• J. Nucl. Med. · Dec 2014

    Comparative Study

    18F-FDG PET and perfusion SPECT in the diagnosis of Alzheimer and Lewy body dementias.

    • John T O'Brien, Michael J Firbank, Christopher Davison, Nicky Barnett, Claire Bamford, Cam Donaldson, Kirsty Olsen, Karl Herholz, David Williams, and Jim Lloyd.
    • Department of Psychiatry, Cambridge Biomedical Campus, University of Cambridge School of Clinical Medicine, Cambridge, United Kingdom Institute for Neuroscience, Campus for Ageing and Vitality, Newcastle University, Newcastle upon Tyne, United Kingdom john.obrien@medschl.cam.ac.uk.
    • J. Nucl. Med. 2014 Dec 1; 55 (12): 1959-65.

    UnlabelledBrain imaging with glucose ((18)F-FDG) PET or blood flow (hexamethylpropyleneamine oxime) SPECT is widely used for the differential diagnosis of dementia, though direct comparisons to clearly establish superiority of one method have not been undertaken.MethodsSubjects with Alzheimer disease (AD; n = 38) and dementia with Lewy bodies (DLB; n = 30) and controls (n = 30) underwent (18)F-FDG PET and SPECT in balanced order. The main outcome measure was area under the curve (AUC) of receiver-operating-characteristic analysis of visual scan rating.ResultsConsensus diagnosis with (18)F-FDG PET was superior to SPECT for both dementia vs. no-dementia (AUC = 0.93 vs. 0.72, P = 0.001) and AD vs. DLB (AUC = 0.80 vs. 0.58, P = 0.005) comparisons. The sensitivity and specificity for dementia/no-dementia was 85% and 90%, respectively, for (18)F-FDG PET and 71% and 70%, respectively, for SPECT.Conclusion(18)F-FDG PET was significantly superior to blood flow SPECT. We recommend (18)F-FDG PET be performed instead of perfusion SPECT for the differential diagnosis of degenerative dementia if functional imaging is indicated.© 2014 by the Society of Nuclear Medicine and Molecular Imaging, Inc.

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