title: 18F-FDG PET and perfusion SPECT in the diagnosis of Alzheimer and Lewy body dementias.
abstract: Brain imaging with glucose ((18)F-FDG) PET or blood flow (hexamethylpropyleneamine oxime) SPECT is widely used for the differential diagnosis of dementia, though direct comparisons to clearly establish superiority of one method have not been undertaken.
  
  
  METHODS
  Subjects with Alzheimer disease (AD; n = 38) and dementia with Lewy bodies (DLB; n = 30) and controls (n = 30) underwent (18)F-FDG PET and SPECT in balanced order. The main outcome measure was area under the curve (AUC) of receiver-operating-characteristic analysis of visual scan rating.
  
  
  RESULTS
  Consensus diagnosis with (18)F-FDG PET was superior to SPECT for both dementia vs. no-dementia (AUC = 0.93 vs. 0.72, P = 0.001) and AD vs. DLB (AUC = 0.80 vs. 0.58, P = 0.005) comparisons. The sensitivity and specificity for dementia/no-dementia was 85% and 90%, respectively, for (18)F-FDG PET and 71% and 70%, respectively, for SPECT.
  
  
  CONCLUSIONS
  (18)F-FDG PET was significantly superior to blood flow SPECT. We recommend (18)F-FDG PET be performed instead of perfusion SPECT for the differential diagnosis of degenerative dementia if functional imaging is indicated.
authors.affiliation: Department of Psychiatry, Cambridge Biomedical Campus, University of Cambridge School of Clinical Medicine, Cambridge, United Kingdom Institute for Neuroscience, Campus for Ageing and Vitality, Newcastle University, Newcastle upon Tyne, United Kingdom john.obrien@medschl.cam.ac.uk.
authors.forename: John T
authors.initials: JT
authors.lastname: O'Brien
authors.affiliation: Institute for Neuroscience, Campus for Ageing and Vitality, Newcastle University, Newcastle upon Tyne, United Kingdom Nuclear Medicine Department, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, United Kingdom.
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Firbank
authors.affiliation: Institute for Neuroscience, Campus for Ageing and Vitality, Newcastle University, Newcastle upon Tyne, United Kingdom.
authors.forename: Christopher
authors.initials: C
authors.lastname: Davison
authors.affiliation: Institute for Neuroscience, Campus for Ageing and Vitality, Newcastle University, Newcastle upon Tyne, United Kingdom.
authors.forename: Nicky
authors.initials: N
authors.lastname: Barnett
authors.affiliation: Institute of Health and Society, Newcastle University, Newcastle upon Tyne, United Kingdom.
authors.forename: Claire
authors.initials: C
authors.lastname: Bamford
authors.affiliation: Institute of Health and Society, Newcastle University, Newcastle upon Tyne, United Kingdom Yunus Centre, Glasgow Caledonian University, Glasgow, United Kingdom; and.
authors.forename: Cam
authors.initials: C
authors.lastname: Donaldson
authors.affiliation: Institute for Neuroscience, Campus for Ageing and Vitality, Newcastle University, Newcastle upon Tyne, United Kingdom.
authors.forename: Kirsty
authors.initials: K
authors.lastname: Olsen
authors.affiliation: Wolfson Molecular Imaging Centre, Institute of Brain, Behaviours and Mental Health, University of Manchester, Manchester, United Kingdom.
authors.forename: Karl
authors.initials: K
authors.lastname: Herholz
authors.affiliation: Institute for Neuroscience, Campus for Ageing and Vitality, Newcastle University, Newcastle upon Tyne, United Kingdom.
authors.forename: David
authors.initials: D
authors.lastname: Williams
authors.affiliation: Nuclear Medicine Department, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, United Kingdom.
authors.forename: Jim
authors.initials: J
authors.lastname: Lloyd
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000000981:diagnostic imaging* / Q000523:psychology; D001921:Brain / Q000000981:diagnostic imaging; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D020961:Lewy Body Disease / Q000000981:diagnostic imaging* / Q000523:psychology; D008297:Male; D009483:Neuropsychological Tests; D010477:Perfusion; D049268:Positron-Emission Tomography / Q000379:methods; D011446:Prospective Studies; D019690:Technetium Tc 99m Exametazime; D015899:Tomography, Emission-Computed, Single-Photon / Q000379:methods
chemical_list: D019788:Fluorodeoxyglucose F18; D019690:Technetium Tc 99m Exametazime
keywords: 18F-FDG PET; Alzheimer’s disease; HMPAO SPECT; dementia with Lewy bodies; diagnosis; sensitivity; specificity