Echeveste Beatriz, Prieto Elena, Guillén Edgar Fernando, Jimenez Adolfo, Montoya Genoveva, Villino Rafael, Riverol Mario, Arbizu Javier
Clínica Universidad de Navarra, calle pio XII 36. Pamplona, Madrid, España.
Clínica Universidad de Navarra, Madrid, España.
Eur J Nucl Med Mol Imaging. 2025 Apr 21. doi: 10.1007/s00259-025-07275-2.
Amnestic mild cognitive impairment (aMCI) is considered a precursor to Alzheimer's disease (AD). Since cerebral amyloid aggregation and neurodegeneration can be detected at an early stage, it can serve as a diagnostic aid. This study aimed to determine the predictive value of Amyloid-PET and FDG-PET in determining progression to AD among patients with aMCI.
This study recruited 145 patients with aMCI from October 2013 to March 2021. The patients were classified into four groups based on whether Amyloid-PET (A) and FDG-PET (N) were positive (+) or negative (-). The patients were then clinically followed to establish progression to dementia due to AD.
Amyloid-PET demonstrated high sensitivity (100% in year 1, 94.67% in year 4) and a high negative predictive value (100% in year 1, 88.24% in year 4). FDG-PET exhibited a high negative predictive value initially (94.59% in year 1), and during follow-up, both specificity (85%) and positive predictive value (88%) increased. The conversion from aMCI to AD had a global mean time of 39.95 months. However, progression to AD was slower in amyloid-negative patients versus amyloid-positive patients (75.07 [CI 56.54-81] vs. 32.59 months [CI 20.56-40.74] months). Taking both tests together, the time to conversion was faster in A+/N + versus A+/N- patients (27.79 [CI 20.40-33.21] vs. 37.38 [CI 20.73-48.26] months).
Among patients with aMCI, those with a positive Amyloid-PET and an AD pattern on FDG-PET progressed to dementia significantly earlier versus those with a positive Amyloid-PET only. Using both biomarkers during the initial diagnosis enhances the prediction of short-term conversion.
Not applicable. It is not a clinical trial.
遗忘型轻度认知障碍（aMCI）被认为是阿尔茨海默病（AD）的前驱症状。由于脑淀粉样蛋白聚集和神经退行性变可在早期被检测到，其可作为一种诊断辅助手段。本研究旨在确定淀粉样蛋白正电子发射断层扫描（Amyloid-PET）和氟代脱氧葡萄糖正电子发射断层扫描（FDG-PET）在判定aMCI患者进展为AD方面的预测价值。
本研究于2013年10月至2021年3月招募了145例aMCI患者。根据Amyloid-PET（A）和FDG-PET（N）是否为阳性（+）或阴性（-），将患者分为四组。然后对患者进行临床随访，以确定是否进展为AD所致痴呆。
Amyloid-PET显示出高敏感性（第1年为100%，第4年为94.67%）和高阴性预测值（第1年为100%，第4年为88.24%）。FDG-PET最初显示出高阴性预测值（第1年为94.59%），在随访期间，特异性（85%）和阳性预测值（88%）均有所增加。从aMCI转化为AD的总体平均时间为39.95个月。然而，淀粉样蛋白阴性患者进展为AD的速度比淀粉样蛋白阳性患者慢（75.07[置信区间56.54 - 81]对32.59个月[置信区间20.56 - 40.74]）。两项检查联合使用时，A+/N +组与A+/N -组相比，转化时间更快（27.79[置信区间20.40 - 33.21]对月37.38[置信区间20.73 - 48.26]）。
在aMCI患者中，Amyloid-PET阳性且FDG-PET呈AD模式的患者比仅Amyloid-PET阳性的患者进展为痴呆的时间显著更早。在初始诊断时使用这两种生物标志物可增强对短期转化的预测。
不适用。这不是一项临床试验。
