Title | Optimization of Statistical Single Subject Analysis of Brain FDG PET for the Prognosis of Mild Cognitive Impairment-to-Alzheimer's Disease Conversion. |
Publication Type | Journal Article |
Year of Publication | 2016 |
Authors | Lange, C, Suppa, P, Frings, L, Brenner, W, Spies, L, Buchert, R |
Journal | J Alzheimers Dis |
Volume | 49 |
Issue | 4 |
Pagination | 945-59 |
Date Published | 2016 |
ISSN | 1875-8908 |
Keywords | Aged, Alzheimer Disease, Area Under Curve, Brain, Cognitive Dysfunction, Disease Progression, Female, Fluorodeoxyglucose F18, Follow-Up Studies, Glucose, Humans, Image Interpretation, Computer-Assisted, Male, Positron-Emission Tomography, Prognosis, Radiopharmaceuticals, ROC Curve |
Abstract | BACKGROUND: Positron emission tomography (PET) with the glucose analog F-18-fluorodeoxyglucose (FDG) is widely used in the diagnosis of neurodegenerative diseases. Guidelines recommend voxel-based statistical testing to support visual evaluation of the PET images. However, the performance of voxel-based testing strongly depends on each single preprocessing step involved. OBJECTIVE: To optimize the processing pipeline of voxel-based testing for the prognosis of dementia in subjects with amnestic mild cognitive impairment (MCI). METHODS: The study included 108 ADNI MCI subjects grouped as 'stable MCI' (n = 77) or 'MCI-to-AD converter' according to their diagnostic trajectory over 3 years. Thirty-two ADNI normals served as controls. Voxel-based testing was performed with the statistical parametric mapping software (SPM8) starting with default settings. The following modifications were added step-by-step: (i) motion correction, (ii) custom-made FDG template, (iii) different reference regions for intensity scaling, and (iv) smoothing was varied between 8 and 18 mm. The t-sum score for hypometabolism within a predefined AD mask was compared between the different settings using receiver operating characteristic (ROC) analysis with respect to differentiation between 'stable MCI' and 'MCI-to-AD converter'. The area (AUC) under the ROC curve was used as performance measure. RESULTS: The default setting provided an AUC of 0.728. The modifications of the processing pipeline improved the AUC up to 0.832 (p = 0.046). Improvement of the AUC was confirmed in an independent validation sample of 241 ADNI MCI subjects (p = 0.048). CONCLUSION: The prognostic value of voxel-based single subject analysis of brain FDG PET in MCI subjects can be improved considerably by optimizing the processing pipeline. |
DOI | 10.3233/JAD-150814 |
Alternate Journal | J. Alzheimers Dis. |
PubMed ID | 26577523 |
Grant List | U01 AG024904 / AG / NIA NIH HHS / United States |