Visual versus semiquantitative analysis of 18F-fluorodeoxyglucose-positron emission tomography brain images in patients with dementia

Ismet Sarikaya; Walaa Kamel; Khattab Ateyah; Nooraessa Essa; Samira AlTailji; Ali Sarikaya

doi:10.4103/wjnm.WJNM_53_18

World Journal of Nuclear Medicine, Inhaltsverzeichnis

CC BY-NC-ND 4.0 · World J Nucl Med 2021; 20(01): 82-89
DOI: 10.4103/wjnm.WJNM_53_18

Original Article

Visual versus semiquantitative analysis of ¹⁸F-fluorodeoxyglucose-positron emission tomography brain images in patients with dementia

Ismet Sarikaya

Department of Nuclear Medicine, Faculty of Medicine, Kuwait University

,

Walaa Kamel

¹Department of Neurology, Faculty of Medicine, Beni-Suef University, Egypt; Department of Nuclear Medicine, Ibn Sina Hospital, Kuwait

²Department of Nuclear Medicine, Ibn Sina Hospital, Kuwait

,

Khattab Ateyah

¹Department of Neurology, Faculty of Medicine, Beni-Suef University, Egypt; Department of Nuclear Medicine, Ibn Sina Hospital, Kuwait

,

Nooraessa Essa

⁴Department of Nuclear Medicine, Mubarak Al-Kabeer Hospital, Kuwait City, Kuwait

,

Samira AlTailji

²Department of Nuclear Medicine, Ibn Sina Hospital, Kuwait

,

Ali Sarikaya

⁵Department of Nuclear Medicine, Faculty of Medicine, Trakya University, Edirne, Turkey

› Institutsangaben

Abstract

Various studies have reported to the superiority of semiquantitative (SQ) analysis over visual analysis in detecting metabolic changes in the brain. In this study, we aimed to determine the limitations of SQ analysis programs and the current status of ¹⁸F-fluorodeoxyglucose (FDG)-positron emission tomography (PET) scan in dementia. ¹⁸F-FDG-PET/computed tomography (CT) brain images of 39 patients with a history of dementia were analyzed both visually and semiquantitatively. Using the visually markedly abnormal ¹⁸F-FDG-PET images as standard, we wanted to test the accuracy of two commercially available SQ analysis programs. SQ analysis results were classified as matching, partially matching and nonmatching with visually markedly abnormal studies. On visual analysis, ¹⁸F-FDG-PET showed marked regional hypometabolism in 19 patients, mild abnormalities in 8 and was normal in 12 patients. SQ analysis-1 results matched with visual analysis in 8 patients (42.1%) and partially matched in 11. SQ analysis-2 findings matched with visual analysis in 11 patients (57.8%) and partially matched in 7 and did not match in 1. Marked regional hypometabolism was either on the left side of the brain or was more significant on the left than the right in 63% of patients. Preservation of metabolism in sensorimotor cortex was seen in various dementia subtypes. Reviewing images in color scale and maximum intensity projection (MIP) image was helpful in demonstrating and displaying regional abnormalities, respectively. SQ analysis provides less accurate results as compared to visual analysis by experts. Due to suboptimal image registration and selection of brain areas, SQ analysis provides inaccurate results, particularly in small areas and areas in close proximity. Image registration and selection of areas with SQ programs should be checked carefully before reporting the results.

Keywords

Brain imaging - dementia - ¹⁸F-fluorodeoxyglucose-positron emission tomography - semiquantitative analysis - visual analysis

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References
1 Robinson L, Tang E, Taylor JP. Dementia: Timely diagnosis and early intervention. BMJ 2015;350:h3029.
2 Scott KR, Barrett AM. Dementia syndromes: Evaluation and treatment. Expert Rev Neurother 2007;7:407-22.
3 Matthews FE, Arthur A, Barnes LE, Bond J, Jagger C, Robinson L, et al. A two-decade comparison of prevalence of dementia in individuals aged 65 years and older from three geographical areas of England: Results of the cognitive function and ageing study I and II. Lancet 2013;382:1405-12.
4 Prince M, Bryce R, Ferri C. World Alzheimer Report 2011: The Benefits of Early Diagnosis and Intervention. London, UK: Alzheimer's Disease International; 2011.
5 Murray AD. Imaging approaches for dementia. AJNR Am J Neuroradiol 2012;33:1836-44.
6 Rice L, Bisdas S. The diagnostic value of FDG and amyloid PET in Alzheimer's disease-A systematic review. Eur J Radiol 2017;94:16-24.
7 Donnemiller E, Heilmann J, Wenning GK, Berger W, Decristoforo C, Moncayo R, et al. Brain perfusion scintigraphy with ^99mTc-HMPAO or ^99mTc-ECD and 123I-beta-CIT single-photon emission tomography in dementia of the Alzheimer-type and diffuse Lewy body disease. Eur J Nucl Med 1997;24:320-5.
8 Anderson KE, Brickman AM, Flynn J, Scarmeas N, Van Heertum R, Sackeim H, et al. Impairment of nonverbal recognition in Alzheimer disease: A PET O-15 study. Neurology 2007;69:32-41.
9 Lowe VJ, Wiste HJ, Senjem ML, Weigand SD, Therneau TM, Boeve BF, et al. Widespread brain tau and its association with ageing, braak stage and Alzheimer's dementia. Brain 2018;141:271-87.
10 Small GW, Ercoli LM, Silverman DH, Huang SC, Komo S, Bookheimer SY, et al. Cerebral metabolic and cognitive decline in persons at genetic risk for Alzheimer's disease. Proc Natl Acad Sci U S A 2000;97:6037-42.
11 Tripathi M, Tripathi M, Damle N, Kushwaha S, Jaimini A, D'Souza MM, et al. Differential diagnosis of neurodegenerative dementias using metabolic phenotypes on ¹⁸F-FDG PET/CT. Neuroradiol J 2014;27:13-21.
12 Morbelli S, Brugnolo A, Bossert I, Buschiazzo A, Frisoni GB, Galluzzi S, et al. Visual versus semi-quantitative analysis of ¹⁸F-FDG-PET in amnestic MCI: An European Alzheimer's disease consortium (EADC) project. J Alzheimers Dis 2015;44:815-26.
13 Herholz K, Salmon E, Perani D, Baron JC, Holthoff V, Frölich L, et al. Discrimination between Alzheimer dementia and controls by automated analysis of multicenter FDG PET. Neuroimage 2002;17:302-16.
14 Lehman VT, Carter RE, Claassen DO, Murphy RC, Lowe V, Petersen RC, et al. Visual assessment versus quantitative three-dimensional stereotactic surface projection fluorodeoxyglucose positron emission tomography for detection of mild cognitive impairment and Alzheimer disease. Clin Nucl Med 2012;37:721-6.
15 Gallivanone F, Della Rosa PA, Castiglioni I. Statistical voxel-based methods and [18F] FDG PET brain imaging: Frontiers for the diagnosis of AD. Curr Alzheimer Res 2016;13:682-94.
16 Minoshima S, Frey KA, Koeppe RA, Foster NL, Kuhl DE. A diagnostic approach in Alzheimer's disease using three-dimensional stereotactic surface projections of fluorine-18-FDG PET. J Nucl Med 1995;36:1238-48.
17 Yamane T, Ikari Y, Nishio T, Ishii K, Ishii K, Kato T, et al. Visual-statistical interpretation of (18)F-FDG-PET images for characteristic Alzheimer patterns in a multicenter study: Inter-rater concordance and relationship to automated quantitative evaluation. AJNR Am J Neuroradiol 2014;35:244-9.
18 Partovi S, Yuh R, Pirozzi S, Lu Z, Couturier S, Grosse U, et al. Diagnostic performance of an automated analysis software for the diagnosis of Alzheimer's dementia with18F FDG PET. Am J Nucl Med Mol Imaging 2017;7:12-23.
19 Shivamurthy VK, Tahari AK, Marcus C, Subramaniam RM. Brain FDG PET and the diagnosis of dementia. AJR Am J Roentgenol 2015;204:W76-85.
20 Herholz K. Guidance for reading FDG PET scans in dementia patients. Q J Nucl Med Mol Imaging 2014;58:332-43.
21 Bhogal P, Mahoney C, Graeme-Baker S, Roy A, Shah S, Fraioli F, et al. The common dementias: A pictorial review. Eur Radiol 2013;23:3405-17.
22 Brown RK, Bohnen NI, Wong KK, Minoshima S, Frey KA. Brain PET in suspected dementia: Patterns of altered FDG metabolism. Radiographics 2014;34:684-701.
23 McKeith IG, Boeve BF, Dickson DW, Halliday G, Taylor JP, Weintraub D, et al. Diagnosis and management of dementia with Lewy bodies: Fourth consensus report of the DLB consortium. Neurology 2017;89:88-100.
24 Lancaster JL, Fox PT, Downs H, Nickerson DS, Hander TA, El Mallah M, et al. Global spatial normalization of human brain using convex hulls. J Nucl Med 1999;40:942-55.
25 Talairach I, Tournoux P. Co-Planar Stereotaxic Atlas of the Human Brain. New York, NY: Thieme Medical Publishers; 1988.
26 Galton CJ, Patterson K, Xuereb JH, Hodges JR. Atypical and typical presentations of Alzheimer's disease: A clinical, neuropsychological, neuroimaging and pathological study of 13 cases. Brain 2000;123 Pt 3:484-98.
27 de Souza LC, Bertoux M, Funkiewiez A, Samri D, Azuar C, Habert MO, et al. Frontal presentation of Alzheimer's disease: A series of patients with biological evidence by CSF biomarkers. Dement Neuropsychol 2013;7:66-74.
28 Brigo F, Turri G, Tinazzi M. 123I-FP-CIT SPECT in the differential diagnosis between dementia with Lewy bodies and other dementias. J Neurol Sci 2015;359:161-71.
29 Kobylecki C, Langheinrich T, Hinz R, Vardy ER, Brown G, Martino ME, et al. 18F-florbetapir PET in patients with frontotemporal dementia and Alzheimer disease. J Nucl Med 2015;56:386-91.
30 Sedaghat F, Gotzamani-Psarrakou A, Dedousi E, Arnaoutoglou M, Psarrakos K, Baloyannis I, et al. Evaluation of dopaminergic function in frontotemporal dementia using I-FP-CIT single photon emission computed tomography. Neurodegener Dis 2007;4:382-5.
31 Engler H, Santillo AF, Wang SX, Lindau M, Savitcheva I, Nordberg A, et al. In vivo amyloid imaging with PET in frontotemporal dementia. Eur J Nucl Med Mol Imaging 2008;35:100-6.
32 Fodero-Tavoletti MT, Cappai R, McLean CA, Pike KE, Adlard PA, Cowie T, et al. Amyloid imaging in Alzheimer's disease and other dementias. Brain Imaging Behav 2009;3:246-61.
33 Rowe CC, Ellis KA, Rimajova M, Bourgeat P, Pike KE, Jones G, et al. Amyloid imaging results from the Australian imaging, biomarkers and lifestyle (AIBL) study of aging. Neurobiol Aging 2010;31:1275-83.
34 Cairns NJ, Ikonomovic MD, Benzinger T, Storandt M, Fagan AM, Shah AR, et al. Absence of Pittsburgh compound B detection of cerebral amyloid beta in a patient with clinical, cognitive, and cerebrospinal fluid markers of Alzheimer disease: A case report. Arch Neurol 2009;66:1557-62.
35 Levy-Cooperman N, Burhan AM, Rafi-Tari S, Kusano M, Ramirez J, Caldwell C, et al. Frontal lobe hypoperfusion and depressive symptoms in Alzheimer disease. J Psychiatry Neurosci 2008;33:218-26.
36 Kataoka K, Hashimoto H, Kawabe J, Higashiyama S, Akiyama H, Shimada A, et al. Frontal hypoperfusion in depressed patients with dementia of Alzheimer type demonstrated on 3DSRT. Psychiatry Clin Neurosci 2010;64:293-8.
37 Imran MB, Kawashima R, Awata S, Sato K, Kinomura S, Ono S, et al. Tc-99m HMPAO SPECT in the evaluation of Alzheimer's disease: Correlation between neuropsychiatric evaluation and CBF images. J Neurol Neurosurg Psychiatry 1999;66:228-32.