Rapid Assessment of Regional Cerebral Metabolic Abnormalities in Single Subjects with Quantitative and Nonquantitative [18F]FDG PET: A Clinical Validation of Statistical Parametric Mapping

• Published in: NeuroImage (Orlando, Fla.) Fla.), 1999-01, Vol.9 (1), p.63-80
• Main Authors: Signorini, M., Paulesu, E., Friston, K., Perani, D., Colleluori, A., Lucignani, G., Grassi, F., Bettinardi, V., Frackowiak, R.S.J., Fazio, F.
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Aged; Alzheimer Disease - diagnostic imaging; Alzheimer's disease; Aphasia; Aphasia - diagnostic imaging; Blood Glucose - metabolism; Brain - diagnostic imaging; Brain Diseases - diagnostic imaging; Brain Mapping; Cannulation; dementia; Developmental disabilities; Energy Metabolism - physiology; Epilepsy; Epilepsy - diagnostic imaging; Female; Fluorodeoxyglucose F18; Humans; Image Processing, Computer-Assisted; Language Development Disorders - diagnostic imaging; Localization; Male; Middle Aged; Multiple sclerosis; Multiple Sclerosis - diagnostic imaging; Neurodegenerative diseases; Neurodevelopmental disorders; Perfusion; Positron emission tomography; Quantitation; Radioactivity; Reference Values; Single photon emission computed tomography; single-case studies; specific language impairment; statistical parametric mapping; Statistics; Tomography, Emission-Computed
• ISSN: 1053-8119; 1095-9572
• DOI: 10.1006/nimg.1998.0381

The [18F]fluorodeoxyglucose ([18F]FDG) method for measuring brain metabolism has not the wide clinical application that one might expect, partly because of its high cost and the complexity of the quantification procedure, but also because of reporting techniques based on region of interest (ROI) analysis, which are time-consuming and not fully objective. In this paper we report a clinical validation of statistical parametric mapping (SPM) using rCMRglc (quantitative) and radioactivity distribution (nonquantitative) [18F]FDG PET data. We show that a 10-min noninteractive voxel-based SPM analysis on a standard workstation enables objective assessment, including localization in stereotactic space, of regional glucose consumption abnormalities, whose reliability can be assessed on statistical and clinical grounds. Clinical validity was established using a small series of patients with degenerative or developmental disorders, including probable Alzheimer's disease, progressive aphasia, multiple sclerosis, developmental specific language impairment, and epilepsy. Analysis of quantitative and nonquantitative data showed the same pattern of results, suggesting that, for clinical purposes, quantitation and invasive arterial cannulation can be avoided. This should facilitate a wider application of the technique and the extension of SPM clinical analysis to H215O PET or high resolution SPECT perfusion studies.