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Amyloid vs FDG-PET in the differential diagnosis of AD and FTLD.
MedLine Citation:
PMID:  22131541     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
OBJECTIVE:To compare the diagnostic performance of PET with the amyloid ligand Pittsburgh compound B (PiB-PET) to fluorodeoxyglucose (FDG-PET) in discriminating between Alzheimer disease (AD) and frontotemporal lobar degeneration (FTLD). METHODS:Patients meeting clinical criteria for AD (n = 62) and FTLD (n = 45) underwent PiB and FDG-PET. PiB scans were classified as positive or negative by 2 visual raters blinded to clinical diagnosis, and using a quantitative threshold derived from controls (n = 25). FDG scans were visually rated as consistent with AD or FTLD, and quantitatively classified based on the region of lowest metabolism relative to controls. RESULTS:PiB visual reads had a higher sensitivity for AD (89.5% average between raters) than FDG visual reads (77.5%) with similar specificity (PiB 83%, FDG 84%). When scans were classified quantitatively, PiB had higher sensitivity (89% vs 73%) while FDG had higher specificity (83% vs 98%). On receiver operating characteristic analysis, areas under the curve for PiB (0.888) and FDG (0.910) were similar. Interrater agreement was higher for PiB (κ = 0.96) than FDG (κ = 0.72), as was agreement between visual and quantitative classification (PiB κ = 0.88-0.92; FDG κ = 0.64-0.68). In patients with known histopathology, overall classification accuracy (2 visual and 1 quantitative classification per patient) was 97% for PiB (n = 12 patients) and 87% for FDG (n = 10). CONCLUSIONS:PiB and FDG showed similar accuracy in discriminating AD and FTLD. PiB was more sensitive when interpreted qualitatively or quantitatively. FDG was more specific, but only when scans were classified quantitatively. PiB slightly outperformed FDG in patients with known histopathology.
Authors:
G D Rabinovici; H J Rosen; A Alkalay; J Kornak; A J Furst; N Agarwal; E C Mormino; J P O'Neil; M Janabi; A Karydas; M E Growdon; J Y Jang; E J Huang; S J Dearmond; J Q Trojanowski; L T Grinberg; M L Gorno-Tempini; W W Seeley; B L Miller; W J Jagust
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-11-30
Journal Detail:
Title:  Neurology     Volume:  -     ISSN:  1526-632X     ISO Abbreviation:  -     Publication Date:  2011 Nov 
Date Detail:
Created Date:  2011-12-1     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0401060     Medline TA:  Neurology     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
From the Memory & Aging Center and Departments of Neurology (G.D.R., H.J.R., A.A., A.K., M.E.G., J.Y.J., L.T.G., M.L.G.-T., W.W.S., B.L.M., W.J.J.), Epidemiology and Biostatistics (J.K.), and Pathology (E.J.H., S.J.D.), University of California San Francisco, San Francisco; Helen Wills Neuroscience Institute (G.D.R., A.A., A.J.F., N.A., E.C.M., W.J.J.), University of California Berkeley, Berkeley; Lawrence Berkeley National Laboratory (G.D.R., A.J.F., E.C.M., J.P.O., M.J., W.J.J.), Berkeley, CA; and Center for Neurodegenerative Research (J.Q.T.), University of Pennsylvania, Philadelphia.
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