A Comparison of the Diagnostic Sensitivity of MRI, CBF-SPECT, FDG-PET and Cerebrospinal Fluid Biomarkers for Detecting Alzheimer’s Disease in a Memory Clinic

• Published in: Dementia and geriatric cognitive disorders 2010-01, Vol.30 (4), p.285-292
• Main Authors: Morinaga, Akiyoshi, Ono, Kenjiro, Ikeda, Tokuhei, Ikeda, Yoshihisa, Shima, Keisuke, Noguchi-Shinohara, Moeko, Samuraki, Miharu, Yanase, Daisuke, Yoshita, Mitsuhiro, Iwasa, Kazuo, Mastunari, Ichiro, Yamada, Masahito
• Format: Article
• Language: English
• Subjects: Aged; Aged, 80 and over; Alzheimer Disease - cerebrospinal fluid; Alzheimer Disease - diagnosis; Alzheimer Disease - pathology; Amyloid beta-Peptides - cerebrospinal fluid; Atrophy - diagnostic imaging; Atrophy - pathology; Biological and medical sciences; Biomarkers - metabolism; Cerebrospinal Fluid - diagnostic imaging; Cerebrospinal Fluid - metabolism; Degenerative and inherited degenerative diseases of the nervous system. Leukodystrophies. Prion diseases; Early Diagnosis; Female; Fluorodeoxyglucose F18; Headache. Facial pains. Syncopes. Epilepsia. Intracranial hypertension. Brain oedema. Cerebral palsy; Humans; Magnetic Resonance Imaging; Male; Medical sciences; Middle Aged; Nervous system (semeiology, syndromes); Neurology; Original Research Article; Peptide Fragments - cerebrospinal fluid; Positron-Emission Tomography; Radiography; Radiopharmaceuticals; Sensitivity and Specificity; Severity of Illness Index; Single-Blind Method; tau Proteins - cerebrospinal fluid; Temporal Lobe - diagnostic imaging; Temporal Lobe - pathology; Tomography, Emission-Computed, Single-Photon
• ISSN: 1420-8008; 1421-9824
• DOI: 10.1159/000320265

Background/Aim: Magnetic resonance imaging (MRI), cerebral blood flow single photon emission computed tomography (CBF-SPECT), fluorodeoxyglucose-positron emission tomography (FDG-PET) and cerebrospinal fluid (CSF) biomarkers are used for the diagnosis of Alzheimer’s disease (AD). We aimed to reveal the relative sensitivity of these tools in a memory clinic setting. Methods: In 207 patients with probable AD in our memory clinic, medial temporal lobe atrophy on MRI, hypoperfusion/hypometabolism of the parietotemporal lobe and posterior cingulate gyrus in ethylcysteinate dimer-CBF-SPECT/FDG-PET, and abnormalities of CSF amyloid β-protein 1–42, total tau and phosphorylated tau were evaluated as findings characteristic of AD. Results: The AD findings were observed in 77.4% of all AD patients with MRI, 81.6% with CBF-SPECT, 93.1% with FDG-PET and 94.0% with CSF biomarkers. At the stage of Clinical Dementia Rating (CDR) 0.5, CSF biomarkers were the most sensitive (90.0%); at the stage of CDR 1, FDG-PET (96.7%) and CSF biomarkers (95.5%) were highly sensitive. At the stage of CDR 2, all tools showed high positive percentages. Conclusion: The diagnosis of AD was most often supported by CSF biomarkers and FDG-PET at the early stage of dementia (CDR 1) and by CSF biomarkers at the earlier stage (CDR 0.5).