Department of Psychiatry, Cambridge Biomedical Campus, University of Cambridge School of Clinical Medicine, Cambridge, United Kingdom Institute for Neuroscience, Campus for Ageing and Vitality, Newcastle University, Newcastle upon Tyne, United Kingdom
Institute for Neuroscience, Campus for Ageing and Vitality, Newcastle University, Newcastle upon Tyne, United Kingdom Nuclear Medicine Department, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, United Kingdom.
J Nucl Med. 2014 Dec;55(12):1959-65. doi: 10.2967/jnumed.114.143347. Epub 2014 Nov 5.
Brain imaging with glucose ((18)F-FDG) PET or blood flow (hexamethylpropyleneamine oxime) SPECT is widely used for the differential diagnosis of dementia, though direct comparisons to clearly establish superiority of one method have not been undertaken.
Subjects with Alzheimer disease (AD; n = 38) and dementia with Lewy bodies (DLB; n = 30) and controls (n = 30) underwent (18)F-FDG PET and SPECT in balanced order. The main outcome measure was area under the curve (AUC) of receiver-operating-characteristic analysis of visual scan rating.
Consensus diagnosis with (18)F-FDG PET was superior to SPECT for both dementia vs. no-dementia (AUC = 0.93 vs. 0.72, P = 0.001) and AD vs. DLB (AUC = 0.80 vs. 0.58, P = 0.005) comparisons. The sensitivity and specificity for dementia/no-dementia was 85% and 90%, respectively, for (18)F-FDG PET and 71% and 70%, respectively, for SPECT.
(18)F-FDG PET was significantly superior to blood flow SPECT. We recommend (18)F-FDG PET be performed instead of perfusion SPECT for the differential diagnosis of degenerative dementia if functional imaging is indicated.
脑成像使用葡萄糖 ((18)F-FDG) PET 或血流 (六甲基丙烯酰胺肟) SPECT 广泛用于痴呆的鉴别诊断，尽管尚未进行直接比较以明确一种方法的优势。
阿尔茨海默病 (AD；n = 38) 和路易体痴呆 (DLB；n = 30) 患者和对照组 (n = 30) 按平衡顺序接受 (18)F-FDG PET 和 SPECT。主要观察指标为视觉扫描评分的受试者工作特征分析曲线下面积 (AUC)。
共识诊断使用 (18)F-FDG PET 优于 SPECT 进行痴呆与非痴呆 (AUC = 0.93 对 0.72，P = 0.001) 和 AD 与 DLB (AUC = 0.80 对 0.58，P = 0.005) 比较。对于痴呆/非痴呆，(18)F-FDG PET 的敏感性和特异性分别为 85%和 90%，SPECT 分别为 71%和 70%。
(18)F-FDG PET 明显优于血流 SPECT。如果需要功能成像进行退行性痴呆的鉴别诊断，我们建议使用 (18)F-FDG PET 代替灌注 SPECT。
