Comparison of FDG-PET and IMP-SPECT in patients with dementia with Lewy bodies

Ishii, Kazunari; Hosaka, Kayo; Mori, Tetsuya; Mori, Etsuro

doi:10.1007/bf02984489

Cited by 41 publications

(21 citation statements)

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“…However, images obtained with positron emission tomography (PET) have much greater spatial resolution and attenuation correction than those obtained with SPECT. A study comparing PET and SPECT images in patients with DLB has verified the superiority of PET in demonstrating regional effects on cerebral metabolism in DLB [8]. In the present study, we compared cerebral glucose metabolism in patients with DLB, PDD and PD, using PET to search for any differences in the metabolic patterns produced by these diseases.…”

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confidence: 79%

A comparison of cerebral glucose metabolism in Parkinson's disease, Parkinson's disease dementia and dementia with Lewy bodies

Yong

Yoon

et al. 2007

Euro J of Neurology

130

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Parkinson's disease dementia (PDD) and dementia with Lewy bodies (DLB) share many similar aspects, and making a clinical diagnosis of one disorder over the other relies heavily on an arbitrary criterion, so-called 1-year rule. This study was designed to search for any difference of metabolic patterns in these two disorders using F-18 fluorodeoxyglucose (FDG) positron emission tomography (PET) images. We enrolled 16 patients with PD, 13 patients with PDD, and seven patients with DLB. FDG PET was performed, and images were reconstructed by iterative reconstruction using the computed tomography (CT) images, and were normalized to a standard template. Statistical comparison between groups were performed on a voxel-by-voxel basis using t-statistics (two-sample t-test). Compared with the patients with PD, both PDD and DLB patients showed similar patterns of decreased metabolism in bilateral inferior and medial frontal lobes, and right parietal lobe (P uncorrected < 0.001). In a direct comparison, DLB patients had significant metabolic decrease (p uncorrected < 0.005) in the anterior cingulate compared with those with PDD. These findings support the concept that PDD and DLB have similar underlying neurobiological characteristics, and that they can be regarded as a spectrum of Lewy body disorders.The current diagnostic consensus for differentiating dementia with Lewy bodies (DLB) from Parkinson's disease dementia (PDD) relies heavily on an arbitrary criterion, the so-called 1-year rule, in which the clinical diagnosis depends on the duration of parkinsonism prior to onset of dementia [1]. However, DLB and PDD share many clinical and neurobiological similarities, including similar motor effects, neuropsychological profiles, and neurochemical and neuropathological findings [2].Previous studies about cerebral metabolic profiles, which are helpful in understanding the underlying neurobiological basis have separately focused on patients with either DLB or PDD and have compared these patients with those suffering from Alzheimer's disease [3][4][5]. The few reports directly comparing perfusion profiles in patients with DLB and PDD using single-photon emission computed tomography (SPECT) have shown that DLB and PDD produce similar perfusion deficits in the frontal and lateral parieto-occipital regions [6,7]. However, images obtained with positron emission tomography (PET) have much greater spatial resolution and attenuation correction than those obtained with SPECT. A study comparing PET and SPECT images in patients with DLB has verified the superiority of PET in demonstrating regional effects on cerebral metabolism in DLB [8]. In the present study, we compared cerebral glucose metabolism in patients with DLB, PDD and PD, using PET to search for any differences in the metabolic patterns produced by these diseases. Patients and methods SubjectsWe enrolled 36 patients evaluated at Ajou University Hospital: seven patients with DLB, 13 with PDD and 16 with PD. Clinical diagnosis were made according to the consensus criteria for DLB...

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confidence: 79%

A comparison of cerebral glucose metabolism in Parkinson's disease, Parkinson's disease dementia and dementia with Lewy bodies

Yong

Yoon

et al. 2007

Euro J of Neurology

130

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“…PET has a higher sensitivity and a higher spatial resolution than SPECT, so it may be more suitable for distinguishing DLB and AD. 35 Combining measures of metaiodobenzylguanidine cardiac uptake reduction and MMSE score-change patterns with SPECT reduction patterns has been found to increase the accuracy of differentiating DLB from AD. 36,37 Moreover, MR imaging is widely available in general hospitals.…”

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confidence: 99%

Differential Diagnosis of Dementia with Lewy Bodies and Alzheimer Disease Using Combined MR Imaging and Brain Perfusion Single-Photon Emission Tomography

Goto¹,

Ishii²,

Uemura³

et al. 2010

AJNR Am J Neuroradiol

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“…For example, although some studies have suggested slight superiority of 18 F-FDG PET for diagnostic accuracy, in the largest study to date, both HMPAO SPECT and 18 F-FDG PET were able to completely separate all 26 AD cases from controls (11). There has been 1 small direct comparison study in DLB, finding that deficits on 18 F-FDG PET were greater than SPECT, though diagnostic accuracy was similar (12). This uncertainty over the relative merits of 18 F-FDG PET and HMPAO SPECT is reflected in guidelines for the use of imaging in the United Kingdom (2) and from the European Federation of Neurologic Societies (1), which advocate use of SPECT or 18 F-FDG PET and consider both diagnostically equivalent.…”

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¹⁸F-FDG PET and Perfusion SPECT in the Diagnosis of Alzheimer and Lewy Body Dementias

et al. 2014

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Brain imaging with glucose ( 18 F-FDG) PET or blood flow (hexamethylpropyleneamine oxime) SPECT is widely used for the differential diagnosis of dementia, though direct comparisons to clearly establish superiority of one method have not been undertaken. Methods: Subjects with Alzheimer disease (AD; n 5 38) and dementia with Lewy bodies (DLB; n 5 30) and controls (n 5 30) underwent 18 F-FDG PET and SPECT in balanced order. The main outcome measure was area under the curve (AUC) of receiver-operating-characteristic analysis of visual scan rating. Results: Consensus diagnosis with 18 F-FDG PET was superior to SPECT for both dementia vs. no-dementia (AUC 5 0.93 vs. 0.72, P 5 0.001) and AD vs. DLB (AUC 5 0.80 vs. 0.58, P 5 0.005) comparisons. The sensitivity and specificity for dementia/no-dementia was 85% and 90%, respectively, for 18 F-FDG PET and 71% and 70%, respectively, for SPECT. Conclusion: 18 F-FDG PET was significantly superior to blood flow SPECT. We recommend 18 F-FDG PET be performed instead of perfusion SPECT for the differential diagnosis of degenerative dementia if functional imaging is indicated.

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Comparison of FDG-PET and IMP-SPECT in patients with dementia with Lewy bodies

Abstract: Our findings suggest that parietal metabolism and perfusion are severely affected in DLB patients, though the occipital metabolic and perfusional reduction is thought to be a feature of DLB. FDG-PET is thought to be superior to IMP-SPECT in detecting functional changes in the DLB brain.

Cited by 41 publications

References 16 publications

A comparison of cerebral glucose metabolism in Parkinson's disease, Parkinson's disease dementia and dementia with Lewy bodies

A comparison of cerebral glucose metabolism in Parkinson's disease, Parkinson's disease dementia and dementia with Lewy bodies

Differential Diagnosis of Dementia with Lewy Bodies and Alzheimer Disease Using Combined MR Imaging and Brain Perfusion Single-Photon Emission Tomography

¹⁸F-FDG PET and Perfusion SPECT in the Diagnosis of Alzheimer and Lewy Body Dementias

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Comparison of FDG-PET and IMP-SPECT in patients with dementia with Lewy bodies

Abstract: Our findings suggest that parietal metabolism and perfusion are severely affected in DLB patients, though the occipital metabolic and perfusional reduction is thought to be a feature of DLB. FDG-PET is thought to be superior to IMP-SPECT in detecting functional changes in the DLB brain.

Cited by 41 publications

References 16 publications

A comparison of cerebral glucose metabolism in Parkinson's disease, Parkinson's disease dementia and dementia with Lewy bodies

A comparison of cerebral glucose metabolism in Parkinson's disease, Parkinson's disease dementia and dementia with Lewy bodies

Differential Diagnosis of Dementia with Lewy Bodies and Alzheimer Disease Using Combined MR Imaging and Brain Perfusion Single-Photon Emission Tomography

18F-FDG PET and Perfusion SPECT in the Diagnosis of Alzheimer and Lewy Body Dementias

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¹⁸F-FDG PET and Perfusion SPECT in the Diagnosis of Alzheimer and Lewy Body Dementias