He jishu (Jul 2022)
18F-flutemetamol PET/CT imaging in the diagnosis of mild cognitive impairment and Alzheimer's disease：a preliminary study
Abstract
Background18F-Flutemetamol (18F-FMM) PET/CT imaging has been widely applied to the diagnosis of mild cognitive impairment and Alzheimer's disease.PurposeThis study aims to explore the distributions of 18F-FMM in different brain regions of mild cognitive impairment (MCI) and Alzheimer's disease (AD) patients and the factors that may affect the combination of 18F-FMM, evaluating the use of 18F-FMM PET/CT imaging in the diagnosis of MCI and AD patients.MethodsFrom July 2020 to April 2021, 24 subjects with MCI (12 males, 12 females, aged of (70.54±9.27) years old), 25 subjects with AD (11 males, 14 females, aged (70.56±7.30) years old) and 9 subjects as normal controls (NC, 2 males, 7 females, aged (57.67±9.00) years old) were recruited from Shanghai. The 18F-FMM PET/CT brain imaging of all subjects were qualitatively and semi-quantitatively analyzed by visual evaluation and standardized uptake value ratio (SUVR), respectively. Student's t-test, one-way analysis of variance and rank sum test were used for the comparison of quantitative variables. Pearson's chi-squared test and Fisher's exact test were used for the comparison of qualitative variables. The diagnostic efficiency was obtained by ROC curve. Multiple linear regression analysis was used to analyze the factors that might affect the combination of 18F-FMM.ResultsThe positive rate of visual assessment was significantly different in NC, MCI and AD groups (χ2=26.85, p < 0.001), and significant differences existed statistically in SUVR of all brain regions among the three groups (H value: 11.54~19.34, F value: 7.43, 11.48, all p < 0.01). The mean values of SUVR in the whole brain of the three groups were statistically different (Z value: -3.87, -2.79, -2.45, all p < 0.016 7). Compared with MCI group, the positive rate in occipital lobe, temporal lobe, parietal lobe and posterior cingulate gyrus was statistically significant (χ2=7.53~10.89, all p < 0.01). With respect to NC, SUVR of all brain regions was lower than that in AD, while SUVR of temporal lobe, frontal lobe and precuneu were lower than that in MCI. Meanwhile, SUVR of occipital lobe, temporal lobe, frontal lobe and parietal lobe in MCI were lower than that in AD. Receiver operating characteristic (ROC) curves showed that the SUVR value of temporal lobe and the mean value of SUVR in the whole brain had the ability to distinguish NC, MCI and AD in sequence. Multiple linear regression analysis showed that cognitive level was significantly negatively correlated with 18F-FMM SUVR in different brain regions.Conclusion18F-FMM PET/CT brain imaging could reflect the cognitive level of middle-aged and elderly people intuitively and has clear diagnostic value for MCI and AD.
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