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Longer-Term Investigation of the Value of 18F-FDG-PET and Magnetic Resonance Imaging for Predicting the Conversion of Mild Cognitive Impairment to Alzheimer's Disease: A Multicenter Study.
J Alzheimers Dis. 2017; 60(3):877-887.JA

Abstract

BACKGROUND

The value of fluorine-18-fluorodeoxyglucose positron emission tomography (18F-FDG-PET) and magnetic resonance imaging (MRI) for predicting conversion of mild cognitive impairment (MCI) to Alzheimer's disease (AD) in longer-term is unclear.

OBJECTIVE

To evaluate longer-term prediction of MCI to AD conversion using 18F-FDG-PET and MRI in a multicenter study.

METHODS

One-hundred and fourteen patients with MCI were followed for 5 years. They underwent clinical and neuropsychological examinations, 18F-FDG-PET, and MRI at baseline. PET images were visually classified into predefined dementia patterns. PET scores were calculated as a semi quantitative index. For structural MRI, z-scores in medial temporal area were calculated by automated volume-based morphometry (VBM).

RESULTS

Overall, 72% patients with amnestic MCI progressed to AD during the 5-year follow-up. The diagnostic accuracy of PET scores over 5 years was 60% with 53% sensitivity and 84% specificity. Visual interpretation of PET images predicted conversion to AD with an overall 82% diagnostic accuracy, 94% sensitivity, and 53% specificity. The accuracy of VBM analysis presented little fluctuation through 5 years and it was highest (73%) at the 5-year follow-up, with 79% sensitivity and 63% specificity. The best performance (87.9% diagnostic accuracy, 89.8% sensitivity, and 82.4% specificity) was with a combination identified using multivariate logistic regression analysis that included PET visual interpretation, educational level, and neuropsychological tests as predictors.

CONCLUSION

18F-FDG-PET visual assessment showed high performance for predicting conversion to AD from MCI, particularly in combination with neuropsychological tests. PET scores showed high diagnostic specificity. Structural MRI focused on the medial temporal area showed stable predictive value throughout the 5-year course.

Links

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Authors+Show Affiliations

Inui Y
Department of Clinical and Experimental Neuroimaging, National Center for Geriatrics and Gerontology, Aichi, Japan. Department of Radiology, Fujita Health University School of Medicine, Aichi, Japan.
Ito K
Department of Clinical and Experimental Neuroimaging, National Center for Geriatrics and Gerontology, Aichi, Japan. Department of Radiology, National Center for Geriatrics and Gerontology, Aichi, Japan.
Kato T
Department of Clinical and Experimental Neuroimaging, National Center for Geriatrics and Gerontology, Aichi, Japan. Department of Radiology, National Center for Geriatrics and Gerontology, Aichi, Japan.
SEAD-J Study Group
No affiliation info available

MeSH

AgedAlzheimer DiseaseBrainCognitive DysfunctionDisease ProgressionEducational StatusFemaleFluorodeoxyglucose F18Follow-Up StudiesHumansLogistic ModelsMagnetic Resonance ImagingMaleMultivariate AnalysisNeuropsychological TestsPositron-Emission TomographyPrognosisProspective StudiesRadiopharmaceuticalsSensitivity and Specificity

Pub Type(s)

Journal Article
Multicenter Study

Language

eng

PubMed ID

28922157

Citation

Inui, Yoshitaka, et al. "Longer-Term Investigation of the Value of 18F-FDG-PET and Magnetic Resonance Imaging for Predicting the Conversion of Mild Cognitive Impairment to Alzheimer's Disease: a Multicenter Study." Journal of Alzheimer's Disease : JAD, vol. 60, no. 3, 2017, pp. 877-887.
Inui Y, Ito K, Kato T, et al. Longer-Term Investigation of the Value of 18F-FDG-PET and Magnetic Resonance Imaging for Predicting the Conversion of Mild Cognitive Impairment to Alzheimer's Disease: A Multicenter Study. J Alzheimers Dis. 2017;60(3):877-887.
Inui, Y., Ito, K., & Kato, T. (2017). Longer-Term Investigation of the Value of 18F-FDG-PET and Magnetic Resonance Imaging for Predicting the Conversion of Mild Cognitive Impairment to Alzheimer's Disease: A Multicenter Study. Journal of Alzheimer's Disease : JAD, 60(3), 877-887. https://doi.org/10.3233/JAD-170395
Inui Y, et al. Longer-Term Investigation of the Value of 18F-FDG-PET and Magnetic Resonance Imaging for Predicting the Conversion of Mild Cognitive Impairment to Alzheimer's Disease: a Multicenter Study. J Alzheimers Dis. 2017;60(3):877-887. PubMed PMID: 28922157.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Longer-Term Investigation of the Value of 18F-FDG-PET and Magnetic Resonance Imaging for Predicting the Conversion of Mild Cognitive Impairment to Alzheimer's Disease: A Multicenter Study. AU - Inui,Yoshitaka, AU - Ito,Kengo, AU - Kato,Takashi, AU - ,, PY - 2017/9/19/pubmed PY - 2018/5/31/medline PY - 2017/9/19/entrez KW - Alzheimer’s disease KW - fluorodeoxyglucose F18 KW - magnetic resonance imaging KW - mild cognitive impairment KW - multicenter studies KW - positron-emission tomography SP - 877 EP - 887 JF - Journal of Alzheimer's disease : JAD JO - J Alzheimers Dis VL - 60 IS - 3 N2 - BACKGROUND: The value of fluorine-18-fluorodeoxyglucose positron emission tomography (18F-FDG-PET) and magnetic resonance imaging (MRI) for predicting conversion of mild cognitive impairment (MCI) to Alzheimer's disease (AD) in longer-term is unclear. OBJECTIVE: To evaluate longer-term prediction of MCI to AD conversion using 18F-FDG-PET and MRI in a multicenter study. METHODS: One-hundred and fourteen patients with MCI were followed for 5 years. They underwent clinical and neuropsychological examinations, 18F-FDG-PET, and MRI at baseline. PET images were visually classified into predefined dementia patterns. PET scores were calculated as a semi quantitative index. For structural MRI, z-scores in medial temporal area were calculated by automated volume-based morphometry (VBM). RESULTS: Overall, 72% patients with amnestic MCI progressed to AD during the 5-year follow-up. The diagnostic accuracy of PET scores over 5 years was 60% with 53% sensitivity and 84% specificity. Visual interpretation of PET images predicted conversion to AD with an overall 82% diagnostic accuracy, 94% sensitivity, and 53% specificity. The accuracy of VBM analysis presented little fluctuation through 5 years and it was highest (73%) at the 5-year follow-up, with 79% sensitivity and 63% specificity. The best performance (87.9% diagnostic accuracy, 89.8% sensitivity, and 82.4% specificity) was with a combination identified using multivariate logistic regression analysis that included PET visual interpretation, educational level, and neuropsychological tests as predictors. CONCLUSION: 18F-FDG-PET visual assessment showed high performance for predicting conversion to AD from MCI, particularly in combination with neuropsychological tests. PET scores showed high diagnostic specificity. Structural MRI focused on the medial temporal area showed stable predictive value throughout the 5-year course. SN - 1875-8908 UR - https://www.unboundmedicine.com/medline/citation/28922157/Longer_Term_Investigation_of_the_Value_of_18F_FDG_PET_and_Magnetic_Resonance_Imaging_for_Predicting_the_Conversion_of_Mild_Cognitive_Impairment_to_Alzheimer's_Disease:_A_Multicenter_Study_ DB - PRIME DP - Unbound Medicine ER -