These different regional CMRglc reductions substantiate the pathologic, neurochemical, and clinical differences between DLB and AD.

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In very mild AD, both FDG-PET and VBM-MRI had high accuracy for diagnosis, but FDG-PET showed slightly higher accuracy than VBM-MRI. Combination of the two techniques will yield a higher diagnostic accuracy in very mild AD by making full use of functional and morphological images.

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The fully automatic diagnostic system for EO and LO AD was able to perform at a similar diagnostic level to visual inspection of conventional axial images by experts.

The fully automatic differential diagnosis system for distinction between mild DLB and AD showed a similar diagnostic accuracy to visual inspection by experts. It would be a useful diagnostic tool to distinguish mild DLB from mild AD in clinical practice.

Although decreased posterior cingulate metabolism in Alzheimer's disease (AD) has been previously reported, there have been no reports on posterior cingulate perfusion. In this study we evaluated posterior cingulate perfusion as a relative value using statistical parametric maps (SPMs) and as an absolute value using conventional region of interest (ROI) settings. Twenty-eight subjects, including 14 patients with mild AD (mean age: 66.4+/-12.1 years) and 14 normal controls (65.9+/-7.3 years) were studied. Regional cerebral blood flow (CBF) was measured with H215O and positron emission tomography (PET). In the SPM analysis, the left posterior cingulate and left parietotemporal CBFs were significantly decreased in the patients with mild AD (P<0.001). At a lower statistical threshold (P<0.05), the right posterior cingulate and right parietotemporal CBFs were also significantly decreased in the AD patients. In the ROI studies, the left parietal and posterior cingulate CBFs in the patients with mild AD were significantly lower than those of the normal controls by analysis of variance and post-hoc Scheffé's test (P<0.001). We conclude that posterior cingulate perfusion is decreased in mild AD, reflecting the pathological changes and metabolic reduction in the posterior cingulate gyrus that have previously been reported to occur in mild AD.