title: Visual versus semi-quantitative analysis of 18F-FDG-PET in amnestic MCI: an European Alzheimer's Disease Consortium (EADC) project.
abstract: We aimed to investigate the accuracy of FDG-PET to detect the Alzheimer's disease (AD) brain glucose hypometabolic pattern in 142 patients with amnestic mild cognitive impairment (aMCI) and 109 healthy controls. aMCI patients were followed for at least two years or until conversion to dementia. Images were evaluated by means of visual read by either moderately-skilled or expert readers, and by means of a summary metric of AD-like hypometabolism (PALZ score). Seventy-seven patients converted to AD-dementia after 28.6 ± 19.3 months of follow-up. Expert reading was the most accurate tool to detect these MCI converters from healthy controls (sensitivity 89.6%, specificity 89.0%, accuracy 89.2%) while two moderately-skilled readers were less (p < 0.05) specific (sensitivity 85.7%, specificity 79.8%, accuracy 82.3%) and PALZ score was less (p < 0.001) sensitive (sensitivity 62.3%, specificity 91.7%, accuracy 79.6%). Among the remaining 67 aMCI patients, 50 were confirmed as aMCI after an average of 42.3 months, 12 developed other dementia, and 3 reverted to normalcy. In 30/50 persistent MCI patients, the expert recognized the AD hypometabolic pattern. In 13/50 aMCI, both the expert and PALZ score were negative while in 7/50, only the PALZ score was positive due to sparse hypometabolic clusters mainly in frontal lobes. Visual FDG-PET reads by an expert is the most accurate method but an automated, validated system may be particularly helpful to moderately-skilled readers because of high specificity, and should be mandatory when even a moderately-skilled reader is unavailable.
authors.affiliation: Nuclear Medicine, Department of Health Sciences (DISSAL), University of Genoa, IRCCS AOU San Martino-IST, Genoa, Italy.
authors.forename: Silvia
authors.initials: S
authors.lastname: Morbelli
authors.affiliation: Clinical Neurology, Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, and Mother-Child health (DINOGMI), University of Genoa, IRCCS AOU San Martino-IST, Genoa, Italy.
authors.forename: Andrea
authors.initials: A
authors.lastname: Brugnolo
authors.affiliation: Nuclear Medicine, Department of Health Sciences (DISSAL), University of Genoa, IRCCS AOU San Martino-IST, Genoa, Italy.
authors.forename: Irene
authors.initials: I
authors.lastname: Bossert
authors.affiliation: Nuclear Medicine, Department of Health Sciences (DISSAL), University of Genoa, IRCCS AOU San Martino-IST, Genoa, Italy.
authors.forename: Ambra
authors.initials: A
authors.lastname: Buschiazzo
authors.affiliation: LENITEM Laboratory of Epidemiology and Neuroimaging-IRCCS S. Giovanni di Dio-FBF, Brescia, Italy University Hospitals and University of Geneva, Geneva, Switzerland.
authors.forename: Giovanni B
authors.initials: GB
authors.lastname: Frisoni
authors.affiliation: LENITEM Laboratory of Epidemiology and Neuroimaging-IRCCS S. Giovanni di Dio-FBF, Brescia, Italy.
authors.forename: Samantha
authors.initials: S
authors.lastname: Galluzzi
authors.affiliation: Department of Nuclear Medicine & PET Research, VU University Medical Center, Amsterdam, The Netherlands.
authors.forename: Bart N M
authors.initials: BN
authors.lastname: van Berckel
authors.affiliation: Department of Nuclear Medicine & PET Research, VU University Medical Center, Amsterdam, The Netherlands.
authors.forename: Rik
authors.initials: R
authors.lastname: Ossenkoppele
authors.affiliation: Neuroepidemiology and Ageing Research Unit, School of Public Health, Faculty of Medicine, The Imperial College of Science, Technology, and Medicine, London, UK West London Cognitive Disorders Treatment and Research Unit, London, UK Department of Psychiatry and Psychotherapy, Technische Universität, Munich, Germany.
authors.forename: Robert
authors.initials: R
authors.lastname: Perneczky
authors.affiliation: Department of Nuclear Medicine, Technische Universität, Munich, Germany.
authors.forename: Alexander
authors.initials: A
authors.lastname: Drzezga
authors.affiliation: APHM, CHU Timone, Service de Neurologie et Neuropsychologie, Aix-Marseille University, INSERM U 1106, Marseille, France.
authors.forename: Mira
authors.initials: M
authors.lastname: Didic
authors.affiliation: APHM, CHU Timone, Service de MédecineNucléaire; Aix-Marseille University, CERIMED, INT CNRS UMR7289, Marseille, France.
authors.forename: Eric
authors.initials: E
authors.lastname: Guedj
authors.affiliation: Nuclear Medicine, Department of Health Sciences (DISSAL), University of Genoa, IRCCS AOU San Martino-IST, Genoa, Italy.
authors.forename: Gianmario
authors.initials: G
authors.lastname: Sambuceti
authors.affiliation: Nuclear Medicine, Department of Health Sciences (DISSAL), University of Genoa, IRCCS AOU San Martino-IST, Genoa, Italy.
authors.forename: Gianluca
authors.initials: G
authors.lastname: Bottoni
authors.affiliation: Clinical Neurology, Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, and Mother-Child health (DINOGMI), University of Genoa, IRCCS AOU San Martino-IST, Genoa, Italy.
authors.forename: Dario
authors.initials: D
authors.lastname: Arnaldi
authors.affiliation: Clinical Neurology, Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, and Mother-Child health (DINOGMI), University of Genoa, IRCCS AOU San Martino-IST, Genoa, Italy.
authors.forename: Agnese
authors.initials: A
authors.lastname: Picco
authors.affiliation: Institute of Bioimaging and Molecular Physiology, Consiglio Nazionale delle Ricerche (CNR), Genoa, Italy.
authors.forename: Fabrizio
authors.initials: F
authors.lastname: De Carli
authors.affiliation: Institute of Cognitive Sciences and Technologies, Consiglio Nazionale delle Ricerche (CNR), Rome, Italy Department of Nuclear Medicine, Karolinska University Hospital, Stockholm, Sweden.
authors.forename: Marco
authors.initials: M
authors.lastname: Pagani
authors.affiliation: Clinical Neurology, Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, and Mother-Child health (DINOGMI), University of Genoa, IRCCS AOU San Martino-IST, Genoa, Italy.
authors.forename: Flavio
authors.initials: F
authors.lastname: Nobili
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000150:complications*; D060825:Cognitive Dysfunction / Q000000981:diagnostic imaging* / Q000209:etiology*; D005060:Europe; D005260:Female; D019788:Fluorodeoxyglucose F18; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D049268:Positron-Emission Tomography / Q000379:methods; D011569:Psychiatric Status Rating Scales; D012680:Sensitivity and Specificity
chemical_list: D019788:Fluorodeoxyglucose F18
keywords: Alzheimer's disease; FDG-PET; PALZ score; amnestic mild cognitive impairment; visual read