LREN, Département des Neurosciences Cliniques, CHUV, Université de Lausanne, Lausanne, Switzerland.
PLoS One. 2013;8(2):e55415. doi: 10.1371/journal.pone.0055415. Epub 2013 Feb 25.
Positron emission tomography with [18F] fluorodeoxyglucose (FDG-PET) plays a well-established role in assisting early detection of frontotemporal lobar degeneration (FTLD). Here, we examined the impact of intensity normalization to different reference areas on accuracy of FDG-PET to discriminate between patients with mild FTLD and healthy elderly subjects. FDG-PET was conducted at two centers using different acquisition protocols: 41 FTLD patients and 42 controls were studied at center 1, 11 FTLD patients and 13 controls were studied at center 2. All PET images were intensity normalized to the cerebellum, primary sensorimotor cortex (SMC), cerebral global mean (CGM), and a reference cluster with most preserved FDG uptake in the aforementioned patients group of center 1. Metabolic deficits in the patient group at center 1 appeared 1.5, 3.6, and 4.6 times greater in spatial extent, when tracer uptake was normalized to the reference cluster rather than to the cerebellum, SMC, and CGM, respectively. Logistic regression analyses based on normalized values from FTLD-typical regions showed that at center 1, cerebellar, SMC, CGM, and cluster normalizations differentiated patients from controls with accuracies of 86%, 76%, 75% and 90%, respectively. A similar order of effects was found at center 2. Cluster normalization leads to a significant increase of statistical power in detecting early FTLD-associated metabolic deficits. The established FTLD-specific cluster can be used to improve detection of FTLD on a single case basis at independent centers - a decisive step towards early diagnosis and prediction of FTLD syndromes enabling specific therapies in the future.
正电子发射断层扫描(PET)与[18F]氟脱氧葡萄糖(FDG-PET)在协助早期发现额颞叶变性(FTLD)方面发挥着重要作用。在这里,我们研究了将强度归一化为不同参考区域对 FDG-PET 区分轻度 FTLD 患者和健康老年受试者准确性的影响。在两个中心使用不同的采集方案进行 FDG-PET 检查:中心 1 研究了 41 名 FTLD 患者和 42 名对照组,中心 2 研究了 11 名 FTLD 患者和 13 名对照组。所有 PET 图像均强度归一化为小脑、初级感觉运动皮层(SMC)、大脑全局均值(CGM)和中心 1 患者组中摄取 FDG 保留最多的参考簇。当将示踪剂摄取归一化为参考簇而不是小脑、SMC 和 CGM 时,中心 1 患者组的代谢缺陷在空间范围上分别增加了 1.5、3.6 和 4.6 倍。基于 FTLD 典型区域的归一化值进行的逻辑回归分析表明,在中心 1,小脑、SMC、CGM 和簇归一化分别以 86%、76%、75%和 90%的准确度区分了患者和对照组。在中心 2 也发现了类似的效果顺序。簇归一化可显著提高检测早期 FTLD 相关代谢缺陷的统计能力。已建立的 FTLD 特异性簇可用于提高在独立中心对单个病例进行 FTLD 检测的能力-这是实现早期诊断和预测 FTLD 综合征的决定性步骤,以便将来能够进行特定的治疗。