Amyloid vs FDG-PET in the differential diagnosis of AD and FTLD
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- 6 December 2011
- journal article
- Published by Ovid Technologies (Wolters Kluwer Health) in Neurology
- Vol. 77 (23), 2034-2042
- https://doi.org/10.1212/wnl.0b013e31823b9c5e
Abstract
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.Keywords
This publication has 43 references indexed in Scilit:
- Temporoparietal Hypometabolism in Frontotemporal Lobar Degeneration and Associated Imaging Diagnostic ErrorsArchives of Neurology, 2011
- Absence of Pittsburgh Compound B Detection of Cerebral Amyloid β in a Patient With Clinical, Cognitive, and Cerebrospinal Fluid Markers of Alzheimer DiseaseArchives of Neurology, 2009
- Nomenclature and nosology for neuropathologic subtypes of frontotemporal lobar degeneration: an updateActa Neuropathologica, 2009
- Deficient high-affinity binding of Pittsburgh compound B in a case of Alzheimer’s diseaseActa Neuropathologica, 2009
- Episodic memory loss is related to hippocampal-mediated -amyloid deposition in elderly subjectsBrain, 2008
- Frequent Amyloid Deposition Without Significant Cognitive Impairment Among the ElderlyArchives of Neurology, 2008
- Aβ amyloid and glucose metabolism in three variants of primary progressive aphasiaAnnals of Neurology, 2008
- A90V TDP‐43 variant results in the aberrant localization of TDP‐43 in vitroFEBS Letters, 2008
- Frontotemporal dementia: Clinicopathological correlationsAnnals of Neurology, 2006
- Imaging brain amyloid in Alzheimer's disease with Pittsburgh Compound‐BAnnals of Neurology, 2004