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neuroimaging

Can FDG PET spot prodromal DLB vs AD?

Kantarci K, Boeve BF, Przybelski SA, et al. · NeuroImage. Clinical · 2021

Open access · cc by · source: Europe PMC

In MCI converters, DLB-like hypometabolism (including substantia nigra) with preserved medial temporal/posterior cingulate metabolism, and a medial temporal/SN ratio (94% sens / 83% spec), distinguished future DLB from AD.

Study at a glance

Design
Cohort — Baseline FDG PET in MCI converters to DLB vs AD vs CU controls
N
N=158 · MCI-DLB n=17; MCI-AD n=41; CU controls n=100
Population
Mayo ADRC MCI patients who later met probable DLB or AD, plus CU controls
Outcome
FDG PET hypometabolism patterns and CIS / medial temporal–SN ratios distinguishing prodromal DLB vs AD

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Key findings

MCI-DLB showed parieto-occipital hypometabolism extending to temporal lobes, SN, and thalamus, with relatively preserved medial temporal and posterior cingulate metabolism vs MCI-AD. CIS was specific (90%) but not sensitive (59%); medial temporal/SN ratio was both sensitive (94%) and specific (83%).

Methodology

Compared baseline FDG PET in Mayo ADRC MCI patients who progressed to probable DLB (n=17) or AD dementia (n=41) versus CU controls (n=100), evaluating CIS and regional metabolic ratios.

Limitations

Small MCI-DLB n and single-center Mayo sample limit generalizability; PET patterns are biomarkers, not definitive pathologic diagnoses at the MCI stage.

How this study connects

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