Early identification of MCI converting to AD: a FDG PET study

Marco Pagani, Flavio Nobili, Silvia Morbelli, Dario Arnaldi, Alessandro Giuliani, Johanna Öberg, Nicola Girtler, Andrea Brugnolo, Agnese Picco, Matteo Bauckneht, Roberta Piva, Andrea Chincarini, Gianmario Sambuceti, Cathrine Jonsson, Fabrizio De Carli

Research output: Contribution to journalArticle

Abstract

Purpose: Mild cognitive impairment (MCI) is a transitional pathological stage between normal ageing (NA) and Alzheimer’s disease (AD). Although subjects with MCI show a decline at different rates, some individuals remain stable or even show an improvement in their cognitive level after some years. We assessed the accuracy of FDG PET in discriminating MCI patients who converted to AD from those who did not. Methods: FDG PET was performed in 42 NA subjects, 27 MCI patients who had not converted to AD at 5 years (nc-MCI; mean follow-up time 7.5 ± 1.5 years), and 95 MCI patients who converted to AD within 5 years (MCI-AD; mean conversion time 1.8 ± 1.1 years). Relative FDG uptake values in 26 meta-volumes of interest were submitted to ANCOVA and support vector machine analyses to evaluate regional differences and discrimination accuracy. Results: The MCI-AD group showed significantly lower FDG uptake values in the temporoparietal cortex than the other two groups. FDG uptake values in the nc-MCI group were similar to those in the NA group. Support vector machine analysis discriminated nc-MCI from MCI-AD patients with an accuracy of 89% (AUC 0.91), correctly detecting 93% of the nc-MCI patients. Conclusion: In MCI patients not converting to AD within a minimum follow-up time of 5 years and MCI patients converting within 5 years, baseline FDG PET and volume-based analysis identified those who converted with an accuracy of 89%. However, further analysis is needed in patients with amnestic MCI who convert to a dementia other than AD.

Original languageEnglish
Pages (from-to)2042-2052
Number of pages11
JournalEuropean Journal of Nuclear Medicine and Molecular Imaging
Volume44
Issue number12
DOIs
Publication statusPublished - Nov 1 2017

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Alzheimer Disease
Cognitive Dysfunction
Area Under Curve
Dementia

Keywords

  • Alzheimer’s disease
  • Conversion to AD
  • Mild cognitive impairment
  • Positron emission tomography
  • Support vector machine
  • Volume of interest analysis

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

Cite this

Early identification of MCI converting to AD : a FDG PET study. / Pagani, Marco; Nobili, Flavio; Morbelli, Silvia; Arnaldi, Dario; Giuliani, Alessandro; Öberg, Johanna; Girtler, Nicola; Brugnolo, Andrea; Picco, Agnese; Bauckneht, Matteo; Piva, Roberta; Chincarini, Andrea; Sambuceti, Gianmario; Jonsson, Cathrine; De Carli, Fabrizio.

In: European Journal of Nuclear Medicine and Molecular Imaging, Vol. 44, No. 12, 01.11.2017, p. 2042-2052.

Research output: Contribution to journalArticle

Pagani, M, Nobili, F, Morbelli, S, Arnaldi, D, Giuliani, A, Öberg, J, Girtler, N, Brugnolo, A, Picco, A, Bauckneht, M, Piva, R, Chincarini, A, Sambuceti, G, Jonsson, C & De Carli, F 2017, 'Early identification of MCI converting to AD: a FDG PET study', European Journal of Nuclear Medicine and Molecular Imaging, vol. 44, no. 12, pp. 2042-2052. https://doi.org/10.1007/s00259-017-3761-x
Pagani, Marco ; Nobili, Flavio ; Morbelli, Silvia ; Arnaldi, Dario ; Giuliani, Alessandro ; Öberg, Johanna ; Girtler, Nicola ; Brugnolo, Andrea ; Picco, Agnese ; Bauckneht, Matteo ; Piva, Roberta ; Chincarini, Andrea ; Sambuceti, Gianmario ; Jonsson, Cathrine ; De Carli, Fabrizio. / Early identification of MCI converting to AD : a FDG PET study. In: European Journal of Nuclear Medicine and Molecular Imaging. 2017 ; Vol. 44, No. 12. pp. 2042-2052.
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abstract = "Purpose: Mild cognitive impairment (MCI) is a transitional pathological stage between normal ageing (NA) and Alzheimer’s disease (AD). Although subjects with MCI show a decline at different rates, some individuals remain stable or even show an improvement in their cognitive level after some years. We assessed the accuracy of FDG PET in discriminating MCI patients who converted to AD from those who did not. Methods: FDG PET was performed in 42 NA subjects, 27 MCI patients who had not converted to AD at 5 years (nc-MCI; mean follow-up time 7.5 ± 1.5 years), and 95 MCI patients who converted to AD within 5 years (MCI-AD; mean conversion time 1.8 ± 1.1 years). Relative FDG uptake values in 26 meta-volumes of interest were submitted to ANCOVA and support vector machine analyses to evaluate regional differences and discrimination accuracy. Results: The MCI-AD group showed significantly lower FDG uptake values in the temporoparietal cortex than the other two groups. FDG uptake values in the nc-MCI group were similar to those in the NA group. Support vector machine analysis discriminated nc-MCI from MCI-AD patients with an accuracy of 89{\%} (AUC 0.91), correctly detecting 93{\%} of the nc-MCI patients. Conclusion: In MCI patients not converting to AD within a minimum follow-up time of 5 years and MCI patients converting within 5 years, baseline FDG PET and volume-based analysis identified those who converted with an accuracy of 89{\%}. However, further analysis is needed in patients with amnestic MCI who convert to a dementia other than AD.",
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T2 - a FDG PET study

AU - Pagani, Marco

AU - Nobili, Flavio

AU - Morbelli, Silvia

AU - Arnaldi, Dario

AU - Giuliani, Alessandro

AU - Öberg, Johanna

AU - Girtler, Nicola

AU - Brugnolo, Andrea

AU - Picco, Agnese

AU - Bauckneht, Matteo

AU - Piva, Roberta

AU - Chincarini, Andrea

AU - Sambuceti, Gianmario

AU - Jonsson, Cathrine

AU - De Carli, Fabrizio

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N2 - Purpose: Mild cognitive impairment (MCI) is a transitional pathological stage between normal ageing (NA) and Alzheimer’s disease (AD). Although subjects with MCI show a decline at different rates, some individuals remain stable or even show an improvement in their cognitive level after some years. We assessed the accuracy of FDG PET in discriminating MCI patients who converted to AD from those who did not. Methods: FDG PET was performed in 42 NA subjects, 27 MCI patients who had not converted to AD at 5 years (nc-MCI; mean follow-up time 7.5 ± 1.5 years), and 95 MCI patients who converted to AD within 5 years (MCI-AD; mean conversion time 1.8 ± 1.1 years). Relative FDG uptake values in 26 meta-volumes of interest were submitted to ANCOVA and support vector machine analyses to evaluate regional differences and discrimination accuracy. Results: The MCI-AD group showed significantly lower FDG uptake values in the temporoparietal cortex than the other two groups. FDG uptake values in the nc-MCI group were similar to those in the NA group. Support vector machine analysis discriminated nc-MCI from MCI-AD patients with an accuracy of 89% (AUC 0.91), correctly detecting 93% of the nc-MCI patients. Conclusion: In MCI patients not converting to AD within a minimum follow-up time of 5 years and MCI patients converting within 5 years, baseline FDG PET and volume-based analysis identified those who converted with an accuracy of 89%. However, further analysis is needed in patients with amnestic MCI who convert to a dementia other than AD.

AB - Purpose: Mild cognitive impairment (MCI) is a transitional pathological stage between normal ageing (NA) and Alzheimer’s disease (AD). Although subjects with MCI show a decline at different rates, some individuals remain stable or even show an improvement in their cognitive level after some years. We assessed the accuracy of FDG PET in discriminating MCI patients who converted to AD from those who did not. Methods: FDG PET was performed in 42 NA subjects, 27 MCI patients who had not converted to AD at 5 years (nc-MCI; mean follow-up time 7.5 ± 1.5 years), and 95 MCI patients who converted to AD within 5 years (MCI-AD; mean conversion time 1.8 ± 1.1 years). Relative FDG uptake values in 26 meta-volumes of interest were submitted to ANCOVA and support vector machine analyses to evaluate regional differences and discrimination accuracy. Results: The MCI-AD group showed significantly lower FDG uptake values in the temporoparietal cortex than the other two groups. FDG uptake values in the nc-MCI group were similar to those in the NA group. Support vector machine analysis discriminated nc-MCI from MCI-AD patients with an accuracy of 89% (AUC 0.91), correctly detecting 93% of the nc-MCI patients. Conclusion: In MCI patients not converting to AD within a minimum follow-up time of 5 years and MCI patients converting within 5 years, baseline FDG PET and volume-based analysis identified those who converted with an accuracy of 89%. However, further analysis is needed in patients with amnestic MCI who convert to a dementia other than AD.

KW - Alzheimer’s disease

KW - Conversion to AD

KW - Mild cognitive impairment

KW - Positron emission tomography

KW - Support vector machine

KW - Volume of interest analysis

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