Esra ARSLAN, Özgül EKMEKÇİOĞLU, Fatma Arzu GÖRTAN, Zeynep Funda Engin AKCAN, Melih Engin ERKAN, Haci Murat EMÜL, Metin HALAÇ, Tevfik Fikret ÇERMİK, Kerim SÖNMEZOĞLU

The value of FDG-PET/CT by using 3-dimensional stereotactic surface projection software analysis in the differential diagnosis of dementia

Background/aim: To retrospectively reevaluate brain fluor-18-fluorodeoxyglucose positron emission tomography (FDG-PET) imaging studies with 3-dimensional stereotactic surface projection (NEUROSTAT) software in order to detect changes in regional brain metabolism and to find out its contribution to the final diagnosis. Materials and methods: A total of 48 cases were included in this study. According to clinical evaluation and neuropsychometric test results, there were 17 (35%) patients with probable Alzheimer disease (AD), 17 (35%) patients with probable frontotemporal dementia (FTD), and 14 (30%) patients with undefined advanced dementia. Brain FDG-PET imaging studies were interpreted visually and also using 3-dimensional stereotactic surface projection. Results: Clinic and PET findings were consistent in 20 patients and inconsistent in 14 patients. When consensus diagnosis was taken as the reference, the sensitivity, specificity, accuracy, and positive and negative predictive values of FDG-PET imaging were 93%, 85%, 90%, 90%, and 89% respectively, for AD diagnosis. The same values were 85%, 93%, 90%, 89%, and 90%, respectively, for FTD definition. Conclusion: Using automatized programs that enable quantitative evaluation of regional brain glucose metabolism, in addition to visual evaluation, may increase diagnostic efficiency, as well as minimize interobserver and/or intercenter variability.

Anahtar Kelimeler:

Alzheimer disease, frontotemporal dementia, fluor-18-FDG-PET, brain positron emission tomography

The value of FDG-PET/CT by using 3-dimensional stereotactic surface projection software analysis in the differential diagnosis of dementia

Keywords:

Alzheimer disease, frontotemporal dementia, fluor-18-FDG-PET, brain positron emission tomography,

PDF

___

Freidl W, Schmidt R, Stronegger WJ, Irmler A, Reinhart B, Koch M. Mini Mental State Examination: influence of sociodemographic, environmental and behavioral factors and vascular risk factors. J Clin Epidemiol 1996; 49: 73–78.
Phelps ME, Huang SC, Hoffman EJ, Selin C, Sokoloff L, Kuhl DE. Tomographic measurement of local cerebral metabolic rate in humans with 18F-FDG: validation of method. Ann Neurol 1979; 6: 371–388.
Green RC. Diagnosis and Management of Alzheimer’s Disease and Other Dementias. Caddo, OK, USA: Professional Communications, Inc.; 2005.
Imamura T, Ishii K, Sasaki M, Kitagaki H, Yamaji S, Hirono N, Shimomura T, Hashimoto M, Tanimukai S, Kazui H et al. Regional cerebral glucose metabolism in dementia with Lewy bodies and Alzheimer’s disease: a comparative study using positron emission tomography. Neurosci Lett 1997; 235: 49– 52. 9. Herholz K, Nordberg A, Salmon E, Perani D, Kessler J, Mielke R, Halber M, Jelic V, Almkvist O, Collette F et al. Impairment of neocortical metabolism predicts progression in Alzheimer’s disease. Dement Geriatr Cogn Disord 1999; 10: 494–504.
De Santi S, de Leon MJ, Rusinek H, Convit A, Tarshish CY, Roche A, Tsui WH, Kandil E, Boppana M, Daisley K et al. Hippocampal formation glucose metabolism and volume losses in MCI and AD. Neurobiol Aging 2001; 22: 529–539.
Silverman DH, Cummings JL, Small GW, Gambhir SS, Chen W, Czernin J, Phelps ME. Added clinical benefit of incorporating 2-deoxy-2-[18F]fluoro-D-glucose with positron emission tomography into the clinical evaluation of patients with cognitive impairment. Mol Imaging Biol 2002; 4: 283–293.
Ishii K, Willoch F, Minoshima S, Drzezga A, Ficaro EP, Cross DJ, Kuhl DE, Schwaiger M. Statistical brain mapping of 18F-FDG PET in Alzheimer’s disease: validation of anatomic standardization for atrophied brains. J Nucl Med 2001; 42: 548–557.
Minoshima S, Frey KA, Koeppe RA, Foster NL, Kuhl DE. A diagnostic approach in Alzheimer’s disease using three- dimensional stereotactic surface projections fluorine-18-FDG PE. J Nucl Med 1995; 36: 1238–1248.
Koeppe RA, Gilman S, Joshi A, Liu S, Little R, Junck L, Heumann M, Frey KA, Albin RL. 11 C-DTBZ and 18FDG- PET measures in differentiating dementias. J Nucl Med 2005; 46: 936–944.
Foster NL, Heidebrink JL, Clark CM, Jagust WJ, Arnold SE, Barbas NR, DeCarli CS, Turner RS, Koeppe RA, Higdon R et al. FDG-PET improves accuracy in distinguishing frontotemporal dementia and Alzheimer’s disease. Brain 2007; 130: 2616–2635.
Hirono N, Mori E, Ikejiri Y, Imamura T, Shimomura T, Hashimoto M, Yamashita H, Sasaki M. Hypofunction in the posterior cingulate gyrus correlates with disorientation for time and place in Alzheimer’s disease. J Neurol Neurosurg Psychiatry 1998; 64: 552–554.
Li Y, Rinne JO, Mosconi L, Pirraglia E, Rusinek H, DeSanti S, Kemppainen N, Någren K, Kim BC, Tsui W et al. Regional analysis of FDG and PIB-PET images in normal aging, mild cognitive impairment, and Alzheimer’s disease. Eur J Nucl Med Mol Imaging 2008; 35: 2169–2181.
Friston KJ, Holmes AP, Worsley KJ, Poline JP, Frith CD, Frackowiak RSJ. Statistical parametric maps in functional imaging: a general linear approach. Hum Brain Mapp 1994; 2: 189–210.