PURPOSE: This study was designed to examine the utility of visual inspection of medial temporal lobe (MTL) metabolism in the diagnosis of mild cognitive impairment (MCI) and Alzheimer's disease (AD) using FDG-PET scans. METHODS: Seventy-five subjects [27 normal controls (NL), 26 MCI, and 22 AD] with FDG-PET and MRI scans were included in this study. We developed a four-point visual rating scale to evaluate the presence and severity of MTL hypometabolism on FDG-PET scans. The visual MTL ratings were compared with quantitative glucose metabolic rate (MR(glc)) data extracted using regions of interest (ROIs) from the MRI-coregistered PET scans of all subjects. A standard rating evaluation of neocortical hypometabolism was also completed. Logistic regressions were used to determine and compare the diagnostic accuracy of the MTL and cortical ratings. RESULTS: For both MTL and cortical ratings, high intra- and inter-rater reliabilities were found (p values <0.001). The MTL rating was highly correlated with and yielded a diagnostic accuracy equivalent to the ROI MR(glc) measures (p values <0.001). The combination of MTL and cortical ratings significantly improved the diagnostic accuracy over the cortical rating alone, with 100% of AD, 77% of MCI, and 85% of NL cases being correctly identified. CONCLUSION: This study shows that the visual rating of MTL hypometabolism on PET is reliable, yields a diagnostic accuracy equal to the quantitative ROI measures, and is clinically useful and more sensitive than cortical ratings for patients with MCI. We suggest this method be further evaluated for its potential in the early diagnosis of AD.
PURPOSE: This study was designed to examine the utility of visual inspection of medial temporal lobe (MTL) metabolism in the diagnosis of mild cognitive impairment (MCI) and Alzheimer's disease (AD) using FDG-PET scans. METHODS: Seventy-five subjects [27 normal controls (NL), 26 MCI, and 22 AD] with FDG-PET and MRI scans were included in this study. We developed a four-point visual rating scale to evaluate the presence and severity of MTL hypometabolism on FDG-PET scans. The visual MTL ratings were compared with quantitative glucose metabolic rate (MR(glc)) data extracted using regions of interest (ROIs) from the MRI-coregistered PET scans of all subjects. A standard rating evaluation of neocortical hypometabolism was also completed. Logistic regressions were used to determine and compare the diagnostic accuracy of the MTL and cortical ratings. RESULTS: For both MTL and cortical ratings, high intra- and inter-rater reliabilities were found (p values <0.001). The MTL rating was highly correlated with and yielded a diagnostic accuracy equivalent to the ROI MR(glc) measures (p values <0.001). The combination of MTL and cortical ratings significantly improved the diagnostic accuracy over the cortical rating alone, with 100% of AD, 77% of MCI, and 85% of NL cases being correctly identified. CONCLUSION: This study shows that the visual rating of MTL hypometabolism on PET is reliable, yields a diagnostic accuracy equal to the quantitative ROI measures, and is clinically useful and more sensitive than cortical ratings for patients with MCI. We suggest this method be further evaluated for its potential in the early diagnosis of AD.
Authors: M J de Leon; A Convit; O T Wolf; C Y Tarshish; S DeSanti; H Rusinek; W Tsui; E Kandil; A J Scherer; A Roche; A Imossi; E Thorn; M Bobinski; C Caraos; P Lesbre; D Schlyer; J Poirier; B Reisberg; J Fowler Journal: Proc Natl Acad Sci U S A Date: 2001-08-28 Impact factor: 11.205
Authors: M J de Leon; J Golomb; A E George; A Convit; C Y Tarshish; T McRae; S De Santi; G Smith; S H Ferris; M Noz Journal: AJNR Am J Neuroradiol Date: 1993 Jul-Aug Impact factor: 3.825
Authors: L Mosconi; D Perani; S Sorbi; K Herholz; B Nacmias; V Holthoff; E Salmon; J-C Baron; M T R De Cristofaro; A Padovani; B Borroni; M Franceschi; L Bracco; A Pupi Journal: Neurology Date: 2004-12-28 Impact factor: 9.910
Authors: Lisa Mosconi; Wai H Tsui; Henry Rusinek; Susan De Santi; Yi Li; Gene-Jack Wang; Alberto Pupi; Joanna Fowler; Mony J de Leon Journal: Eur J Nucl Med Mol Imaging Date: 2007-04-04 Impact factor: 9.236
Authors: Lisa Mosconi; Susan De Santi; Juan Li; Wai Hon Tsui; Yi Li; Madhu Boppana; Eugene Laska; Henry Rusinek; Mony J de Leon Journal: Neurobiol Aging Date: 2007-01-11 Impact factor: 4.673
Authors: Lisa Mosconi; Wai H Tsui; Karl Herholz; Alberto Pupi; Alexander Drzezga; Giovanni Lucignani; Eric M Reiman; Vjera Holthoff; Elke Kalbe; Sandro Sorbi; Janine Diehl-Schmid; Robert Perneczky; Francesca Clerici; Richard Caselli; Bettina Beuthien-Baumann; Alexander Kurz; Satoshi Minoshima; Mony J de Leon Journal: J Nucl Med Date: 2008-02-20 Impact factor: 10.057
Authors: Rachel Mistur; Lisa Mosconi; Susan De Santi; Marla Guzman; Yi Li; Wai Tsui; Mony J de Leon Journal: J Clin Neurol Date: 2009-12-31 Impact factor: 3.077