Sanchez-Catasus Carlos A, Stormezand Gilles N, van Laar Peter Jan, De Deyn Peter P, Sanchez Mario Alvarez, Dierckx Rudi A J O
Department of Nuclear Medicine & Molecular Imaging, Medical Imaging Center, University Medical Center, Groningen, The Netherlands.
Curr Alzheimer Res. 2017;14(2):127-142. doi: 10.2174/1567205013666160629081956.
This review article aims at providing a state-of-the-art review of the role of fluorodeoxyglucose (FDG) positron emission tomography (PET) imaging (FDG-PET) in the prediction of Alzheimer's dementia in subjects suffering mild cognitive impairment (MCI), with a particular focus on the predictive power of FDG-PET compared to structural magnetic resonance imaging (sMRI). We also address perfusion single photon emission computed tomography (SPECT) as a less costly and more accessible alternative to FDG-PET. A search in PubMed was performed, taking into consideration relevant scientific articles published in English within the last five years and limited to human studies. This recent literature confirms the effectiveness of FDG-PET and sMRI for prediction of AD dementia in MCI. However, there are discordant results regarding which image modality is superior. This could be explained by the high variability of metrics used to evaluate both imaging modalities and/or by sampling/population issues such as age, disease severity and conversion time. FDG-PET seems to outperform sMRI in rapidly converting early-onset MCI individuals, whereas sMRI may outperform FDG-PET in late-onset MCI subjects, in which case FDG PET might only provide a complementary role. Although FDG-PET performs better than perfusion SPECT, current evidence confirms perfusion SPECT as a valid alternative when FDG- PET is not available. Finally, possible future directions in the field are discussed.
这篇综述文章旨在对氟代脱氧葡萄糖（FDG）正电子发射断层扫描（PET）成像（FDG-PET）在预测轻度认知障碍（MCI）患者患阿尔茨海默病性痴呆方面的作用进行最新综述，特别关注FDG-PET与结构磁共振成像（sMRI）相比的预测能力。我们还将灌注单光子发射计算机断层扫描（SPECT）作为FDG-PET成本更低且更容易获得的替代方法进行探讨。在PubMed上进行了检索，纳入了过去五年内发表的英文相关科学文章，并仅限于人体研究。最近的文献证实了FDG-PET和sMRI在预测MCI患者患AD痴呆方面的有效性。然而，关于哪种成像方式更具优势存在不一致的结果。这可能是由于用于评估这两种成像方式的指标高度可变和/或由于年龄、疾病严重程度和转化时间等抽样/人群问题所致。FDG-PET在快速转化的早发性MCI个体中似乎优于sMRI，而sMRI在晚发性MCI受试者中可能优于FDG-PET，在这种情况下，FDG-PET可能仅起补充作用。尽管FDG-PET比灌注SPECT表现更好，但当前证据证实当无法进行FDG-PET时，灌注SPECT是一种有效的替代方法。最后，讨论了该领域未来可能的发展方向。
