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

作者：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^*

来源：Dementia and Geriatric Cognitive Disorders, 2010, 30(4): 285-292.

DOI：10.1159/000320265

• Alzheimer's disease
• MRI
• CBF-SPECT
• FDG-PET
• CSF biomarkers
• Amyloid beta-protein 1-42
• Total tau
• Phosphorylated tau

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 beta-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).

• 出版日期2010