DOI: 10.1007/s00259-017-3761-xPages: 2042-2052

Early identification of MCI converting to AD: a FDG PET study

1. Institute of Cognitive Sciences and Technologies, CNR

2. Karolinska Hospital Stockholm, Department of Nuclear Medicine

3. University of Genoa and IRCCS AOU San Martino-IST, Clinical Neurology, Department of Neuroscience (DINOGMI)

4. University of Genoa and IRCCS AOU San Martino-IST, Department of Nuclear Medicine, Department of Health Science (DISSAL)

5. Istituto Superiore di Sanità, Environment and Health Department

6. Karolinska Hospital, Department of Hospital Physics

7. IRCCS AOU San Martino-IST, Clinical Psychology

8. National Institute of Nuclear Physics (INFN), Genoa section

9. Karolinska University Hospital, Medical Radiation Physics and Nuclear Medicine, Imaging and Physiology

10. AOU San Martino-IST, Institute of Molecular Bioimaging and Physiology, CNR - Genoa Unit

Correspondence to:
Marco Pagani
Tel: +39-06-44362370-5
Email: marco.pagani@istc.cnr.it

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Abstract

Purpose

Mild cognitive impairment (MCI) is a transitional pathological stage between normal ageing (NA) and Alzheimer’s disease (AD). Although subjects with MCI show a decline at different rates, some individuals remain stable or even show an improvement in their cognitive level after some years. We assessed the accuracy of FDG PET in discriminating MCI patients who converted to AD from those who did not.

Methods

FDG PET was performed in 42 NA subjects, 27 MCI patients who had not converted to AD at 5 years (nc-MCI; mean follow-up time 7.5 ± 1.5 years), and 95 MCI patients who converted to AD within 5 years (MCI-AD; mean conversion time 1.8 ± 1.1 years). Relative FDG uptake values in 26 meta-volumes of interest were submitted to ANCOVA and support vector machine analyses to evaluate regional differences and discrimination accuracy.

Results

The MCI-AD group showed significantly lower FDG uptake values in the temporoparietal cortex than the other two groups. FDG uptake values in the nc-MCI group were similar to those in the NA group. Support vector machine analysis discriminated nc-MCI from MCI-AD patients with an accuracy of 89% (AUC 0.91), correctly detecting 93% of the nc-MCI patients.

Conclusion

In MCI patients not converting to AD within a minimum follow-up time of 5 years and MCI patients converting within 5 years, baseline FDG PET and volume-based analysis identified those who converted with an accuracy of 89%. However, further analysis is needed in patients with amnestic MCI who convert to a dementia other than AD.

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  • Accepted: Jun 13, 2017
  • Online: Jun 29, 2017

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