1. Validation of an optimized SPM procedure for FDG-PET in dementia diagnosis in a clinical setting
- Author
-
Perani D, Della Rosa PA, Cerami C, Gallivanone F, Fallanca F, Vanoli EG, Panzacchi A, Nobili F, Pappatà S, Marcone A, Garibotto V, CASTIGLIONI I, Magnani G, Cappa SF, Gianolli L, Drzezga A, Perneczky R, Didic M, Guedj E, Van Berckel BN, Ossenkoppele R, Morbelli S, Frisoni G, Caroli A, Radiology and nuclear medicine, NCA - Brain imaging technology, NCA - neurodegeneration, Perani, D, Della Rosa, P, Cerami, C, Gallivanone, F, Fallanca, F, Vanoli, E, Panzacchi, A, Nobili, F, Pappatà, S, Marcone, A, Garibotto, V, Castiglioni, I, Magnani, G, Cappa, S, Gianolli, L, Drzezga, A, Perneczky, R, Didic, M, Guedj, E, Van Berckel, B, Ossenkoppele, R, Morbelli, S, Frisoni, G, Caroli, A, Della Rosa, Pasquale Anthony, Cerami, Chiara, Gallivanone, Francesca, Fallanca, Federico, Vanoli, Emilia Giovanna, Panzacchi, Andrea, Nobili, Flavio, Pappata, Sabina, Marcone, Alessandra, Garibotto, Valentina, Castiglioni, Isabella, Magnani, Giuseppe, Cappa, Stefano, and Gianolli, Luigi
- Subjects
NATIONAL INSTITUTE ,Male ,MILD COGNITIVE IMPAIRMENT ,Data Interpretation ,Neurology ,Statistical Parametrical Mapping ,GUIDELINES ,lcsh:RC346-429 ,DISEASE ,RECOMMENDATIONS ,030218 nuclear medicine & medical imaging ,Computer-Assisted ,0302 clinical medicine ,pet ,Dementia diagnosis ,Nuclear Medicine and Imaging ,Diagnosis ,80 and over ,F-18-FDG PET ,Diagnosis, Computer-Assisted ,10. No inequality ,Aged, 80 and over ,FDG-PET imaging ,Statistical parametrical mapping ,Voxel-based analysis ,Aged ,Brain ,Data Interpretation, Statistical ,Female ,Fluorodeoxyglucose F18 ,Humans ,Middle Aged ,Neurodegenerative Diseases ,Positron-Emission Tomography ,Sensitivity and Specificity ,Neurology (clinical) ,Radiology, Nuclear Medicine and Imaging ,Cognitive Neuroscience ,Medicine (all) ,medicine.diagnostic_test ,EADC-PET Consortium ,GLUCOSE-METABOLISM ,ALZHEIMERS ASSOCIATION WORKGROUPS ,Statistical ,LEWY BODIES ,3. Good health ,Positron emission tomography ,lcsh:R858-859.7 ,Radiology ,Psychology ,Life Sciences & Biomedicine ,medicine.medical_specialty ,Neuroimaging ,Neurodegenerative Diseases/diagnosis ,lcsh:Computer applications to medicine. Medical informatics ,ddc:616.0757 ,Article ,03 medical and health sciences ,mental disorders ,medicine ,Dementia ,Brain/metabolism ,Radiology, Nuclear Medicine and imaging ,lcsh:Neurology. Diseases of the nervous system ,Science & Technology ,business.industry ,fungi ,Gold standard (test) ,FRONTOTEMPORAL DEMENTIA ,medicine.disease ,Positron-Emission Tomography/methods ,Clinical diagnosis ,Neurosciences & Neurology ,Differential diagnosis ,Nuclear medicine ,business ,030217 neurology & neurosurgery - Abstract
Diagnostic accuracy in FDG-PET imaging highly depends on the operating procedures. In this clinical study on dementia, we compared the diagnostic accuracy at a single-subject level of a) Clinical Scenarios, b) Standard FDG Images and c) Statistical Parametrical (SPM) Maps generated via a new optimized SPM procedure. We evaluated the added value of FDG-PET, either Standard FDG Images or SPM Maps, to Clinical Scenarios. In 88 patients with neurodegenerative diseases (Alzheimer's Disease—AD, Frontotemporal Lobar Degeneration—FTLD, Dementia with Lewy bodies—DLB and Mild Cognitive Impairment—MCI), 9 neuroimaging experts made a forced diagnostic decision on the basis of the evaluation of the three types of information. There was also the possibility of a decision of normality on the FDG-PET images. The clinical diagnosis confirmed at a long-term follow-up was used as the gold standard. SPM Maps showed higher sensitivity and specificity (96% and 84%), and better diagnostic positive (6.8) and negative (0.05) likelihood ratios compared to Clinical Scenarios and Standard FDG Images. SPM Maps increased diagnostic accuracy for differential diagnosis (AD vs. FTD; beta 1.414, p = 0.019). The AUC of the ROC curve was 0.67 for SPM Maps, 0.57 for Clinical Scenarios and 0.50 for Standard FDG Images. In the MCI group, SPM Maps showed the highest predictive prognostic value (mean LOC = 2.46), by identifying either normal brain metabolism (exclusionary role) or hypometabolic patterns typical of different neurodegenerative conditions., Highlights • Brain FDG-PET was evaluated with a new optimized SPM procedure in dementias. • We compared the diagnostic accuracy of clinical information, visual and SPM FDG-PET. • SPM had the best sensitivity (96%), specificity (84%) and positive and negative LR. • In an MCI subgroup, SPM had the highest predictive prognostic value.
- Published
- 2014