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

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European Journal of Nuclear Medicine and Molecular Imaging Aims and scope Submit manuscript

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.

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Authors and Affiliations

  1. Department of Nuclear Medicine, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany

    Lars Frings, Timo S. Spehl & Philipp T. Meyer

  2. Center for Geriatrics and Gerontology Freiburg, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany

    Lars Frings

  3. Department of Psychiatry and Psychotherapy, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany

    Sabine Hellwig

  4. Department of Neurology, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany

    Tobias Bormann

  5. Department of Nuclear Medicine, University Hospital Hamburg Eppendorf, Hamburg, Germany

    Ralph Buchert

Authors
  1. Lars Frings
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  2. Sabine Hellwig
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  3. Tobias Bormann
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  4. Timo S. Spehl
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  5. Ralph Buchert
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  6. Philipp T. Meyer
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Correspondence to Lars Frings.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the principles of the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards.

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Frings, L., Hellwig, S., Bormann, T. et al. Amyloid load but not regional glucose metabolism predicts conversion to Alzheimer’s dementia in a memory clinic population. Eur J Nucl Med Mol Imaging 45, 1442–1448 (2018). https://doi.org/10.1007/s00259-018-3983-6

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  • DOI: https://doi.org/10.1007/s00259-018-3983-6

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