title: Prediction of Outcomes in Mild Cognitive  Impairment by Using 18F-FDG-PET:  A Multicenter Study.
abstract: BACKGROUND
  18F-FDG-PET is defined as a biomarker of neuronal injury according to the revised National Institute on Aging–Alzheimer’s Association criteria.
  
  
  OBJECTIVE
  The objective of this multicenter prospective cohort study was to examine the value of 18F-FDG-PET in predicting the development of Alzheimer’s disease (AD) in patients with mild cognitive impairment (MCI).
  
  
  METHODS
  In total, 114 patients with MCI at 9 participating institutions underwent clinical and neuropsychological examinations, MRI, and 18F-FDG-PET at baseline. The cases were visually classified into predefined dementia patterns by three experts. Anautomated analysis for 18F-FDG-PET was also performed to calculate the PET score. Subjects were followed periodically for 3 years, and progression to dementia was evaluated.
  
  
  RESULTS
  In 47% of the patients with MCI, progression of symptoms justified the clinical diagnosis of “probable AD”. The PET visual interpretation predicted conversion to AD during 3-year follow-up with an overall diagnostic accuracy of 68%. Overall diagnostic accuracy of the PET score was better than that of PET visual interpretation at all follow-up intervals, and the optimized PET score threshold revealed the best performance at the 2-year follow-up interval with an overall diagnostic accuracy of 83%,a sensitivity of 70%, and a specificity of 90%. Multivariate logistic regression analysis identified the PET score as the most significant predictive factor distinguishing AD converters from non-converters.
  
  
  CONCLUSIONS
  The PET score is the most statistically significant predictive factor for conversion from MCI to AD, and the diagnostic performance of the PET score is more promising for rapid converters over 2 years.
authors.affiliation: Department of Clinical and Experimental Neuroimaging, National Center for Geriatrics and Gerontology, Aichi, Japan. kito@ncgg.go.jp
authors.forename: Kengo
authors.initials: K
authors.lastname: Ito
authors.forename: Hidenao
authors.initials: H
authors.lastname: Fukuyama
authors.forename: Michio
authors.initials: M
authors.lastname: Senda
authors.forename: Kazunari
authors.initials: K
authors.lastname: Ishii
authors.forename: Kiyoshi
authors.initials: K
authors.lastname: Maeda
authors.forename: Yasuji
authors.initials: Y
authors.lastname: Yamamoto
authors.forename: Yasuomi
authors.initials: Y
authors.lastname: Ouchi
authors.forename: Kenji
authors.initials: K
authors.lastname: Ishii
authors.forename: Ayumu
authors.initials: A
authors.lastname: Okumura
authors.forename: Ken
authors.initials: K
authors.lastname: Fujiwara
authors.forename: Takashi
authors.initials: T
authors.lastname: Kato
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Arahata
authors.forename: Yukihiko
authors.initials: Y
authors.lastname: Washimi
authors.forename: Yoshio
authors.initials: Y
authors.lastname: Mitsuyama
authors.forename: Kenichi
authors.initials: K
authors.lastname: Meguro
authors.forename: Mitsuru
authors.initials: M
authors.lastname: Ikeda
mesh_terms: D000368:Aged; D000544:Alzheimer Disease / Q000150:complications; D001921:Brain / Q000000981:diagnostic imaging* / Q000473:pathology*; D060825:Cognitive Dysfunction / Q000175:diagnosis* / Q000209:etiology; D018450:Disease Progression; D005260:Female; D019788:Fluorodeoxyglucose F18 / Q000378:metabolism*; D006801:Humans; D016015:Logistic Models; D008137:Longitudinal Studies; D008279:Magnetic Resonance Imaging; D008297:Male; D008609:Mental Status Schedule; D008875:Middle Aged; D049268:Positron-Emission Tomography; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D012680:Sensitivity and Specificity
chemical_list: D019788:Fluorodeoxyglucose F18