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The role of PET/CT amyloid Imaging compared with Tc99m-HMPAO SPECT imaging for diagnosing Alzheimer's disease

Background: Imaging such as Tc99m-HMPAO single photon emission computed tomography (SPECT), and positron emission tomography/ computed tomography (PET/CT) amyloid scans are used to aid the diagnosis of Alzheimer’s disease (AD). Objective: We aimed to correlate the ability of these modalities to diff...

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Main Authors: Suppiah, Subapriya, Siew, Mooi Ching, Nordin, Abdul Jalil, Vinjamuri, Sobhan
Format: Article
Language:English
Published: Malaysian Medical Association 2018
Online Access:http://psasir.upm.edu.my/id/eprint/74272/1/PET.pdf
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spelling oai:psasir.upm.edu.my:74272 http://psasir.upm.edu.my/id/eprint/74272/ The role of PET/CT amyloid Imaging compared with Tc99m-HMPAO SPECT imaging for diagnosing Alzheimer's disease Suppiah, Subapriya Siew, Mooi Ching Nordin, Abdul Jalil Vinjamuri, Sobhan Background: Imaging such as Tc99m-HMPAO single photon emission computed tomography (SPECT), and positron emission tomography/ computed tomography (PET/CT) amyloid scans are used to aid the diagnosis of Alzheimer’s disease (AD). Objective: We aimed to correlate the ability of these modalities to differentiate Probable AD and Possible AD using the clinical diagnosis as a gold standard. We also investigated the correlation of severity of amyloid deposit in the brain with the diagnosis of AD. Methods: A retrospective study of 47 subjects (17 Probable AD and 30 Possible AD) who were referred for PET/CT amyloid scans to our centre was conducted. Hypoperfusion in the temporo-parietal lobes on Tc99m-HMPAO SPECT and loss of grey-white matter contrast in cortical regions on PET/CT Amyloid scans indicating the presence of amyloid β deposit were qualitatively interpreted as positive for AD. SPECT and PET/CT were also read in combination (Combo reading). The severity of amyloid β deposit was semiquantitatively assessed in a visual binary method using a scale of Grade 0-4. The severity of amyloid β deposit was assessed in a visual binary method and a semi-quantitative method using a scale of Grade 0-4. Results: There was significant correlation of Tc99m-HMPAO SPECT, PET/CT amyloid findings and Combo reading with AD. The sensitivity, specificity, PPV and NPV were 87.5%, 73.7%, 58.3% and 93.3% (SPECT); 62.5%, 77.4%, 58.8% and 80.0% (PET/CT) and 87.5%, 84.2%, 70.0% and 30.0% (Combo reading) respectively. The grade of amyloid deposition was not significantly correlated with AD (Spearman’s correlation, p=0.687). Conclusion: There is an incremental benefit in utilizing PET/CT amyloid imaging in cases with atypical presentation and indeterminate findings on conventional imaging of Alzheimer’s disease. Malaysian Medical Association 2018 Article PeerReviewed text en http://psasir.upm.edu.my/id/eprint/74272/1/PET.pdf Suppiah, Subapriya and Siew, Mooi Ching and Nordin, Abdul Jalil and Vinjamuri, Sobhan (2018) The role of PET/CT amyloid Imaging compared with Tc99m-HMPAO SPECT imaging for diagnosing Alzheimer's disease. Medical Journal of Malaysia, 73 (3). 141 -146. ISSN 0300-5283 https://europepmc.org/article/med/29962497
institution UPM IR
collection UPM IR
language English
description Background: Imaging such as Tc99m-HMPAO single photon emission computed tomography (SPECT), and positron emission tomography/ computed tomography (PET/CT) amyloid scans are used to aid the diagnosis of Alzheimer’s disease (AD). Objective: We aimed to correlate the ability of these modalities to differentiate Probable AD and Possible AD using the clinical diagnosis as a gold standard. We also investigated the correlation of severity of amyloid deposit in the brain with the diagnosis of AD. Methods: A retrospective study of 47 subjects (17 Probable AD and 30 Possible AD) who were referred for PET/CT amyloid scans to our centre was conducted. Hypoperfusion in the temporo-parietal lobes on Tc99m-HMPAO SPECT and loss of grey-white matter contrast in cortical regions on PET/CT Amyloid scans indicating the presence of amyloid β deposit were qualitatively interpreted as positive for AD. SPECT and PET/CT were also read in combination (Combo reading). The severity of amyloid β deposit was semiquantitatively assessed in a visual binary method using a scale of Grade 0-4. The severity of amyloid β deposit was assessed in a visual binary method and a semi-quantitative method using a scale of Grade 0-4. Results: There was significant correlation of Tc99m-HMPAO SPECT, PET/CT amyloid findings and Combo reading with AD. The sensitivity, specificity, PPV and NPV were 87.5%, 73.7%, 58.3% and 93.3% (SPECT); 62.5%, 77.4%, 58.8% and 80.0% (PET/CT) and 87.5%, 84.2%, 70.0% and 30.0% (Combo reading) respectively. The grade of amyloid deposition was not significantly correlated with AD (Spearman’s correlation, p=0.687). Conclusion: There is an incremental benefit in utilizing PET/CT amyloid imaging in cases with atypical presentation and indeterminate findings on conventional imaging of Alzheimer’s disease.
format Article
author Suppiah, Subapriya
Siew, Mooi Ching
Nordin, Abdul Jalil
Vinjamuri, Sobhan
spellingShingle Suppiah, Subapriya
Siew, Mooi Ching
Nordin, Abdul Jalil
Vinjamuri, Sobhan
The role of PET/CT amyloid Imaging compared with Tc99m-HMPAO SPECT imaging for diagnosing Alzheimer's disease
author_facet Suppiah, Subapriya
Siew, Mooi Ching
Nordin, Abdul Jalil
Vinjamuri, Sobhan
author_sort Suppiah, Subapriya
title The role of PET/CT amyloid Imaging compared with Tc99m-HMPAO SPECT imaging for diagnosing Alzheimer's disease
title_short The role of PET/CT amyloid Imaging compared with Tc99m-HMPAO SPECT imaging for diagnosing Alzheimer's disease
title_full The role of PET/CT amyloid Imaging compared with Tc99m-HMPAO SPECT imaging for diagnosing Alzheimer's disease
title_fullStr The role of PET/CT amyloid Imaging compared with Tc99m-HMPAO SPECT imaging for diagnosing Alzheimer's disease
title_full_unstemmed The role of PET/CT amyloid Imaging compared with Tc99m-HMPAO SPECT imaging for diagnosing Alzheimer's disease
title_sort role of pet/ct amyloid imaging compared with tc99m-hmpao spect imaging for diagnosing alzheimer's disease
publisher Malaysian Medical Association
publishDate 2018
url http://psasir.upm.edu.my/id/eprint/74272/1/PET.pdf
_version_ 1782758344899952640
score 12.935284

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