Limits...
Cerebral perfusion and glucose metabolism in Alzheimer's disease and frontotemporal dementia: two sides of the same coin?

Verfaillie SC, Adriaanse SM, Binnewijzend MA, Benedictus MR, Ossenkoppele R, Wattjes MP, Pijnenburg YA, van der Flier WM, Lammertsma AA, Kuijer JP, Boellaard R, Scheltens P, van Berckel BN, Barkhof F - Eur Radiol (2015)

Bottom Line: Voxel-wise comparisons showed decreased CBF and FDG uptake in AD compared with controls and FTD in both precuneus and inferior parietal lobule (IPL).ROC analyses indicated comparable performance of perfusion and metabolism in the precuneus (AUC, 0.72 and 0.74), IPL (0.85 and 0.94) for AD relative to FTD, and in the mPFC in FTD relative to AD (both 0.68).Similar patterns of hypoperfusion and hypometabolism were observed in regions typically associated with AD and FTD, suggesting that ASL-MRI provides information comparable to FDG-PET. • Similar patterns of hypoperfusion and hypometabolism were observed in patients with dementia. • For both imaging modalities, parietal abnormalities were found in Alzheimer's disease. • For both imaging modalities, prefrontal abnormalities were found in frontotemporal dementia.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology & Nuclear Medicine, VU University Medical Centre, Amsterdam, The Netherlands, s.verfaillie@vumc.nl.

ABSTRACT

Objectives: Alzheimer's disease (AD) and frontotemporal (FTD) dementia can be differentiated using [(18)F]-2-deoxy-2-fluoro-D-glucose (FDG)-PET. Since cerebral blood flow (CBF) is related to glucose metabolism, our aim was to investigate the extent of overlap of abnormalities between AD and FTD.

Methods: Normalized FDG-PET and arterial spin labelling (ASL-MRI)-derived CBF was measured in 18 AD patients (age, 64 ± 8), 12 FTD patients (age, 61 ± 8), and 10 controls (age, 56 ± 10). Voxel-wise comparisons, region-of-interest (ROI), correlation, and ROC curve analyses were performed.

Results: Voxel-wise comparisons showed decreased CBF and FDG uptake in AD compared with controls and FTD in both precuneus and inferior parietal lobule (IPL). Compared with controls and AD, FTD patients showed both hypometabolism and hypoperfusion in medial prefrontal cortex (mPFC). ASL and FDG were related in precuneus (r = 0.62, p < 0.001), IPL (r = 0.61, p < 0.001), and mPFC across groups (r = 0.74, p < 001). ROC analyses indicated comparable performance of perfusion and metabolism in the precuneus (AUC, 0.72 and 0.74), IPL (0.85 and 0.94) for AD relative to FTD, and in the mPFC in FTD relative to AD (both 0.68).

Conclusions: Similar patterns of hypoperfusion and hypometabolism were observed in regions typically associated with AD and FTD, suggesting that ASL-MRI provides information comparable to FDG-PET.

Key points: • Similar patterns of hypoperfusion and hypometabolism were observed in patients with dementia. • For both imaging modalities, parietal abnormalities were found in Alzheimer's disease. • For both imaging modalities, prefrontal abnormalities were found in frontotemporal dementia.

No MeSH data available.


Related in: MedlinePlus

ROC curves for FDG and ASL in AD and FTD. A) Precuneus function for ASL and FDG in discriminating AD from FTD. B) mPFC function in discriminating FTD from AD. Ratios were taken between the mPFC and precuneus and entered into ROC analyses as ‘ratio ROI’
© Copyright Policy - OpenAccess
Related In: Results  -  Collection


getmorefigures.php?uid=PMC4562004&req=5

Fig5: ROC curves for FDG and ASL in AD and FTD. A) Precuneus function for ASL and FDG in discriminating AD from FTD. B) mPFC function in discriminating FTD from AD. Ratios were taken between the mPFC and precuneus and entered into ROC analyses as ‘ratio ROI’

Mentions: To investigate the discriminative power of ASL and FDG for AD and FTD, ROC curves were generated. Figure 5 shows ROC curves for AD and FTD based on precuneus (Fig. 5A) and mPFC (Fig. 5B) ROI values. Precuneus AUC was 0.74 for FDG and 0.72 for ASL. For IPL, the AUC was 0.94 for FDG and 0.85 for ASL. For mPFC, the AUC was 0.68 for both FDG and ASL. Additionally, ratios (between mPFC and precuneus, and mPFC and IPL) were used for discriminating AD from FTD, which showed AUC values of 0.80 and 0.90 for the precuneus, and 0.89 and 0.96 for the IPL for FDG and ASL, respectively. Likewise, for discriminating FTD from AD, mPFC showed an AUC of 0.82 for FDG and 0.89 for ASL.Fig. 5


Cerebral perfusion and glucose metabolism in Alzheimer's disease and frontotemporal dementia: two sides of the same coin?

Verfaillie SC, Adriaanse SM, Binnewijzend MA, Benedictus MR, Ossenkoppele R, Wattjes MP, Pijnenburg YA, van der Flier WM, Lammertsma AA, Kuijer JP, Boellaard R, Scheltens P, van Berckel BN, Barkhof F - Eur Radiol (2015)

ROC curves for FDG and ASL in AD and FTD. A) Precuneus function for ASL and FDG in discriminating AD from FTD. B) mPFC function in discriminating FTD from AD. Ratios were taken between the mPFC and precuneus and entered into ROC analyses as ‘ratio ROI’
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4562004&req=5

Fig5: ROC curves for FDG and ASL in AD and FTD. A) Precuneus function for ASL and FDG in discriminating AD from FTD. B) mPFC function in discriminating FTD from AD. Ratios were taken between the mPFC and precuneus and entered into ROC analyses as ‘ratio ROI’
Mentions: To investigate the discriminative power of ASL and FDG for AD and FTD, ROC curves were generated. Figure 5 shows ROC curves for AD and FTD based on precuneus (Fig. 5A) and mPFC (Fig. 5B) ROI values. Precuneus AUC was 0.74 for FDG and 0.72 for ASL. For IPL, the AUC was 0.94 for FDG and 0.85 for ASL. For mPFC, the AUC was 0.68 for both FDG and ASL. Additionally, ratios (between mPFC and precuneus, and mPFC and IPL) were used for discriminating AD from FTD, which showed AUC values of 0.80 and 0.90 for the precuneus, and 0.89 and 0.96 for the IPL for FDG and ASL, respectively. Likewise, for discriminating FTD from AD, mPFC showed an AUC of 0.82 for FDG and 0.89 for ASL.Fig. 5

Bottom Line: Voxel-wise comparisons showed decreased CBF and FDG uptake in AD compared with controls and FTD in both precuneus and inferior parietal lobule (IPL).ROC analyses indicated comparable performance of perfusion and metabolism in the precuneus (AUC, 0.72 and 0.74), IPL (0.85 and 0.94) for AD relative to FTD, and in the mPFC in FTD relative to AD (both 0.68).Similar patterns of hypoperfusion and hypometabolism were observed in regions typically associated with AD and FTD, suggesting that ASL-MRI provides information comparable to FDG-PET. • Similar patterns of hypoperfusion and hypometabolism were observed in patients with dementia. • For both imaging modalities, parietal abnormalities were found in Alzheimer's disease. • For both imaging modalities, prefrontal abnormalities were found in frontotemporal dementia.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology & Nuclear Medicine, VU University Medical Centre, Amsterdam, The Netherlands, s.verfaillie@vumc.nl.

ABSTRACT

Objectives: Alzheimer's disease (AD) and frontotemporal (FTD) dementia can be differentiated using [(18)F]-2-deoxy-2-fluoro-D-glucose (FDG)-PET. Since cerebral blood flow (CBF) is related to glucose metabolism, our aim was to investigate the extent of overlap of abnormalities between AD and FTD.

Methods: Normalized FDG-PET and arterial spin labelling (ASL-MRI)-derived CBF was measured in 18 AD patients (age, 64 ± 8), 12 FTD patients (age, 61 ± 8), and 10 controls (age, 56 ± 10). Voxel-wise comparisons, region-of-interest (ROI), correlation, and ROC curve analyses were performed.

Results: Voxel-wise comparisons showed decreased CBF and FDG uptake in AD compared with controls and FTD in both precuneus and inferior parietal lobule (IPL). Compared with controls and AD, FTD patients showed both hypometabolism and hypoperfusion in medial prefrontal cortex (mPFC). ASL and FDG were related in precuneus (r = 0.62, p < 0.001), IPL (r = 0.61, p < 0.001), and mPFC across groups (r = 0.74, p < 001). ROC analyses indicated comparable performance of perfusion and metabolism in the precuneus (AUC, 0.72 and 0.74), IPL (0.85 and 0.94) for AD relative to FTD, and in the mPFC in FTD relative to AD (both 0.68).

Conclusions: Similar patterns of hypoperfusion and hypometabolism were observed in regions typically associated with AD and FTD, suggesting that ASL-MRI provides information comparable to FDG-PET.

Key points: • Similar patterns of hypoperfusion and hypometabolism were observed in patients with dementia. • For both imaging modalities, parietal abnormalities were found in Alzheimer's disease. • For both imaging modalities, prefrontal abnormalities were found in frontotemporal dementia.

No MeSH data available.


Related in: MedlinePlus