Nihashi Takashi, Yatsuya Hiroshi, Hayasaka Kazumasa, Kato Rikio, Kawatsu Shoji, Arahata Yutaka, Iwai Katsushige, Takeda Akinori, Washimi Yukihiko, Yoshimura Kumiko, Mizuno Kanako, Kato Takashi, Naganawa Shinji, Ito Kengo
Department of Radiology, National Center for Geriatrics and Gerontology, 36-3 Gengo, Morioka-Cho, Ohbu, 474-8522, Japan.
Radiat Med. 2007 Jul;25(6):255-62. doi: 10.1007/s11604-007-0132-8. Epub 2007 Jul 27.
The purpose of this study was to evaluate and compare the diagnostic ability of 2-[(18)F]-fluoro-2-deoxy-D: -glucose (FDG) positron emission tomography (PET) and N-isopropyl-p-(123)I iodoamphetamine single photon emission computed tomography (IMP-SPECT) using three-dimensional stereotactic surface projections (3D-SSP) in patients with moderate Alzheimer's disease (AD).
FDG-PET and IMP-SPECT were performed within 3 months in 14 patients with probable moderate AD. Z-score maps of FDG-PET and IMP-SPECT images of a patient were obtained by comparison with data obtained from control subjects. Four expert physicians evaluated and graded the glucose hypometabolism and regional cerebral blood flow (rCBF), focusing in particular on the posterior cingulate gyri/precunei and parietotemporal regions, and determined the reliability for AD. Receiver operating characteristic (ROC) curves were applied to the results for clarification. To evaluate the correlation between two modalities, the regions of interest (ROIs) were set in the posterior cingulate gyri/precunei and parietotemporal region on 3D-SSP images, and mean Z-values were calculated.
No significant difference was observed in the area under the ROC curve (AUC) between FDG-PET and IMP-SPECT images (FDG-PET 0.95, IMP-SPECT 0.94). However, a significant difference (P < 0.05) was observed in the AUC for the posterior cingulate gyri/precuneus (FDG-PET 0.94, IMP-SPECT 0.81). The sensitivity and specificity of each modality were 86%, and 97% for FDG-PET and 70% and 100% for IMP-SPECT. We could find no significant difference between FDG-PET and IMP-SPECT in terms of diagnosing moderate AD using 3D-SSP. There was a high correlation between the two modalities in the parietotemporal region (Spearman's r = 0.82, P < 0.001). The correlation in the posterior cingulate gyri/precunei region was lower than that in the parietotemporal region (Spearman's r = 0.63, P < 0.016).
本研究旨在评估和比较2-[(18)F]-氟-2-脱氧-D-葡萄糖（FDG）正电子发射断层扫描（PET）和N-异丙基-p-(123)I 碘安非他明单光子发射计算机断层扫描（IMP-SPECT）利用三维立体定向表面投影（3D-SSP）对中度阿尔茨海默病（AD）患者的诊断能力。
对14例可能患有中度AD的患者在3个月内进行了FDG-PET和IMP-SPECT检查。通过与从对照受试者获得的数据进行比较，获得了患者的FDG-PET和IMP-SPECT图像的Z评分图。四位专家医生对葡萄糖代谢减低和局部脑血流（rCBF）进行了评估和分级，特别关注后扣带回/楔前叶和顶颞叶区域，并确定了AD的可靠性。应用受试者操作特征（ROC）曲线对结果进行说明。为了评估两种检查方法之间的相关性，在3D-SSP图像上的后扣带回/楔前叶和顶颞叶区域设置感兴趣区（ROI），并计算平均Z值。
FDG-PET和IMP-SPECT图像的ROC曲线下面积（AUC）无显著差异（FDG-PET为0.95，IMP-SPECT为0.94）。然而，后扣带回/楔前叶的AUC存在显著差异（P < 0.05）（FDG-PET为0.94，IMP-SPECT为0.81）。FDG-PET的敏感性和特异性分别为86%和97%，IMP-SPECT的敏感性和特异性分别为70%和100%。在使用3D-SSP诊断中度AD方面，我们未发现FDG-PET和IMP-SPECT之间存在显著差异。两种检查方法在顶颞叶区域存在高度相关性（Spearman相关系数r = 0.82，P < 0.001）。后扣带回/楔前叶区域的相关性低于顶颞叶区域（Spearman相关系数r = 0.63，P < 0.016）。
