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Initial clinical comparison of 18F-florbetapir and 18F-FDG PET in patients with Alzheimer disease and controls.
J Nucl Med 2012; 53(6):902-7JN

Abstract

The purpose of this study was to determine how clinical interpretations of the (18)F-amyloid tracer florbetapir compares diagnostically with (18)F-FDG PET when evaluating patients with Alzheimer disease (AD) and controls.

METHODS

Nineteen patients with a clinical diagnosis of AD and 21 elderly controls were evaluated with both (18)F-florbetapir and (18)F-FDG PET scans. Scans were interpreted together by 2 expert readers masked to any case information and were assessed for tracer binding patterns consistent with AD. The criteria for interpreting the (18)F-florbetapir scan as positive for AD was the presence of binding in the cortical regions relative to the cerebellum. (18)F-FDG PET scans were interpreted as positive if they displayed the classic pattern of hypometabolism in the temporoparietal regions. Scans were interpreted as either positive or negative for AD. In addition, a relative scoring system was used to assess the degree of either hypometabolism or amyloid binding in specified regions. The metabolism and amyloid binding scores for each region were compared across subjects. An overall ratio was calculated on the basis of values in regions expected to be affected by AD and those not expected to be affected. The metabolic ratio and amyloid ratio were then correlated with the mini-mental status examination (MMSE) score.

RESULTS

The sensitivity and specificity, compared with the clinical diagnosis of AD or controls, for the (18)F-florbetapir scans were 95% and 95%, respectively, and for the (18)F-FDG scans 89% and 86%, respectively. When a comparison with MMSE scores was made, (18)F-FDG significantly correlated with MMSE when both controls and AD patients were included (r = 0.79, P < 0.0001) and in AD patients alone (r = 0.70, P = 0.001). The (18)F-florbetapir scores significantly correlated with MMSE scores only when both controls and AD patients were included (r = 0.62, P < 0.001) but not in the AD group alone (r = 0.12, P = 0.66).

CONCLUSION

Overall, both scans performed well in detecting AD in patients with known clinical AD. Both scans correlated well with cognitive status as determined by MMSE when the entire cohort of controls and AD patients was evaluated. However, only the (18)F-FDG scans correlated with cognitive status when AD patients were evaluated separately.

Authors+Show Affiliations

Thomas Jefferson University and Hospital, Philadelphia, Pennsylvania 19107, USA. Andrew.newberg@jefferson.eduNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Research Support, N.I.H., Extramural

Language

eng

PubMed ID

22577238

Citation

Newberg, Andrew B., et al. "Initial Clinical Comparison of 18F-florbetapir and 18F-FDG PET in Patients With Alzheimer Disease and Controls." Journal of Nuclear Medicine : Official Publication, Society of Nuclear Medicine, vol. 53, no. 6, 2012, pp. 902-7.
Newberg AB, Arnold SE, Wintering N, et al. Initial clinical comparison of 18F-florbetapir and 18F-FDG PET in patients with Alzheimer disease and controls. J Nucl Med. 2012;53(6):902-7.
Newberg, A. B., Arnold, S. E., Wintering, N., Rovner, B. W., & Alavi, A. (2012). Initial clinical comparison of 18F-florbetapir and 18F-FDG PET in patients with Alzheimer disease and controls. Journal of Nuclear Medicine : Official Publication, Society of Nuclear Medicine, 53(6), pp. 902-7. doi:10.2967/jnumed.111.099606.
Newberg AB, et al. Initial Clinical Comparison of 18F-florbetapir and 18F-FDG PET in Patients With Alzheimer Disease and Controls. J Nucl Med. 2012;53(6):902-7. PubMed PMID: 22577238.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Initial clinical comparison of 18F-florbetapir and 18F-FDG PET in patients with Alzheimer disease and controls. AU - Newberg,Andrew B, AU - Arnold,Steven E, AU - Wintering,Nancy, AU - Rovner,Barry W, AU - Alavi,Abass, Y1 - 2012/05/10/ PY - 2012/5/12/entrez PY - 2012/5/12/pubmed PY - 2012/8/8/medline SP - 902 EP - 7 JF - Journal of nuclear medicine : official publication, Society of Nuclear Medicine JO - J. Nucl. Med. VL - 53 IS - 6 N2 - UNLABELLED: The purpose of this study was to determine how clinical interpretations of the (18)F-amyloid tracer florbetapir compares diagnostically with (18)F-FDG PET when evaluating patients with Alzheimer disease (AD) and controls. METHODS: Nineteen patients with a clinical diagnosis of AD and 21 elderly controls were evaluated with both (18)F-florbetapir and (18)F-FDG PET scans. Scans were interpreted together by 2 expert readers masked to any case information and were assessed for tracer binding patterns consistent with AD. The criteria for interpreting the (18)F-florbetapir scan as positive for AD was the presence of binding in the cortical regions relative to the cerebellum. (18)F-FDG PET scans were interpreted as positive if they displayed the classic pattern of hypometabolism in the temporoparietal regions. Scans were interpreted as either positive or negative for AD. In addition, a relative scoring system was used to assess the degree of either hypometabolism or amyloid binding in specified regions. The metabolism and amyloid binding scores for each region were compared across subjects. An overall ratio was calculated on the basis of values in regions expected to be affected by AD and those not expected to be affected. The metabolic ratio and amyloid ratio were then correlated with the mini-mental status examination (MMSE) score. RESULTS: The sensitivity and specificity, compared with the clinical diagnosis of AD or controls, for the (18)F-florbetapir scans were 95% and 95%, respectively, and for the (18)F-FDG scans 89% and 86%, respectively. When a comparison with MMSE scores was made, (18)F-FDG significantly correlated with MMSE when both controls and AD patients were included (r = 0.79, P < 0.0001) and in AD patients alone (r = 0.70, P = 0.001). The (18)F-florbetapir scores significantly correlated with MMSE scores only when both controls and AD patients were included (r = 0.62, P < 0.001) but not in the AD group alone (r = 0.12, P = 0.66). CONCLUSION: Overall, both scans performed well in detecting AD in patients with known clinical AD. Both scans correlated well with cognitive status as determined by MMSE when the entire cohort of controls and AD patients was evaluated. However, only the (18)F-FDG scans correlated with cognitive status when AD patients were evaluated separately. SN - 1535-5667 UR - https://www.unboundmedicine.com/medline/citation/22577238/Initial_clinical_comparison_of_18F_florbetapir_and_18F_FDG_PET_in_patients_with_Alzheimer_disease_and_controls_ L2 - http://jnm.snmjournals.org/cgi/pmidlookup?view=long&amp;pmid=22577238 DB - PRIME DP - Unbound Medicine ER -