Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.
ADVANCED SEARCH
Log in
Top
European Journal of Nuclear Medicine and Molecular Imaging
Published in: European Journal of Nuclear Medicine and Molecular Imaging 8/2018

01-07-2018 | Original Article

Amyloid load but not regional glucose metabolism predicts conversion to Alzheimer’s dementia in a memory clinic population

Authors: Lars Frings, Sabine Hellwig, Tobias Bormann, Timo S. Spehl, Ralph Buchert, Philipp T. Meyer

Published in: European Journal of Nuclear Medicine and Molecular Imaging | Issue 8/2018

Login to get access

Abstract

Purpose

The value of imaging regional glucose metabolism with [18F]FDG PET for the prediction of progression from mild cognitive impairment (MCI) to Alzheimer’s dementia (AD) is controversial. The predictive value of imaging with [18F]FDG PET was therefore tested and compared with that of imaging beta-amyloid load with [11C]PIB PET in the same memory clinic population of MCI patients.

Methods

Thirty-nine patients with MCI who had undergone [18F]FDG as well as [11C]PIB PET were identified from a single-centre clinical registry. [18F]FDG and [11C]PIB PET images were rated as positive or negative for the presence of regional hypometabolism typical of AD and beta-amyloid deposition, respectively. Raters were blinded to the clinical information. Patients were followed clinically for 2.7 ± 1.2 years after PET. Cox proportional hazards models, adjusted for age and sex, were used to test the predictive value of [18F]FDG PET, [11C]PIB PET, and both in combination.

Results

[18F]FDG PET did not significantly predict conversion to AD (p > 0.1). By contrast, models including [11C]PIB PET only (p < 0.05) or both [18F]FDG and [11C]PIB PET (p < 0.05) significantly predicted conversion to AD. The hazard ratio for AD in patients with a positive [11C]PIB scan was 10.2 (95% confidence interval 1.3–78.1). The results were confirmed by analysis of semiquantitative measures using normalized [18F]FDG uptake and [11C]PIB standardized uptake value ratios in AD-typical regions as continuous predictors.

Conclusion

In contrast to [11C]PIB PET, [18F]FDG PET did not predict conversion from MCI to AD in this clinical patient sample. Therefore, amyloid PET should be preferred for individual prediction and patient counselling in clinical practice.
Literature
1.
Petersen RC. Mild cognitive impairment. Continuum (Minneap Minn). 2016;22:404–18.
2.
Vos SJ, Verhey F, Frolich L, Kornhuber J, Wiltfang J, Maier W, et al. Prevalence and prognosis of Alzheimer's disease at the mild cognitive impairment stage. Brain. 2015;138:1327–38.CrossRefPubMedPubMedCentral
3.
Jack CR Jr, Knopman DS, Jagust WJ, Petersen RC, Weiner MW, Aisen PS, et al. Tracking pathophysiological processes in Alzheimer's disease: an updated hypothetical model of dynamic biomarkers. Lancet Neurol. 2013;12:207–16.CrossRefPubMedPubMedCentral
4.
Schreiber S, Landau SM, Fero A, Schreiber F, Jagust WJ. Comparison of visual and quantitative florbetapir F 18 positron emission tomography analysis in predicting mild cognitive impairment outcomes. JAMA Neurol. 2015;72:1183–90.CrossRefPubMed
5.
Grimmer T, Wutz C, Alexopoulos P, Drzezga A, Forster S, Forstl H, et al. Visual versus fully automated analyses of 18F-FDG and amyloid PET for prediction of dementia due to Alzheimer disease in mild cognitive impairment. J Nucl Med. 2016;57:204–7.CrossRefPubMed
6.
Schmand B, Eikelenboom P, van Gool WA. Value of diagnostic tests to predict conversion to Alzheimer's disease in young and old patients with amnestic mild cognitive impairment. J Alzheimers Dis. 2012;29:641–8.CrossRefPubMed
7.
Smailagic N, Vacante M, Hyde C, Martin S, Ukoumunne O, Sachpekidis C. 18F-FDG PET for the early diagnosis of Alzheimer's disease dementia and other dementias in people with mild cognitive impairment (MCI). Cochrane Database Syst Rev. 2015;1:CD010632.PubMed
8.
Morbelli S, Garibotto V, Van De Giessen E, Arbizu J, Chetelat G, Drezgza A, et al. A Cochrane review on brain [18F]FDG PET in dementia: limitations and future perspectives. Eur J Nucl Med Mol Imaging. 2015;42:1487–91.CrossRefPubMed
9.
Prestia A, Caroli A, Wade SK, van der Flier WM, Ossenkoppele R, Van Berckel B, et al. Prediction of AD dementia by biomarkers following the NIA-AA and IWG diagnostic criteria in MCI patients from three European memory clinics. Alzheimers Dement. 2015;11:1191–201.CrossRefPubMed
10.
Albert MS, DeKosky ST, Dickson D, Dubois B, Feldman HH, Fox NC, et al. The diagnosis of mild cognitive impairment due to Alzheimer's disease: recommendations from the National Institute on Aging-Alzheimer's Association workgroups on diagnostic guidelines for Alzheimer's disease. Alzheimers Dement. 2011;7:270–9.CrossRefPubMedPubMedCentral
11.
McKhann GM, Knopman DS, Chertkow H, Hyman BT, Jack CR Jr, Kawas CH, et al. The diagnosis of dementia due to Alzheimer's disease: recommendations from the National Institute on Aging-Alzheimer's Association workgroups on diagnostic guidelines for Alzheimer's disease. Alzheimers Dement. 2011;7:263–9.CrossRefPubMedPubMedCentral
12.
Frings L, Hellwig S, Spehl TS, Bormann T, Buchert R, Vach W, et al. Asymmetries of amyloid-beta burden and neuronal dysfunction are positively correlated in Alzheimer's disease. Brain. 2015;138:3089–99.CrossRefPubMed
13.
Minoshima S, Frey KA, Koeppe RA, Foster NL, Kuhl DE. A diagnostic approach in Alzheimer's disease using three-dimensional stereotactic surface projections of fluorine-18-FDG PET. J Nucl Med. 1995;36:1238–48.PubMed
14.
Trzepacz PT, Yu P, Sun J, Schuh K, Case M, Witte MM, et al. Comparison of neuroimaging modalities for the prediction of conversion from mild cognitive impairment to Alzheimer's dementia. Neurobiol Aging. 2014;35:143–51.CrossRefPubMed
15.
Morbelli S, Brugnolo A, Bossert I, Buschiazzo A, Frisoni GB, Galluzzi S, et al. Visual versus semi-quantitative analysis of 18F-FDG-PET in amnestic MCI: an European Alzheimer's Disease Consortium (EADC) project. J Alzheimers Dis. 2015;44:815–26.CrossRefPubMed
16.
Abner EL, Kryscio RJ, Schmitt FA, Fardo DW, Moga DC, Ighodaro ET, et al. Outcomes after diagnosis of mild cognitive impairment in a large autopsy series. Ann Neurol. 2017;81:549–59.CrossRefPubMedPubMedCentral
Metadata
Title
Amyloid load but not regional glucose metabolism predicts conversion to Alzheimer’s dementia in a memory clinic population
Authors
Lars Frings
Sabine Hellwig
Tobias Bormann
Timo S. Spehl
Ralph Buchert
Philipp T. Meyer
Publication date
01-07-2018
Publisher
Springer Berlin Heidelberg
Published in
European Journal of Nuclear Medicine and Molecular Imaging / Issue 8/2018
Print ISSN: 1619-7070
Electronic ISSN: 1619-7089
DOI
https://doi.org/10.1007/s00259-018-3983-6

Other articles of this Issue 8/2018

European Journal of Nuclear Medicine and Molecular Imaging 8/2018 Go to the issue

Image of the Month

The impact of a Bayesian penalized-likelihood reconstruction algorithm on delayed-time-point Ga-68-PSMA PET for improved recurrent prostate cancer detection

Letter to the Editor

Is there an optimal method for measuring baseline metabolic tumor volume in diffuse large B cell lymphoma?

Original Article

Feasibility of state of the art PET/CT systems performance harmonisation

Original Article

Impact of plasma glucose level on the pattern of brain FDG uptake and the predictive power of FDG PET in mild cognitive impairment

Original Article

Parametric mapping using spectral analysis for 11C-PBR28 PET reveals neuroinflammation in mild cognitive impairment subjects

Original Article

Japanese multicenter database of healthy controls for [123I]FP-CIT SPECT