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CC BY-NC-ND 4.0 · World J Nucl Med 2021; 20(01): 23-31
DOI: 10.4103/wjnm.WJNM_27_20
Original Article

Hybrid imaging in dementia: A semi-quantitative (18F)-fluorodeoxyglucose positron emission tomography/magnetic resonance imaging approach in clinical practice

Ana Franceschi
Department of Radiology, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell Health, Manhasset, NY
,
Kiyon Naser-Tavakolian
1   Department of Radiology, Stony Brook University Hospital, Stony Brook, NY, USA
,
Michael Clifton
1   Department of Radiology, Stony Brook University Hospital, Stony Brook, NY, USA
,
Osama Ahmed
1   Department of Radiology, Stony Brook University Hospital, Stony Brook, NY, USA
,
Katarina Stoffers
1   Department of Radiology, Stony Brook University Hospital, Stony Brook, NY, USA
,
Lev Bangiyev
1   Department of Radiology, Stony Brook University Hospital, Stony Brook, NY, USA
,
Giuseppe Cruciata
1   Department of Radiology, Stony Brook University Hospital, Stony Brook, NY, USA
,
Sean Clouston
2   Department of Family, Population and Preventative Medicine, SUNY Stony Brook, NY, USA
,
Dinko Franceschi
1   Department of Radiology, Stony Brook University Hospital, Stony Brook, NY, USA
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Abstract

Neurodegenerative disorders may demonstrate typical lobar and regional patterns of volume loss with corresponding decreased glucose metabolism. In this retrospective study, we correlated semi-quantitative volumetric changes utilizing NeuroQuant morphometric analysis with decreased fluorodeoxyglucose (FDG) uptake age-matched calculated z-scores utilizing 18F-FDG positron emission tomography/magnetic resonance imaging (PET/MRI). Eighty-nine patients (mean age 71.4) with clinical findings suggestive of various subtypes of dementia underwent PET/MR brain imaging. Cases were categorized as follows: Alzheimer's dementia (AD), frontotemporal lobar degeneration (FTLD), dementia with Lewy bodies (DLB), and corticobasal degeneration (CBD). NeuroQuant software provided semi-quantitative assessment of lobar-specific patterns of volume loss compared to age-matched controls. MIMneuro software provided semi-quantitative FDG uptake data, with metabolic z-scores generated in comparison to age-matched controls. Volumetric and metabolic data were then correlated for statistical significance. In 29 AD cases, Pearson correlation coefficient between z-score and lobar volume was 0.3 (P = 0.120) and 0.38 (P < 0.05), for parietal and temporal lobes, respectively. In 34 FTLD cases, it was 0.35 (P = 0.051) and 0.02 (P = 0.916), for frontal and temporal lobes, respectively. In 14 DLB cases, it was 0.42 (P = 0.130), 0.5 (P = 0.067), and 0.22 (P = 0.447) for the occipital lobes, middle occipital gyrus, and parietal lobes, respectively. In 12 CBD cases, it was 0.58 (P < 0.05) for the superior parietal lobule. Semi-quantitative (F18)-FDG PET/MRI analysis demonstrated a positive relationship between volumetric loss and hypometabolism within certain lobar-specific regions, depending on neurodegenerative disorder subtype. Our findings may add diagnostic confidence in the accurate imaging diagnosis of neurodegenerative disease.

Keywords

Brain hypometabolism - dementia - neurodegeneration - positron emission tomography/magnetic resonance imaging - semi-quantitative analysis

Financial support and sponsorship

Nil.




Publication History

Received: 23 May 2020

Accepted: 01 June 2020

Article published online:
30 March 2022

© 2021. Sociedade Brasileira de Neurocirurgia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commecial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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  • References

  • 1 Franceschi AM, Abballe V, Raad RA, Nelson A, Jackson K, Babb J, et al. Visual detection of regional brain hypometabolism in cognitively impaired patients is independent of positron emission tomography-magnetic resonance attenuation correction method. World J Nucl Med 2018;17:188-94.
  • 2 Franceschi AM, Matthews R, Bangiyev L, Relan N, Chaudhry A, Franceschi D. Added value of including entire brain on body imaging with FDG PET/MRI. Am J Roentgenol 2018;211:176-84.
  • 3 Ehman EC, Johnson GB, Villanueva-Meyer JE, Cha S, Leynes AP, Larson PE, et al. PET/MRI: Where might it replace PET/CT? J Magn Reson Imaging 2017;46:1247-62.
  • 4 Gallucci M, Limbucci N, Catalucci A, Caulo M. Neurodegenerative diseases. Radiol Clin North Am 2008;46:799-817, vii.
  • 5 Herholz K, Carter SF, Jones M. Positron emission tomography imaging in dementia. Br J Radiol 2007;80:S160-7.
  • 6 Togasaki DM, Tanner CM. Epidemiologic aspects. Adv Neurol 2000;82:53-9.
  • 7 Arlt S, Brassen S, Jahn H, Wilke F, Eichenlaub M, Apostolova I, et al. Association between FDG uptake, CSF biomarkers and cognitive performance in patients with probable Alzheimer's disease. Eur J Nucl Med Mol Imaging 2009;36:1090-100.
  • 8 Brown RK, Bohnen NI, Wong KK, Minoshima S, Frey KA. Brain PET in suspected dementia: Patterns of altered FDG metabolism. Radiographics 2014;34:684-701.
  • 9 Choo IH, Lee DY, Youn JC, Jhoo JH, Kim KW, Lee DS, et al. Topographic patterns of brain functional impairment progression according to clinical severity staging in 116 Alzheimer disease patients: FDG-PET study. Alzheimer Dis Assoc Disord 2007;21:77-84.
  • 10 Del Sole A, Clerici F, Chiti A, Lecchi M, Mariani C, Maggiore L, et al. Individual cerebral metabolic deficits in Alzheimer's disease and amnestic mild cognitive impairment: An FDG PET study. Eur J Nucl Med Mol Imaging 2008;35:1357.
  • 11 Jagust W, Reed B, Mungas D, Ellis W, Decarli C. What does fluorodeoxyglucose PET imaging add to a clinical diagnosis of dementia? Neurology 2007;69:871-7.
  • 12 Diehl-Schmid J, Grimmer T, Drzezga A, Bornschein S, Riemenschneider M, Förstl H, et al. Decline of cerebral glucose metabolism in frontotemporal dementia: A longitudinal 18F-FDG-PET-study. Neurobiol Aging 2007;28:42-50.
  • 13 Jeong Y, Cho SS, Park JM, Kang SJ, Lee JS, Kang E, et al. 18F-FDG PET findings in frontotemporal dementia: An SPM analysis of 29 patients. J Nucl Med 2005;46:233-9.
  • 14 Kanda T, Ishii K, Uemura T, Miyamoto N, Yoshikawa T, Kono AK, et al. Comparison of grey matter and metabolic reductions in frontotemporal dementia using FDG-PET and voxel-based morphometric MR studies. Eur J Nucl Med Mol Imaging 2008;35:2227-34.
  • 15 Colloby S, John O. Functional imaging in Parkinson's disease and dementia with Lewy bodies. J Geriatr Psychiatry Neurol 2004;17:158-63.
  • 16 Higuchi M, Tashiro M, Arai H, Okamura N, Hara S, Higuchi S, et al. Glucose hypometabolism and neuropathological correlates in brains of dementia with Lewy bodies. Exp Neurol 2000;162:247-56.
  • 17 Imamura T, Ishii K, Hirono N, Hashimoto M, Tanimukai S, Kazui H, et al. Occipital glucose metabolism in dementia with Lewy bodies with and without Parkinsonism: A study using positron emission tomography. Dement Geriatr Cogn Disord 2001;12:194-7.
  • 18 Grijalvo-Perez AM, Litvan I. Corticobasal degeneration. Semin Neurol 2014;34:160-73.
  • 19 Luo W, Airriess C, Albright J. The neuroquant normative database: Comparing individual brain structures. CorTechs Labs 2015.