Head‐to‐head comparison of cerebral blood flow single‐photon emission computed tomography and 18F‐fluoro‐2‐deoxyglucose positron emission tomography in the diagnosis of Alzheimer disease

• DOI: 10.1111/imj.14890
• Publication Date: 2020-05-10T07:15:11Z
• Authors: David P. Nadebaum; Natasha Krishnadas; Aurora M. T. Poon; Victor Kalff; Meir Lichtenstein; Victor L. Villemagne; Gareth Jones; Christopher C. Rowe
• Keywords: Emission computed tomography

Abstract Background Clinical diagnosis of Alzheimer disease (AD) is only 70% accurate. Reduced cerebral blood flow (CBF) and metabolism in parieto‐temporal posterior cingulate cortex may assist diagnosis. While widely accepted that 18 F‐fluoro‐2‐deoxyglucose positron emission tomography ( F‐FDG PET) has superior accuracy to CBF‐SPECT for AD, there are very limited head‐to‐head data from clinically relevant populations these studies relied on clinical as the reference standard. Aims To compare directly PET patients referred diagnostic detecting β‐amyloid confirmed AD. Methods A total 126 patients, 56% with mild cognitive impairment 44% dementia, completed both part their assessment, subsequently underwent research purposes. Transaxial slices Neurostat 3D‐SSP analyses scans were independently reviewed by five nuclear medicine clinicians blinded all other data. Operators selected most likely confidence. Accuracy analysis used final incorporating Results Clinicians reported high confidence 83% compared 67% P = 0.001). All reviewers showed individually higher using PET. Based majority read, combined area under receiver operating characteristic curve diagnosing AD was 0.71 0.61 0.02). The sensitivity 76% versus 43% < 0.001), while specificity 74% 0.45). Conclusions among assessment impairment.