Comparison of ¹⁸F-FDG PET and arterial spin labeling MRI in evaluating Alzheimer's disease and amnestic mild cognitive impairment using integrated PET/MR.

IF 3.1 3区医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING EJNMMI Research Pub Date : 2024-01-25 DOI:10.1186/s13550-024-01068-8

Sheng Bi, Shaozhen Yan, Zhigeng Chen, Bixiao Cui, Yi Shan, Hongwei Yang, Zhigang Qi, Zhilian Zhao, Ying Han, Jie Lu

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Abstract

Background: Developing biomarkers for early stage AD patients is crucial. Glucose metabolism measured by ¹⁸F-FDG PET is the most common biomarker for evaluating cellular energy metabolism to diagnose AD. Arterial spin labeling (ASL) MRI can potentially provide comparable diagnostic information to ¹⁸F-FDG PET in patients with neurodegenerative disorders. However, the conclusions about the diagnostic performance of AD are still controversial between ¹⁸F-FDG PET and ASL. This study aims to compare quantitative cerebral blood flow (CBF) and glucose metabolism measured by ¹⁸F-FDG PET diagnostic values in patients with Alzheimer's disease (AD) and amnestic mild cognitive impairment (aMCI) using integrated PET/MR.

Results: Analyses revealed overlapping between decreased regional rCBF and ¹⁸F-FDG PET SUVR in patients with AD compared with NC participants in the bilateral parietotemporal regions, frontal cortex, and cingulate cortex. Compared with NC participants, patients with aMCI exclusively demonstrated lower ¹⁸F-FDG PET SUVR in the bilateral temporal cortex, insula cortex, and inferior frontal cortex. Comparison of the rCBF in patients with aMCI and NC participants revealed no significant difference (P > 0.05). The ROC analysis of rCBF in the meta-ROI could diagnose patients with AD (AUC, 0.87) but not aMCI (AUC, 0.61). The specificity of diagnosing aMCI has been improved to 75.56% when combining rCBF and ¹⁸F-FDG PET SUVR.

Conclusion: ASL could detect similar aberrant patterns of abnormalities compared to ¹⁸F-FDG PET in patients with AD compared with NC participants but not in aMCI. The diagnostic efficiency of ¹⁸F-FDG-PET for AD and aMCI patients remained higher to ASL. Our findings support that applying ¹⁸F-FDG PET may be preferable for diagnosing AD and aMCI.

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使用综合 PET/MR 评估阿尔茨海默病和失忆性轻度认知障碍时 18F-FDG PET 与动脉自旋标记 MRI 的比较。

背景：为早期注意力缺失症患者开发生物标志物至关重要。18F-FDG PET 测量的葡萄糖代谢是评估细胞能量代谢的最常见生物标记物，可用于诊断注意力缺失症。动脉自旋标记（ASL）核磁共振成像可为神经退行性疾病患者提供与 18F-FDG PET 相当的诊断信息。然而，18F-FDG PET 和 ASL 对 AD 诊断性能的结论仍存在争议。本研究旨在比较 18F-FDG PET 对阿尔茨海默病（AD）和失智性轻度认知障碍（aMCI）患者的定量脑血流（CBF）和葡萄糖代谢的诊断价值：分析显示，与NC参与者相比，AD患者双侧顶颞区、额叶皮层和扣带皮层的区域rCBF和18F-FDG PET SUVR下降有重叠。与 NC 参与者相比，aMCI 患者的双侧颞叶皮质、岛叶皮质和下额叶皮质的 18F-FDG PET SUVR 均较低。对 aMCI 患者和 NC 参与者的 rCBF 进行比较后发现，两者没有显著差异（P > 0.05）。在元ROI中，rCBF的ROC分析可以诊断出AD患者（AUC，0.87），但不能诊断出aMCI患者（AUC，0.61）。结合 rCBF 和 18F-FDG PET SUVR，诊断 aMCI 的特异性提高到 75.56%：结论：与 18F-FDG PET 相比，ASL 能检测出 AD 患者与 NC 参与者相似的异常模式，但不能检测出 aMCI。18F-FDG-PET对AD和aMCI患者的诊断效率仍然高于ASL。我们的研究结果支持应用18F-FDG PET诊断AD和aMCI。

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来源期刊

EJNMMI Research RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING&nb-

CiteScore

5.90

自引率

3.10%

发文量

审稿时长

13 weeks

期刊介绍： EJNMMI Research publishes new basic, translational and clinical research in the field of nuclear medicine and molecular imaging. Regular features include original research articles, rapid communication of preliminary data on innovative research, interesting case reports, editorials, and letters to the editor. Educational articles on basic sciences, fundamental aspects and controversy related to pre-clinical and clinical research or ethical aspects of research are also welcome. Timely reviews provide updates on current applications, issues in imaging research and translational aspects of nuclear medicine and molecular imaging technologies. The main emphasis is placed on the development of targeted imaging with radiopharmaceuticals within the broader context of molecular probes to enhance understanding and characterisation of the complex biological processes underlying disease and to develop, test and guide new treatment modalities, including radionuclide therapy.