<sup>18</sup> F-FDG PET for the differential diagnosis of Alzheimer's disease and frontotemporal lobar degeneration: A multicenter prospective study in Japan
Background<sup>18</sup>F-fluoro-2-deoxy-2-D-glucose positron emission tomography (<sup>18</sup>F-FDG PET) is a biomarker of neuronal injury, according to the revised National Institute on Aging-Alzheimer's Association criteria.ObjectiveThis multicenter prospective cohort study aimed to evaluate the value of <sup>18</sup>F-FDG PET for differential diagnosis of Alzheimer's disease (AD) and frontotemporal lobar degeneration (FTLD) in comparison with phosphorylated tau protein (p-tau181) in cerebrospinal fluid (CSF).MethodsIn total, 138 patients (AD, 119; FTLD, 19) from 11 participating institutions underwent clinical and neuropsychological examinations, magnetic resonance imaging (MRI), CSF examination, and <sup>18</sup>F-FDG PET at baseline. The cases were visually classified into predefined dementia patterns using <sup>18</sup>F-FDG PET by three experts. A region-of-interest (ROI)-based automated analysis of <sup>18</sup>F-FDG PET was also performed. The participants were followed up for 12 months, and the clinical diagnosis of dementia was re-evaluated.ResultsThe sensitivity, specificity, and accuracy of the visual reading of<sup>18</sup> F-FDG PET for differentiating AD from FTLD were 94%, 78%, and 92%, respectively. In contrast, those of p-tau181 in CSF were 62%, 79%, and 65%, respectively. The sensitivity, the primary endpoint, was 32% higher for <sup>18</sup>F-FDG PET than for p-tau181 in CSF. Additionally, the accuracy, the secondary endpoint, was 27% higher for <sup>18</sup>F-FDG PET than for p-tau181 in CSF. In addition to the visual reading of <sup>18</sup>F-FDG PET, the ROI-based automated analysis showed sensitivity, specificity, and accuracy of 81%, 79%, and 81%, respectively.ConclusionsThis study showed that the diagnostic performance of <sup>18</sup>F-FDG PET in differential diagnosis of AD and FTLD was higher than that of p-tau181 in CSF.Trial registrationUMIN-CTR (UMIN 000016427, https://www.umin.ac.jp/ctr/) and Japan Registry of Clinical Trials (jRCTs041180098, https://jrct.mhlw.go.jp/).
Authors
- Mikio Shoji (ORCID: https://orcid.org/0000-0003-1027-1712)
- Keisuke Suzuki (ORCID: https://orcid.org/0000-0001-5790-1289)
- Yumiko Kutoku
- Takeshi Kawarabayashi (ORCID: https://orcid.org/0000-0002-1697-6310)
- Michio Kitayama
- Harumasa Takano (ORCID: https://orcid.org/0000-0001-8492-1533)
- Yasuomi Ouchi (ORCID: https://orcid.org/0000-0002-1795-0614)
- Hiroaki Adachi (ORCID: https://orcid.org/0000-0002-9302-4663)
- Yoshihide Sunada
- Kenji Ishii (ORCID: https://orcid.org/0000-0002-2928-0072)
- Kazunari Ishii (ORCID: https://orcid.org/0000-0001-6601-952X)
- Noriyuki Kimura (ORCID: https://orcid.org/0000-0001-7137-7268)
- Kazuhiro Hara (ORCID: https://orcid.org/0000-0001-8410-8550)
- Takashi Kato (ORCID: https://orcid.org/0000-0002-4293-4333)
- Kengo Ito (ORCID: https://orcid.org/0000-0002-8322-7045)
- N. Sugimoto
- Yukihiko Washimi
- Chigusa Watanabe
- Etsuro Matsubara (ORCID: https://orcid.org/0009-0006-5150-1130)
Institutions
- University of Occupational and Environmental Health Japan (JP)
- Oita University (JP)
- Kawasaki Medical School (JP)
- Hamamatsu University School of Medicine (JP)
- National Center of Neurology and Psychiatry (JP)
- National Hospital Organization (JP)
- Tokyo Metropolitan Institute of Gerontology (JP)
- Hokuto Hospital (JP)
- National Center for Geriatrics and Gerontology (JP)
- Nagoya University (JP)
- Kindai University (JP)
Publication Details
- Journal
- Journal of Alzheimer s Disease
- Published
- 2025-05-05
- DOI
- https://doi.org/10.1177/13872877251338691
- Citations
- 2
- Primary Topic
- Dementia and Cognitive Impairment Research
- Type
- article
- Field-Weighted Citation Impact
- 2.94