
authors.forename: Laure
authors.initials: L
authors.lastname: Joly
authors.affiliation: Department of Geriatrics, CHU-Nancy, Nancy, France.
authors.forename: Ghassan
authors.initials: G
authors.lastname: Watfa
authors.affiliation: Department of Geriatrics, CHU-Nancy, Nancy, France.
authors.forename: Athanase
authors.initials: A
authors.lastname: Benetos
authors.affiliation: Department of Nuclear Medicine, CHU-Nancy, Vandoeuvre-lès-Nancy, France Nancyclotep Experimental Imaging Platform, Nancy, France.
authors.forename: Gilles
authors.initials: G
authors.lastname: Karcher
authors.affiliation: Department of Nuclear Medicine, CHU-Nancy, Vandoeuvre-lès-Nancy, France Nancyclotep Experimental Imaging Platform, Nancy, France.
authors.forename: Pierre-Yves
authors.initials: PY
authors.lastname: Marie
mesh_terms: D000368:Aged; D001921:Brain / Q000000981:diagnostic imaging*; D060825:Cognitive Dysfunction / Q000000981:diagnostic imaging*; D005260:Female; D019788:Fluorodeoxyglucose F18; D015577:Geriatric Assessment / Q000379:methods; D006801:Humans; D006973:Hypertension / Q000000981:diagnostic imaging*; D007090:Image Interpretation, Computer-Assisted / Q000379:methods; D021621:Imaging, Three-Dimensional / Q000379:methods; D008297:Male; D008569:Memory Disorders / Q000000981:diagnostic imaging*; D008875:Middle Aged; D015588:Observer Variation; D049268:Positron-Emission Tomography / Q000379:methods*; D019275:Radiopharmaceuticals; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity
chemical_list: D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18
keywords: Alzheimer’s disease; FDG PET; brain imaging; mild cognitive impairment; statistical parametric mapping