Amyloid vs FDG-PET in the differential diagnosis of AD and FTLD
Open accessAbstract
OBJECTIVE: To compare the diagnostic performance of PET with the amyloid ligand Pittsburgh compound B (PiB-PET) to fluorodeoxyglucose (FDG-PET) in discriminating between Alzheimer disease (AD) and frontotemporal lobar degeneration (FTLD). METHODS: Patients meeting clinical criteria for AD (n = 62) and FTLD (n = 45) underwent PiB and FDG-PET. PiB scans were classified as positive or negative by 2 visual raters blinded to clinical diagnosis, and using a quantitative threshold derived from controls (n = 25). FDG scans were visually rated as consistent with AD or FTLD, and quantitatively classified based on the region of lowest metabolism relative to controls. RESULTS: PiB visual reads had a higher sensitivity for AD (89.5% average between raters) than FDG visual reads (77.5%) with similar specificity (PiB 83%, FDG 84%). When scans were classified quantitatively, PiB had higher sensitivity (89% vs 73%) while FDG had higher specificity (83% vs 98%). On receiver operating characteristic analysis, areas under the curve for PiB (0.888) and FDG (0.910) were similar. Interrater agreement was higher for PiB (κ = 0.96) than FDG (κ = 0.72), as was agreement between visual and quantitative classification (PiB κ = 0.88-0.92; FDG κ = 0.64-0.68). In patients with known histopathology, overall classification accuracy (2 visual and 1 quantitative classification per patient) was 97% for PiB (n = 12 patients) and 87% for FDG (n = 10). CONCLUSIONS: PiB and FDG showed similar accuracy in discriminating AD and FTLD. PiB was more sensitive when interpreted qualitatively or quantitatively. FDG was more specific, but only when scans were classified quantitatively. PiB slightly outperformed FDG in patients with known histopathology.
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Compared to FDG-PET, amyloid PET is more sensitive (89% vs 73%) but less specific (83% vs 98%) for differential diagnosis between AD and FTD.
“Compared to FDG-PET, amyloid PET is more sensitive (89% vs 73%) but less specific (83% compared to 98%) for the differential diagnosis between AD and FTD [167, 168].”
From The use of neuroimaging techniques in the early and differential diagnosis of dementia (2023) · cites this paper as [168]
Studies suggest amyloid PET provides incremental diagnostic value beyond clinical and FDG-PET diagnoses of AD.
“Studies have suggested that amyloid PET provides incremental diagnostic value beyond clinical and FDG-PET diagnoses of AD.”
From The use of neuroimaging techniques in the early and differential diagnosis of dementia (2023) · cites this paper as [168]
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- Authors
- Rabinovici, G. D., Rosen, H. J., Alkalay, A., Kornak, J., Furst, A. J., Agarwal, N., Mormino, E. C., O'Neil, J. P., Janabi, M., Karydas, A., Growdon, M. E., Jang, J. Y., Huang, E. J., DeArmond, S. J., Trojanowski, J. Q., Grinberg, L. T., Gorno-Tempini, M. L., Seeley, W. W., Miller, B. L., & Jagust, W. J.
- Affiliations
- University of California, San Francisco (US)
- From the Memory & Aging Center and Departments of Neurology (G.D.R., H.J.R., A.A., A.K., M.E.G., J.Y.J., L.T.G., M.L.G.-T., W.W.S., B.L.M., W.J.J.), Epidemiology and Biostatistics (J.K.), and Pathology (E.J.H., S.J.D.), University of California San Francisco, San Francisco; Helen Wills Neuroscience Institute (G.D.R., A.A., A.J.F., N.A., E.C.M., W.J.J.), University of California Berkeley, Berkeley; Lawrence Berkeley National Laboratory (G.D.R., A.J.F., E.C.M., J.P.O., M.J., W.J.J.), Berkeley, CA;...
- ORCID
- Venue
- Neurology
- Published
- 2011-12-06
- Volume
- 77
- Issue
- 23
- Pages
- 2034-2042
- ISSN
- 0028-3878 (ISSN-L)
- 1526-632X
- PMC
- PMC3236517
- OpenAlex
- W2121673076
- Cited by
- 318
- References
- 6
- Citations by year
- 2026: 3 · 2025: 20 · 2024: 17 · 2023: 17 · 2022: 17 · 2021: 27 · 2020: 20 · 2019: 24 · 2018: 24 · 2017: 27 · 2016: 26 · 2015: 21 · 2014: 23 · 2013: 29 · 2012: 21
- FWCI
- 16.51
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Neurology (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Institutional Research Information System (Università degli Studi di Trento) (submittedVersion)
- Iris (University of Trento) (submittedVersion)
- Funders
- National Institute on Aging (R01AG032306, K23AG031861, P01AG019724)
- National Institute of Neurological Disorders and Stroke (R01NS050915)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
- Health Sciences › Medicine › Physiology › Alzheimer's disease research and treatments
- Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Medical Imaging Techniques and Applications
- Keywords
- Alzheimer's disease, frontotemporal lobar degeneration, amyloid PET, Pittsburgh compound B, FDG-PET, differential diagnosis, diagnostic accuracy, visual rating, quantitative classification, interobserver agreement
- MeSH terms
- Aged, Aged, 80 and over, Alzheimer Disease, Amyloid, Brain, Diagnosis, Differential, Female, Humans, Image Processing, Computer-Assisted, Male, Middle Aged, Fluorodeoxyglucose F18, Positron-Emission Tomography, Frontotemporal Lobar Degeneration
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