Lowe Val J, Kemp Bradley J, Jack Clifford R, Senjem Matthew, Weigand Stephen, Shiung Maria, Smith Glenn, Knopman David, Boeve Bradley, Mullan Brian, Petersen Ronald C
Department of Radiology, Mayo Clinic, Rochester, Minnesota 55905, USA.
J Nucl Med. 2009 Jun;50(6):878-86. doi: 10.2967/jnumed.108.058529. Epub 2009 May 14.
The purpose of this study was to compare the diagnostic accuracy of glucose metabolism and amyloid deposition as demonstrated by (18)F-FDG and Pittsburg Compound B (PiB) PET to evaluate subjects with cognitive impairment.
Subjects were selected from existing participants in the Mayo Alzheimer's Disease Research Center or Alzheimer's Disease Patient Registry programs. A total of 20 healthy controls and 17 amnestic mild cognitive impairment (aMCI), 6 nonamnestic mild cognitive impairment (naMCI), and 13 Alzheimer disease (AD) subjects were imaged with both PiB and (18)F-FDG PET between March 2006 and August 2007. Global measures for PiB and (18)F-FDG PET uptake, normalized to cerebellum for PiB and pons for (18)F-FDG, were compared. Partial-volume correction, standardized uptake value (SUV), and cortical ratio methods of image analysis were also evaluated in an attempt to optimize the analysis for each test.
Significant discrimination (P < 0.05) between controls and AD, naMCI and aMCI, naMCI and AD, and aMCI and AD by PiB PET measurements was observed. The paired groupwise comparisons of the global measures demonstrated that PiB PET versus (18)F-FDG PET showed similar significant group separation, with only PiB showing significant separation of naMCI and aMCI subjects.
PiB PET and (18)F-FDG PET have similar diagnostic accuracy in early cognitive impairment. However, significantly better group discrimination in naMCI and aMCI subjects by PiB, compared with (18)F-FDG, was seen and may suggest early amyloid deposition before cerebral metabolic disruption in this group.
本研究的目的是比较用（18）F - FDG和匹兹堡化合物B（PiB）PET所显示的葡萄糖代谢和淀粉样蛋白沉积的诊断准确性，以评估认知障碍患者。
受试者选自梅奥阿尔茨海默病研究中心或阿尔茨海默病患者登记项目的现有参与者。2006年3月至2007年8月期间，对20名健康对照者、17名遗忘型轻度认知障碍（aMCI）患者、6名非遗忘型轻度认知障碍（naMCI）患者和13名阿尔茨海默病（AD）患者进行了PiB和（18）F - FDG PET成像。比较了PiB和（18）F - FDG PET摄取的整体测量值，PiB以小脑为参照进行标准化，（18）F - FDG以脑桥为参照进行标准化。还评估了部分容积校正、标准化摄取值（SUV）和图像分析的皮质比率方法，试图优化每项检查的分析。
通过PiB PET测量，观察到对照组与AD组、naMCI组与aMCI组、naMCI组与AD组以及aMCI组与AD组之间有显著差异（P < 0.05）。整体测量值的配对组间比较表明，PiB PET与（18）F - FDG PET显示出相似的显著组间分离，只有PiB显示出naMCI组和aMCI组受试者的显著分离。
PiB PET和（18）F - FDG PET在早期认知障碍中具有相似的诊断准确性。然而，与（18）F - FDG相比，PiB在naMCI组和aMCI组受试者中具有明显更好的组间区分能力，这可能表明该组在脑代谢破坏之前存在早期淀粉样蛋白沉积。
