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FDG PET imaging in patients with pathologically verified dementia.

Publication ,  Journal Article
Hoffman, JM; Welsh-Bohmer, KA; Hanson, M; Crain, B; Hulette, C; Earl, N; Coleman, RE
Published in: J Nucl Med
November 2000

UNLABELLED: The purpose of this study was to confirm with pathologic verification 2 beliefs related to Alzheimer's disease (AD): (a) the long-standing impression that bilateral temporo-parietal hypometabolism, as noted on FDG PET imaging, is the metabolic abnormality associated with Alzheimer's disease (AD) and (b) that the sensitivity, specificity, and diagnostic accuracy of the metabolic pattern of bilateral temporo-parietal hypometabolism allows differentiation between other degenerative causes of dementia. METHODS: Twenty two individuals (8 women, 14 men) with difficult-to-characterize memory loss or dementia (using standard clinical criteria), and who eventually received pathologic confirmation of diagnosis, were evaluated. FDG PET brain scans were obtained and visually graded by an experienced nuclear medicine physician as to the presence of classic bilateral temporo-parietal hypometabolism as seen in Alzheimer's type dementia. Sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic accuracy of the metabolic pattern of bilateral temporo-parietal hypometabolism were determined using pathologic diagnosis as the gold standard. RESULTS: The clinical diagnosis of possible or probable AD was determined as the primary cause of dementia in 12 patients. The sensitivity and specificity of the clinical diagnosis for probable AD were 63% and 100%, respectively. The sensitivity and specificity of the clinical diagnosis for possible and probable AD were 75% and 100%, respectively. The sensitivity, specificity, and diagnostic accuracy of bilateral temporo-parietal hypometabolism being associated with AD were 93%, 63%, and 82%, respectively. CONCLUSION: This study confirms that bilateral temporo-parietal hypometabolism is indeed the classic metabolic abnormality associated with AD. Furthermore, in individuals with dementia whose FDG PET scans indicated a metabolic pattern other than bilateral temporo-parietal hypometabolism, a cause of dementia other than AD should be suspected. These observations may be of clinical importance in differentiating dementia syndromes. The sensitivity, specificity, and diagnostic accuracy of FDG PET are acceptable as tests to be used in the evaluation of dementia and particularly to confirm the clinical suspicion of AD.

Duke Scholars

Published In

J Nucl Med

ISSN

0161-5505

Publication Date

November 2000

Volume

41

Issue

11

Start / End Page

1920 / 1928

Location

United States

Related Subject Headings

  • Tomography, Emission-Computed
  • Temporal Lobe
  • Sensitivity and Specificity
  • Radiopharmaceuticals
  • Predictive Value of Tests
  • Parietal Lobe
  • Nuclear Medicine & Medical Imaging
  • Middle Aged
  • Male
  • Humans
 

Citation

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MLA
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Hoffman, J. M., Welsh-Bohmer, K. A., Hanson, M., Crain, B., Hulette, C., Earl, N., & Coleman, R. E. (2000). FDG PET imaging in patients with pathologically verified dementia. J Nucl Med, 41(11), 1920–1928.
Hoffman, J. M., K. A. Welsh-Bohmer, M. Hanson, B. Crain, C. Hulette, N. Earl, and R. E. Coleman. “FDG PET imaging in patients with pathologically verified dementia.J Nucl Med 41, no. 11 (November 2000): 1920–28.
Hoffman JM, Welsh-Bohmer KA, Hanson M, Crain B, Hulette C, Earl N, et al. FDG PET imaging in patients with pathologically verified dementia. J Nucl Med. 2000 Nov;41(11):1920–8.
Hoffman, J. M., et al. “FDG PET imaging in patients with pathologically verified dementia.J Nucl Med, vol. 41, no. 11, Nov. 2000, pp. 1920–28.
Hoffman JM, Welsh-Bohmer KA, Hanson M, Crain B, Hulette C, Earl N, Coleman RE. FDG PET imaging in patients with pathologically verified dementia. J Nucl Med. 2000 Nov;41(11):1920–1928.

Published In

J Nucl Med

ISSN

0161-5505

Publication Date

November 2000

Volume

41

Issue

11

Start / End Page

1920 / 1928

Location

United States

Related Subject Headings

  • Tomography, Emission-Computed
  • Temporal Lobe
  • Sensitivity and Specificity
  • Radiopharmaceuticals
  • Predictive Value of Tests
  • Parietal Lobe
  • Nuclear Medicine & Medical Imaging
  • Middle Aged
  • Male
  • Humans