The value of FDG-PET/CT by using 3-dimensional stereotactic surface projection software analysis in the differential diagnosis of dementia

Authors: ESRA ARSLAN, ÖZGÜL EKMEKÇİOĞLU, FATMA ARZU GÖRTAN, ZEYNEP FUNDA ENGİN AKCAN, MELİH ENGİN ERKAN, HACI MURAT EMÜL, METİN HALAÇ, TEVFİK FİKRET ÇERMİK, KERİM SÖNMEZOĞLU

Abstract: Background/aim: To retrospectively reevaluate brain fluor-18-fluorodeoxyglucose positron emission tomography (FDG-PET) imaging studies with 3-dimensional stereotactic surface projection (NEUROSTAT) software in order to detect changes in regional brain metabolism and to find out its contribution to the final diagnosis. Materials and methods: A total of 48 cases were included in this study. According to clinical evaluation and neuropsychometric test results, there were 17 (35%) patients with probable Alzheimer disease (AD), 17 (35%) patients with probable frontotemporal dementia (FTD), and 14 (30%) patients with undefined advanced dementia. Brain FDG-PET imaging studies were interpreted visually and also using 3-dimensional stereotactic surface projection. Results: Clinic and PET findings were consistent in 20 patients and inconsistent in 14 patients. When consensus diagnosis was taken as the reference, the sensitivity, specificity, accuracy, and positive and negative predictive values of FDG-PET imaging were 93%, 85%, 90%, 90%, and 89% respectively, for AD diagnosis. The same values were 85%, 93%, 90%, 89%, and 90%, respectively, for FTD definition. Conclusion: Using automatized programs that enable quantitative evaluation of regional brain glucose metabolism, in addition to visual evaluation, may increase diagnostic efficiency, as well as minimize interobserver and/or intercenter variability.

Keywords: Alzheimer disease, frontotemporal dementia, fluor-18-FDG-PET, brain positron emission tomography

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