Fluorodeoxyglucose-Positron-Emission Tomography, Single-Photon Emission Tomography, and Structural MR Imaging for Prediction of Rapid Conversion to Alzheimer Disease in Patients with Mild Cognitive Impairment: A Meta-Analysis

• Published in: American journal of neuroradiology : AJNR Vol. 30; no. 2; pp. 404 - 410
• Main Authors: Yuan, Y, Gu, Z.-X, Wei, W.-S
• Format: Journal Article
• Language: English
• Published: Oak Brook, IL Am Soc Neuroradiology 01.02.2009; American Society of Neuroradiology
• Subjects: Alzheimer Disease - diagnostic imaging; Alzheimer Disease - pathology; Biological and medical sciences; Cognition Disorders - diagnostic imaging; Cognition Disorders - pathology; Degenerative and inherited degenerative diseases of the nervous system. Leukodystrophies. Prion diseases; Disease Progression; Fluorodeoxyglucose F18; Functional; Humans; Investigative techniques, diagnostic techniques (general aspects); Magnetic Resonance Imaging; Medical sciences; Nervous system; Neurology; Predictive Value of Tests; Radiodiagnosis. Nmr imagery. Nmr spectrometry; Severity of Illness Index; Tomography, Emission-Computed, Single-Photon; Human; Nervous system diseases; Radiodiagnosis; Alzheimer disease; Prediction; Single photon emission tomography; Conversion; Nuclear magnetic resonance imaging; Cerebral disorder; Drug conversion; Central nervous system disease; Degenerative disease; Positron emission tomography
• ISSN: 0195-6108; 1936-959X
• DOI: 10.3174/ajnr.A1357

Patients with mild cognitive impairment (MCI) are at risk for developing Alzheimer disease (AD). To diagnose AD at an early stage, one must develop highly specific and sensitive tools to identify it among at-risk subjects. The purpose of this study was to evaluate and compare the ability of fluorodeoxyglucose-positron-emission tomography (FDG-PET), single-photon emission tomography (SPECT), and structural MR imaging to predict conversion to AD in patients with MCI. Relevant studies were identified with MEDLINE from January 1990 to April 2008. Meta-analysis and meta-regression were done on the diagnostic performance data for each technique from eligible studies. We estimated and compared the weighted summary sensitivities, specificities, likelihood ratios (LRs), and summary receiver operating characteristic curves of each imaging technique. Twenty-four eligible studies were included, with a total of 1112 patients. FDG-PET performed statistically better in LR+ and odds ratio (OR), whereas no statistical difference was found in pooled sensitivity, specificity, and LR- for each technique. No statistical difference was confirmed between SPECT and MR imaging. The Q* index estimates for FDG-PET, SPECT, and structural MR imaging were respectively 0.86, 0.75, and 0.76. In meta-regression, statistical significance was found only between technique and log OR, with a regression coefficient of -0.575. This meta-analysis showed that FDG-PET performs slightly better than SPECT and structural MR imaging in the prediction of conversion to AD in patients with MCI; parallel performance was found between SPECT and MR imaging.