PDF(Pubmed)
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.
CONCLUSIONS: 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.
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.
CONCLUSIONS: 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.
摘要：
背景：开发早期AD患者的生物标志物至关重要。通过18F-FDGPET测量的葡萄糖代谢是用于评估细胞能量代谢以诊断AD的最常见的生物标志物。动脉自旋标记（ASL）MRI可能为神经退行性疾病患者提供与18F-FDGPET相当的诊断信息。然而,18F-FDGPET和ASL对AD诊断性能的结论仍存在争议。这项研究旨在比较使用集成PET/MR通过18F-FDGPET测量的定量脑血流量（CBF）和葡萄糖代谢对阿尔茨海默病（AD）和遗忘型轻度认知障碍（aMCI）患者的诊断价值。
结果：分析显示，与双侧顶颞区的NC参与者相比，AD患者中降低的区域rCBF和18F-FDGPETSUVR重叠，额叶皮质,和扣带皮质.与NC参与者相比，aMCI患者仅在双侧颞叶皮质表现出较低的18F-FDGPETSUVR，脑岛皮层,和下额叶皮层.aMCI患者和NC患者的rCBF比较差异无统计学意义（P>0.05）。meta-ROI中rCBF的ROC分析可以诊断AD患者(AUC,0.87)，但不是aMCI(AUC，0.61)。结合rCBF和18F-FDGPETSUVR诊断aMCI的特异性提高到75.56%。
结论：与18F-FDGPET相比，在AD患者中，与NC参与者相比，ASL可以检测到类似的异常异常模式，但在aMCI中没有。18F-FDG-PET对AD和aMCI患者的诊断效率仍然高于ASL。我们的发现支持应用18F-FDGPET可能更适合诊断AD和aMCI。
结果：分析显示，与双侧顶颞区的NC参与者相比，AD患者中降低的区域rCBF和18F-FDGPETSUVR重叠，额叶皮质,和扣带皮质.与NC参与者相比，aMCI患者仅在双侧颞叶皮质表现出较低的18F-FDGPETSUVR，脑岛皮层,和下额叶皮层.aMCI患者和NC患者的rCBF比较差异无统计学意义（P>0.05）。meta-ROI中rCBF的ROC分析可以诊断AD患者(AUC,0.87)，但不是aMCI(AUC，0.61)。结合rCBF和18F-FDGPETSUVR诊断aMCI的特异性提高到75.56%。
结论：与18F-FDGPET相比，在AD患者中，与NC参与者相比，ASL可以检测到类似的异常异常模式，但在aMCI中没有。18F-FDG-PET对AD和aMCI患者的诊断效率仍然高于ASL。我们的发现支持应用18F-FDGPET可能更适合诊断AD和aMCI。
