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European Journal of Nuclear Medicine and Molecular Imaging

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01-08-2019 | Computed Tomography | Original Article

Brain metabolic patterns in patients with suspected non-Alzheimer’s pathophysiology (SNAP) and Alzheimer’s disease (AD): is [¹⁸F] FDG a specific biomarker in these patients?

Authors: Agostino Chiaravalloti, Gaetano Barbagallo, Alessandro Martorana, Anna Elisa Castellano, Francesco Ursini, Orazio Schillaci

Published in: European Journal of Nuclear Medicine and Molecular Imaging | Issue 9/2019

Abstract

Purpose

The present study was conducted to compare the pattern of brain [¹⁸F] FDG uptake in suspected non-Alzheimer’s pathophysiology (SNAP), AD, and healthy controls using 2-deoxy-2-[¹⁸F]fluoroglucose ([¹⁸F] FDG) positron emission tomography imaging. Cerebrospinal fluid (CSF) biomarkers amyloid-β1-42 peptide (Aβ1-42) and tau were used in order to differentiate AD from SNAP.

Methods

The study included 43 newly diagnosed AD patients (female = 23; male = 20) according to the NINCDS-ADRDA criteria, 15 SNAP patients (female = 12; male =3), and a group of 34 healthy subjects that served as the control group (CG), who were found to be normal at neurological evaluation (male = 20; female = 14). A battery of neuropsychological tests was administrated in AD and SNAP subjects; cerebrospinal fluid assay was conducted in both AD and SNAP as well. Brain PET/CT acquisition was started 30 ± 5 min after [¹⁸F] FDG injection in all subjects. SPM12 [statistical parametric mapping] implemented in MATLAB 2018a was used for the analysis of PET scans in this study.

Results

As compared to SNAP, AD subjects showed significant hypometabolism in a wide cortical area involving the right frontal, parietal, and temporal lobes. As compared to CG, AD subjects showed a significant reduction in [¹⁸F] FDG uptake in the parietal, limbic, and frontal cortex, while a more limited reduction in [¹⁸F] FDG uptake in the same areas was found when comparing SNAP to CG.

Conclusions

SNAP subjects show milder impairment of brain [¹⁸F] FDG uptake as compared to AD. The partial overlap of the metabolic pattern between SNAP and AD limits the use of [¹⁸F] FDG PET/CT in effectively discriminating these clinical entities.

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Title: Brain metabolic patterns in patients with suspected non-Alzheimer’s pathophysiology (SNAP) and Alzheimer’s disease (AD): is [18F] FDG a specific biomarker in these patients?
Authors: Agostino Chiaravalloti
Gaetano Barbagallo
Alessandro Martorana
Anna Elisa Castellano
Francesco Ursini
Orazio Schillaci
Publication date: 01-08-2019
Publisher: Springer Berlin Heidelberg
Keywords: Computed Tomography
Computed Tomography
Alzheimer's Disease
Positron Emission Tomography
Alzheimer's Disease
Biomarkers
Published in: European Journal of Nuclear Medicine and Molecular Imaging / Issue 9/2019
Print ISSN: 1619-7070
Electronic ISSN: 1619-7089
DOI: https://doi.org/10.1007/s00259-019-04379-4

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Brain metabolic patterns in patients with suspected non-Alzheimer’s pathophysiology (SNAP) and Alzheimer’s disease (AD): is [¹⁸F] FDG a specific biomarker in these patients?

Abstract

Purpose

Methods

Results

Conclusions

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

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