Review Article

Clinical and Translational Imaging

, Volume 1, Issue 4, pp 279-288

First online:

Computer-aided diagnostic reporting of FDG PET for the diagnosis of Alzheimer’s disease

  • A. PrestiaAffiliated withLENITEM-Laboratory of Epidemiology Neuroimaging and Telemedicine, and Unit for the Clinical Translation of Research, IRCCS Centro San Giovanni di Dio FBF
  • , C. MuscioAffiliated withLENITEM-Laboratory of Epidemiology Neuroimaging and Telemedicine, and Unit for the Clinical Translation of Research, IRCCS Centro San Giovanni di Dio FBF
  • , A. CaroliAffiliated withLENITEM-Laboratory of Epidemiology Neuroimaging and Telemedicine, and Unit for the Clinical Translation of Research, IRCCS Centro San Giovanni di Dio FBFMedical Imaging Unit, Biomedical Engineering Department, Mario Negri Institute for Pharmacological Research
  • , G. B. FrisoniAffiliated withLENITEM-Laboratory of Epidemiology Neuroimaging and Telemedicine, and Unit for the Clinical Translation of Research, IRCCS Centro San Giovanni di Dio FBF Email author 

Abstract

Temporoparietal hypometabolism on 18F-FDG PET is one of the core biomarkers for the biomarker-based diagnosis of Alzheimer’s disease. The traditional readout of 18F-FDG PET for diagnostic reports is a subjective visual rating. However, this is loaded with substantial inter-rater variability. Standardization of readouts is a key factor for the use of markers in the clinic. Automated tools have been developed aimed at aiding diagnostic reporting and making it more reliable. Some involve the statistical voxel-by-voxel comparison of 18F-FDG uptake compared to a normative dataset, which provides a statistical map of difference of metabolism and requires expert judgement. Others provide a summary metric of temporoparietal hypometabolism, where a cutoff defines normality/abnormality. Strengths, weaknesses, and cautionary warnings of visual rating and both classes of tools are reviewed and discussed.

Keywords

FDG PET Dementia diagnosis Visual rating Global indices