Institute of Biomedical Engineering, School of Communication and Information Engineering, Shanghai University.
Clin Nucl Med. 2023 May 1;48(5):400-403. doi: 10.1097/RLU.0000000000004627. Epub 2023 Mar 22.
This study aimed to optimize the analysis of cingulate island sign (CIS) to improve its diagnostic accuracy in discriminating dementia with Lewy bodies (DLB) from Alzheimer disease (AD).
Patients with DLB (n = 80), AD (n = 75), and normal controls (n = 22) with 18 F-FDG PET imaging were enrolled in this study. Sixty-two DLB patients also underwent dopaminergic PET scans. The optimized/conventional CIS ratios and metabolism in associated brain regions were evaluated by diagnostic accuracy among groups and correlation with cognitive/dopaminergic dysfunction.
In discriminating DLB from AD, the optimized CIS ratio calculated by dorsal posterior cingulate cortex (PCC)/lateral occipital lobe metabolism achieved the highest specificity, sensitivity, and accuracy at 0.907, 0.750, and 0.825, respectively. The metabolism of dorsal-PCC positively correlated with cognitive impairment in DLB patients cross-sectionally and longitudinally ( P < 0.001, r = 0.601; P = 0.044, r = 0.645), and also correlated with dopaminergic impairment in the caudate ( P = 0.048, r = 0.315).
Optimized CIS ratios of incorporated metabolic activity of dorsal-PCC and occipital subregions are clinically useful for differentiating DLB from AD, in which dorsal-PCC metabolism may provide an objective biomarker to reflect the severity of cognitive impairment in DLB.
本研究旨在优化扣带回岛征（CIS）的分析，以提高其在区分路易体痴呆（DLB）与阿尔茨海默病（AD）中的诊断准确性。
本研究纳入了 18F-FDG PET 成像的 80 例 DLB 患者、75 例 AD 患者和 22 例正常对照者。62 例 DLB 患者还接受了多巴胺能 PET 扫描。通过组间诊断准确性评估、与认知/多巴胺能功能障碍的相关性，来评价优化的/常规 CIS 比及相关脑区代谢。
在区分 DLB 与 AD 中，由背侧后扣带回皮质（PCC）/外侧枕叶代谢计算的优化 CIS 比具有最高的特异性、敏感性和准确性，分别为 0.907、0.750 和 0.825。DLB 患者的背侧 PCC 代谢与认知障碍在横断面上和纵向呈正相关（P < 0.001，r = 0.601；P = 0.044，r = 0.645），与尾状核多巴胺能损伤也呈正相关（P = 0.048，r = 0.315）。
纳入背侧 PCC 和枕叶亚区代谢活性的优化 CIS 比对于区分 DLB 与 AD 具有临床意义，其中背侧 PCC 代谢可能为反映 DLB 患者认知障碍严重程度的客观生物标志物。
