Comparison of 18F-FDG PET and arterial spin labeling MRI in evaluating Alzheimer's disease and amnestic mild cognitive impairment using integrated PET/MR

Sheng Bi; Shaozhen Yan; Zhigeng Chen; Bixiao Cui; Yi Shan; Hongwei Yang; Zhigang Qi; Zhilian Zhao; Ying Han; Jie Lu

doi:10.1186/s13550-024-01068-8

Comparison of ¹⁸F-FDG PET and arterial spin labeling MRI in evaluating Alzheimer's disease and amnestic mild cognitive impairment using integrated PET/MR

EJNMMI Res. 2024 Jan 25;14(1):9. doi: 10.1186/s13550-024-01068-8.

Authors

Sheng Bi^{1

2

3}, Shaozhen Yan^{1

2

3}, Zhigeng Chen^{1

2

3}, Bixiao Cui^{1

2

3}, Yi Shan^{1

2

3}, Hongwei Yang^{1

2

3}, Zhigang Qi^{1

2

3}, Zhilian Zhao^{1

2

3}, Ying Han⁴, Jie Lu^{5

6

7}

Affiliations

¹ Department of Radiology & Nuclear Medicine, Xuanwu Hospital, Capital Medical University, 45 Changchun Street, Xicheng District, Beijing, 100053, China.
² Beijing Key Laboratory of Magnetic Resonance Imaging and Brain Informatics, Beijing, China.
³ Key Laboratory of Neurodegenerative Diseases, Ministry of Education, Beijing, China.
⁴ Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China.
⁵ Department of Radiology & Nuclear Medicine, Xuanwu Hospital, Capital Medical University, 45 Changchun Street, Xicheng District, Beijing, 100053, China. imaginglu@hotmail.com.
⁶ Beijing Key Laboratory of Magnetic Resonance Imaging and Brain Informatics, Beijing, China. imaginglu@hotmail.com.
⁷ Key Laboratory of Neurodegenerative Diseases, Ministry of Education, Beijing, China. imaginglu@hotmail.com.

Abstract

Background: Developing biomarkers for early stage AD patients is crucial. Glucose metabolism measured by ¹⁸F-FDG PET is the most common biomarker for evaluating cellular energy metabolism to diagnose AD. Arterial spin labeling (ASL) MRI can potentially provide comparable diagnostic information to ¹⁸F-FDG PET in patients with neurodegenerative disorders. However, the conclusions about the diagnostic performance of AD are still controversial between ¹⁸F-FDG PET and ASL. This study aims to compare quantitative cerebral blood flow (CBF) and glucose metabolism measured by ¹⁸F-FDG PET diagnostic values in patients with Alzheimer's disease (AD) and amnestic mild cognitive impairment (aMCI) using integrated PET/MR.

Results: Analyses revealed overlapping between decreased regional rCBF and ¹⁸F-FDG PET SUVR in patients with AD compared with NC participants in the bilateral parietotemporal regions, frontal cortex, and cingulate cortex. Compared with NC participants, patients with aMCI exclusively demonstrated lower ¹⁸F-FDG PET SUVR in the bilateral temporal cortex, insula cortex, and inferior frontal cortex. Comparison of the rCBF in patients with aMCI and NC participants revealed no significant difference (P > 0.05). The ROC analysis of rCBF in the meta-ROI could diagnose patients with AD (AUC, 0.87) but not aMCI (AUC, 0.61). The specificity of diagnosing aMCI has been improved to 75.56% when combining rCBF and ¹⁸F-FDG PET SUVR.

Conclusion: ASL could detect similar aberrant patterns of abnormalities compared to ¹⁸F-FDG PET in patients with AD compared with NC participants but not in aMCI. The diagnostic efficiency of ¹⁸F-FDG-PET for AD and aMCI patients remained higher to ASL. Our findings support that applying ¹⁸F-FDG PET may be preferable for diagnosing AD and aMCI.

Keywords: 18F-FDG PET; Alzheimer’s disease; Arterial spin labeling MRI; Integrated PET/MR; Mild cognitive impairment.

Abstract

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