Differential effects of global and cerebellar normalization on detection and differentiation of dementia in FDG-PET studies
Abstract
FDG-PET ([18F]fluorodeoxyglucose positron emission tomography) is frequently used to improve the differential diagnosis of dementia. However, a fundamental methodological issue of the reference area for the intensity normalization procedure is still unsolved. Here, we systematically compared the two most commonly used normalization methods to the cerebral and to the cerebellar metabolic rate for glucose with regard to detection and differentiation of dementia syndromes. FDG-PET imaging was performed on 19 subjects with early Alzheimer's disease, 13 subjects with early frontotemporal lobar degeneration and 10 subjects complaining of memory impairment, which had not been confirmed by comprehensive clinical testing. Images were normalized to either the cerebral or the cerebellar metabolic rate for glucose. Differences in relative regional glucose metabolism were assessed by voxelwise comparison. Analysis using the two normalization procedures revealed remarkable differential effects. Whereas cerebellar normalization was superior in identifying dementia patients in comparison to control subjects, cerebral normalization showed better results for differential diagnosis between types of dementia. These effects were shown for both, Alzheimer's disease and frontotemporal lobar degeneration. Relative hypermetabolism in comparison to the control group was only detected in both kinds of dementia using global normalization. The results indicate that normalization has a decisive impact on diagnostic accuracy in dementia. While cerebellar normalization seems to be more sensitive for early diagnosis, cerebral global normalization might be superior for differential diagnostic purposes in dementia syndromes.
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FDG-PET measurement can differentiate AD patients from other clinical diagnoses.
“this measurement can be used to differentiate AD patients from other clinical diagnoses [221]”
From Genetic architecture of Alzheimer's disease (2020) · cites this paper as [221]
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- Authors
- Dukart, J., Mueller, K., Horstmann, A., Vogt, B., Frisch, S., Barthel, H., Becker, G., Möller, H. E., Villringer, A., Sabri, O., & Schroeter, M. L.
- Affiliations
- Max Planck Institute for Human Cognitive and Brain Sciences (DE)
- Leipzig University (DE)
- Corresponding author
- Dukart, Juergen
- ORCID
- Venue
- NeuroImage
- Publisher
- Elsevier BV
- Published
- 2010-01
- Volume
- 49
- Issue
- 2
- Pages
- 1490-1495
- ISSN
- 1053-8119 (ISSN-L)
- OpenAlex
- W2165206443
- Cited by
- 134
- References
- 36
- Citations by year
- 2026: 5 · 2025: 4 · 2024: 6 · 2023: 5 · 2022: 3 · 2021: 7 · 2020: 7 · 2019: 13 · 2018: 10 · 2017: 11 · 2016: 11 · 2015: 13 · 2014: 10 · 2013: 8 · 2012: 7
- FWCI
- 4.32
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- NeuroImage (publishedVersion)
- PubMed (publishedVersion)
- Max Planck Digital Library (submittedVersion)
- MPG.PuRe (Max Planck Society) (submittedVersion)
- LSHTM Research Online (London School of Hygiene and Tropical Medicine) (submittedVersion)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
- Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Medical Imaging Techniques and Applications
- Life Sciences › Neuroscience › Cognitive Neuroscience › Functional Brain Connectivity Studies
- Keywords
- FDG-PET, global normalization, cerebral metabolic rate of glucose, Alzheimer's disease, frontotemporal lobar degeneration, differential diagnosis of dementia, early detection of dementia, regional glucose metabolism, memory impairment
- MeSH terms
- Age Factors, Alzheimer Disease, Analysis of Variance, Brain, Brain Mapping, Cerebellum, Dementia, Diagnosis, Differential, Female, Glucose, Humans, Male, Memory Disorders, Middle Aged, Severity of Illness Index, Signal Processing, Computer-Assisted, Radiopharmaceuticals, Fluorodeoxyglucose F18, Positron-Emission Tomography, Frontotemporal Lobar Degeneration
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