Yuhei Chiba1,2,3, Hiroshige Fujishiro1,4, Eizo Iseki1,5, Koji Kasanuki1,6, Kiyoshi Sato1. 1. PET/CT Dementia Research Center, Juntendo Tokyo Koto Geriatric Medical Center, Juntendo University School of Medicine, 3-3-20 Shinsuna, Koto-Ku, Tokyo, 136-0075, Japan. 2. Department of Psychiatry, Yokohama Maioka Hospital, 3482 Maiokacho, Totsuka-Ku, Yokohama City, Kanagawa, 244-0813, Japan. 3. Department of Psychiatry, Yokohama City University School of Medicine, 3-9 Fukuura, Kanazawa-Ku, Yokohama-shi, Kanagawa, 236-0004, Japan. 4. Department of Psychiatry, Kawasaki Memorial Hospital, 20-1 Shiomidai, Miyamae-Ku, Kawasaki City, Yokohama, Kanagawa, 216-0013, Japan. 5. Senior Mental Clinic Nihonbashi Ningyocho, 2-2-3 Nihonbashi Ningyocho, Chuo, Tokyo, 103-0013, Japan. 6. Department of Psychiatry, Juntendo University School of Medicine, 2-1-1 Hongo, Bunkyo-Ku, Tokyo, 113-8421, Japan.
Abstract
BACKGROUND AND PURPOSE: The cingulate island sign (CIS) on 18 F-fluorodeoxyglucose positron emission tomography (FDG-PET); ie, the relative preservation of mid-posterior cingulate cortex metabolism, is a supportive biomarker in the diagnostic criteria for dementia with Lewy bodies (DLB). However, limited information is currently available on the diagnostic value of the CIS on FDG-PET or 123 I-iodoamphetamine single-photon emission computed tomography (IMP-SPECT) for differentiating between mild cognitive impairment (MCI) due to Alzheimer's disease (AD) (MCI-AD) and MCI due to DLB (MCI-DLB). METHODS: We examined the CIS ratio in 9 AD patients, 9 DLB patients, 8 patients with MCI-AD, and 9 patients with MCI-DLB using FDG-PET and IMP-SPECT. The CIS ratio was calculated using NEUROSTAT software. RESULTS: In the dementia groups, a receiver operating characteristic analysis of the CIS ratio showed significant accuracy for differentiating between AD and DLB on FDG-PET and IMP-SPECT. In the MCI groups, only the FDG-PET derived CIS ratio displayed significant accuracy for differentiating between AD and DLB. CONCLUSIONS: The FDG-PET and IMP-SPECT derived CIS ratios are both useful for differentiating between AD and DLB. The FDG-PET derived CIS ratio is more valuable than the IMP-SPECT derived CIS ratio for differential diagnosis in patients with MCI. A larger study is needed to confirm these results.
BACKGROUND AND PURPOSE: The cingulate island sign (CIS) on 18 F-fluorodeoxyglucose positron emission tomography (FDG-PET); ie, the relative preservation of mid-posterior cingulate cortex metabolism, is a supportive biomarker in the diagnostic criteria for dementia with Lewy bodies (DLB). However, limited information is currently available on the diagnostic value of the CIS on FDG-PET or 123 I-iodoamphetamine single-photon emission computed tomography (IMP-SPECT) for differentiating between mild cognitive impairment (MCI) due to Alzheimer's disease (AD) (MCI-AD) and MCI due to DLB (MCI-DLB). METHODS: We examined the CIS ratio in 9 ADpatients, 9 DLB patients, 8 patients with MCI-AD, and 9 patients with MCI-DLB using FDG-PET and IMP-SPECT. The CIS ratio was calculated using NEUROSTAT software. RESULTS: In the dementia groups, a receiver operating characteristic analysis of the CIS ratio showed significant accuracy for differentiating between AD and DLB on FDG-PET and IMP-SPECT. In the MCI groups, only the FDG-PET derived CIS ratio displayed significant accuracy for differentiating between AD and DLB. CONCLUSIONS: The FDG-PET and IMP-SPECT derived CIS ratios are both useful for differentiating between AD and DLB. The FDG-PET derived CIS ratio is more valuable than the IMP-SPECT derived CIS ratio for differential diagnosis in patients with MCI. A larger study is needed to confirm these results.
Authors: Michael J Firbank; John T O'Brien; Rory Durcan; Louise M Allan; Sally Barker; Joanna Ciafone; Paul C Donaghy; Calum A Hamilton; Sarah Lawley; Jim Lloyd; Gemma Roberts; John-Paul Taylor; Alan J Thomas Journal: J Neurol Date: 2020-10-21 Impact factor: 4.849