Clinical impact and diagnostic accuracy of 2-[18F]-fluoro-2-deoxy-d-glucose positron-emission tomography/computed tomography (PET/CT) brain imaging in patients with cognitive impairment: a tertiary centre experience in the UK

Motara, H.; Olusoga, Tolulope; Russell, Gregor; Jamieson, Stuart W.; Ahmed, Suman; Brindle, Nick; Pillai, Anil K.; Scarsbrook, Andrew; Patel, Chirag; Chowdhury, Fahmid U.

doi:10.1016/j.crad.2016.08.003

Cited by 7 publications

(3 citation statements)

References 25 publications

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“…Furthermore, in our cohort, the use of biomarkers led to a therapeutic change in one-third of the patients. These data are in accordance with previous studies that showed a similar proportion of treatment change when evaluating isolated amyloid-PET or CSF [15,16]. All of these data suggest that well-defined diagnosis in patients with early-onset cognitive impairment could have direct implications on their therapeutic management.…”

Section: Discussionsupporting

confidence: 91%

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Clinical applicability of diagnostic biomarkers in early‐onset cognitive impairment

Falgàs

Tort‐Merino

Balasa

et al. 2019

Euro J of Neurology

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Background and purpose Several diagnostic biomarkers are currently available for clinical use in early‐onset cognitive impairment. The decision on which biomarker is used in each patient depends on several factors such as its predictive value or tolerability. Methods There were a total of 40 subjects with early‐onset cognitive complaints (<65 years of age): 26 with Alzheimer's disease (AD), five with frontotemporal dementia and nine with diagnostic suspicion of non‐neurodegenerative disorder. Clinical and neuropsychological evaluation, lumbar puncture for cerebrospinal fluid (CSF) AD core biochemical marker determination, medial temporal atrophy evaluation on magnetic resonance imaging, amyloid‐positron emission tomography (PET) and 18F‐fluorodeoxyglucose‐PET were performed. Neurologists provided pre‐ and post‐biomarker diagnosis, together with diagnostic confidence and clinical/therapeutic management. Patients scored the tolerability of each procedure. Results Cerebrospinal fluid biomarkers and amyloid‐PET increased diagnostic confidence in AD (77.4%–86.2% after CSF, 92.4% after amyloid‐PET, P < 0.01) and non‐neurodegenerative conditions (53.6%–75% after CSF, 95% after amyloid‐PET, P < 0.05). Biomarker results led to diagnostic (32.5%) and treatment (32.5%) changes. All tests were well tolerated. Conclusions Biomarker procedures are well tolerated and have an important diagnostic/therapeutic impact on early‐onset cognitive impairment.

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Section: Discussionsupporting

confidence: 91%

“…The percentage of diagnostic/therapeutic change due to biomarkers is in accordance with other publications although most of them evaluated it in late‐onset AD . These data together reflect the important impact of AD biomarkers in daily clinical practice in the diagnostic work‐up of early‐onset cognitive impairment.…”

Section: Discussionsupporting

confidence: 87%

Clinical applicability of diagnostic biomarkers in early‐onset cognitive impairment

Falgàs

Tort‐Merino

Balasa

et al. 2019

Euro J of Neurology

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“…The effects of neuroimaging on clinical confidence analyses are not an area that has been investigated rigourously, the effects of analyses even less so. [58][59][60][61] The literature appears to concentrate more on novel methods rather than demonstrating the usefulness of existing ones.…”

Section: Discussionmentioning

confidence: 99%

Creation of an anthropomorphic CT head phantom for verification of image segmentation

Holmes¹,

Negus²,

Wiltshire³

et al. 2020

Medical Physics

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Purpose: Many methods are available to segment structural magnetic resonance (MR) images of the brain into different tissue types. These have generally been developed for research purposes but there is some clinical use in the diagnosis of neurodegenerative diseases such as dementia. The potential exists for computed tomography (CT) segmentation to be used in place of MRI segmentation, but this will require a method to verify the accuracy of CT processing, particularly if algorithms developed for MR are used, as MR has notably greater tissue contrast. Methods: To investigate these issues we have created a three-dimensional (3D) printed brain with realistic Hounsfield unit (HU) values based on tissue maps segmented directly from an individual T1 MRI scan of a normal subject. Several T1 MRI scans of normal subjects from the ADNI database were segmented using SPM12 and used to create stereolithography files of different tissues for 3D printing. The attenuation properties of several material blends were investigated, and three suitable formulations were used to print an object expected to have realistic geometry and attenuation properties. A skull was simulated by coating the object with plaster of Paris impregnated bandages. Using two CT scanners, the realism of the phantom was assessed by the measurement of HU values, SPM12 segmentation and comparison with the source data used to create the phantom. Results: Realistic relative HU values were measured although a subtraction of 60 was required to obtain equivalence with the expected values (gray matter 32.9-35.8 phantom, 29.9-34.2 literature). Segmentation of images acquired at different kVps/mAs showed excellent agreement with the source data (Dice Similarity Coefficient 0.79 for gray matter). The performance of two scanners with two segmentation methods was compared, with the scanners found to have similar performance and with one segmentation method clearly superior to the other. Conclusion: The ability to use 3D printing to create a realistic (in terms of geometry and attenuation properties) head phantom has been demonstrated and used in an initial assessment of CT segmentation accuracy using freely available software developed for MRI.

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Frontotemporal Dementia

2018

Specialty Imaging: PET

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Frontotemporal dementia refers to a diverse group of conditions that collectively are a major cause of young onset dementia Frontotemporal dementia produces selective brain atrophy involving the frontal and temporal lobes, requiring brain magnetic resonance imaging for accurate diagnosis Clinically, these diseases present chiefly as progressive aphasia or as disintegration of personality and behaviour that may be misdiagnosed as a psychiatric disorder Up to around a quarter of cases arise from dominant mutations in one of three major causative genes Frontotemporal dementia is commonly associated with other neurological impairment, in particular parkinsonism or motor neurone disease Treatment remains supportive, but patients and families need extensive counselling, future planning, and involvement of social and mental health services Sources and selection criteria We examined recent literature on frontotemporal dementia, targeting full text English language studies published since 1990. We selected articles on the basis of our personal knowledge and searches of the Medline database using the terms "frontotemporal dementia," "frontotemporal lobar degeneration," "progressive nonfluent aphasia," "semantic dementia," and "logopenic aphasia," and each of these terms in conjunction with "diagnosis," "treatment," and "therapy." The final selection of references was based on our judgment of relevance, completeness, and compatibility with recent clinical, pathological, and genetic criteria.

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Clinical impact and diagnostic accuracy of 2-[18F]-fluoro-2-deoxy-d-glucose positron-emission tomography/computed tomography (PET/CT) brain imaging in patients with cognitive impairment: a tertiary centre experience in the UK

Cited by 7 publications

References 25 publications

Clinical applicability of diagnostic biomarkers in early‐onset cognitive impairment

Clinical applicability of diagnostic biomarkers in early‐onset cognitive impairment

Creation of an anthropomorphic CT head phantom for verification of image segmentation

Frontotemporal Dementia

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