Differential Diagnosis of Neurodegenerative Dementias Using Metabolic Phenotypes on F-18 FDG PET/CT

Tripathi, Madhavi; Damle, Nishikant; Kushwaha, Suman; Jaimini, Abhinav; D’Souza, Maria; Sharma, Rajnish; Saw, Sanjiv; Mondal, Anupam

doi:10.15274/nrj-2014-10002

Cited by 42 publications

(35 citation statements)

References 21 publications

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“…Diagnosis of bvFTD remains difficult, with patients being erroneously diagnosed with Alzheimer's disease (AD) or psychiatric disorders 5, 6, 7. A large body of work has demonstrated that brain imaging, in particular structural magnetic resonance imaging (MRI) and functional imaging of cerebral blood flow (CBF) with SPECT or cerebral metabolic rate of glucose (CMRgl) with fluorodeoxyglucose (FDG) positron emission tomography (PET), can improve the accuracy of differential diagnosis in bvFTD 8, 9, 10, 11, 12, 13, 14, 15, 16, 17. These findings led the Center for Medicare and Medicaid Services (CMS) to approve FDG‐PET as a diagnostic test for differentiating bvFTD from AD (https://www.cms.gov/medicare-coverage-database/details/ncd-details.aspx?NCDId=288&ncdver=3&bc=BAABAAAAAAAA&).…”

Section: Introductionmentioning

confidence: 99%

Diagnostic utility of ASL‐MRI and FDG‐PET in the behavioral variant of FTD and AD

Tosun

Schuff

Rabinovici

et al. 2016

Ann Clin Transl Neurol

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ObjectiveTo compare the values of arterial spin‐labeled (ASL) MRI and fluorodeoxyglucose (FDG) PET in the diagnosis of behavioral variant of frontotemporal dementia (bvFTD) and Alzheimer's disease (AD).MethodsPartial least squares logistic regression was used to identify voxels with diagnostic value in cerebral blood flow (CBF) and cerebral metabolic rate of glucose (CMRgl) maps from patients with bvFTD (n = 32) and AD (n = 28), who were compared with each other and with cognitively normal controls (CN, n = 15). Diagnostic values of these maps were compared with each other.ResultsRegions that differentiated each disorder from controls were similar for CBF and CMRgl. For differentiating AD from CN, the areas under the curve (AUC) for CBF (0.89) and CMRgl (0.91) were similar, with similar sensitivity (CBF: 86%, CMRgl: 78%) and specificity (CBF: 92%, CMRgl: 100%). Likewise, for differentiating bvFTD from CN performances of CBF (AUC = 0.83) and CMRgl (AUC = 0.85) were equivalent, with similar sensitivity (CBF: 78%, CMRgl: 79%) and specificity (CBF: 92%, CMRgl: 100%). In differentiating bvFTD from AD, classification was again similar for CBF (AUC = 0.87) and CMRgl (AUC = 0.79), as were sensitivity (CBF: 83%, CMRgl: 89%) and specificity (CBF: 93%, CMRgl: 78%). None of the differences in any performance measure were statistically significant.InterpretationASL‐MRI has similar diagnostic utility as FDG‐PET in the diagnosis of AD and bvFTD. Continued development of ASL‐MRI as a diagnostic tool for neurodegenerative dementias is warranted.

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Section: Introductionmentioning

confidence: 99%

Diagnostic utility of ASL‐MRI and FDG‐PET in the behavioral variant of FTD and AD

Tosun

Schuff

Rabinovici

et al. 2016

Ann Clin Transl Neurol

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“…F-18 FDG PET ile saptanan serebral glukoz hipometabolizması nöronal hasar ve nörodejenerasyonun bir göstergesidir. Bölgesel glukoz hipometabolizmasının karakteristik paternleri AH, FTD ve LCD gibi pek çok nörodejeneratif demans tipi ile ilişkilidir (6). Sağlıklı bireylerde en yoğun FDG uptake'i subkortikal gri cevherde (putamen, kaudat nükleus ve talamusta) izlenirken bunları kortikal gri cevher izlemektedir.…”

Section: F-18 Florodeoksiglukoz Pozitron Emisyon Tomografi/bilgisayarunclassified

Nuclear Medicine Methods in Dementia

Budak¹,

Aydın²

2017

Nts

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“…[9] SA is among a minority of countries that can provide both 18 [6,7] and Worsely et al [8] Evidence is also rapidly accumulating for multiple non-oncological indications in the fields of cardiology, [10] neurology [11] and infection imaging. [12] This growth is expected to continue with existing tracers, and with the numerous possibilities created by new tracers.…”

Section: The South African Contextmentioning

confidence: 99%

Appropriate indications for positron emission tomography/computed tomography: College of Nuclear Physicians of the Colleges of Medicine of South Africa

et al. 2015

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A patient-tailored treatment approach demands precise determin ation of initial disease extent combined with early, accurate assessment of response to treatment. Positron emission tomography/computed tomography (PET/CT) is currently the most widely used molecular imaging technology and is central to the advancement of patient care and biological research. [1,2] PET/CT whole-body imaging PET is a non-invasive tool that provides tomographic images and quantitative parameters of perfusion, cell viability, and proliferation and/or metabolic activity of tissues. These images result from the use of various biological compounds (such as sugars, amino acids, metabolic precursors and hormones) labelled with positronemitting radionuclides (PET radiopharmaceuticals).[1] Fusion of the functional information with the morphological detail provided by CT as PET/CT can provide clinicians with a sensitive and accurate one-step whole-body diagnostic and prognostic tool, which directs and changes patient management. [1,3] Several studies have demonstrated the superiority of combined PET/CT over either modality alone, and for many indications this is generally accepted as the gold standard for imaging in oncol ogy. [4] The value of PET/CT imaging has been best demonstrated in the setting of oncology with the use of fluorine-18-fluorodeoxyglucose ( 18 F-FDG). FDG is an analogue of glucose and is taken up by cells via the first stages of the normal glucose pathway and trapped inside cells with high glucose transporter expression and/or glycolytic activity. Tumour uptake therefore correlates with tumour growth and viability, providing metabolic quantification and frequently useful information for tumour characterisation, patient prognosis and monitoring of therapeutic response.[1] Impact on the management of oncology patientsCurrent data suggest that in as many as one-third to one-half of cancer cases, physicians without access to PET are at an increased risk of selecting the wrong management/treatment strategy for their patients. Three large-scale national studies published by the National Oncologic PET Registry in the USA have shown that PET imaging changes the intended patient management strategy in 36.5%, 38% and 49% of cases, respectively. [5][6][7] Results were consistent across all cancer types.[6] A recent study by Worsley et al. [8] found that the information derived from PET Individualised patient treatment approaches demand precise determination of initial disease extent combined with early, accurate assessment of response to treatment, which is made possible by positron emission tomography/computed tomography (PET/CT). PET is a non-invasive tool that provides tomographic images and quantitative parameters of perfusion, cell viability, proliferation and/or metabolic activity of tissues. Fusion of the functional information with the morphological detail provided by CT as PET/CT can provide clinicians with a sensitive and accurate one-step whole-body diagnostic and prognostic tool, which directs and changes patient management...

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Differential Diagnosis of Neurodegenerative Dementias Using Metabolic Phenotypes on F-18 FDG PET/CT

Cited by 42 publications

References 21 publications

Diagnostic utility of ASL‐MRI and FDG‐PET in the behavioral variant of FTD and AD

Diagnostic utility of ASL‐MRI and FDG‐PET in the behavioral variant of FTD and AD

Nuclear Medicine Methods in Dementia

Appropriate indications for positron emission tomography/computed tomography: College of Nuclear Physicians of the Colleges of Medicine of South Africa

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