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18F-FDG PET and Perfusion SPECT in the Diagnosis of Alzheimer and Lewy Body Dementias

Lookup NU author(s): Professor John O'Brien, Dr Michael Firbank, Dr Christopher Davison, Nicola Barnett, Claire Bamford, Professor Cam Donaldson, Kirsty Olsen, Dr David Williams, Dr James Lloyd


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Brain imaging with glucose (F-18-FDG) PET or blood flow (hexamethylpropyleneamine oxime) SPECT is widely used for the differential diagnosis of dementia, though direct comparisons to clearly establish superiority of one method have not been undertaken. Methods: Subjects with Alzheimer disease (AD; n = 38) and dementia with Lewy bodies (DLB; n = 30) and controls (n = 30) underwent F-18-FDG PET and SPECT in balanced order. The main outcome measure was area under the curve (AUC) of receiver-operating-characteristic analysis of visual scan rating. Results: Consensus diagnosis with F-18-FDG PET was superior to SPECT for both dementia vs. no-dementia (AUC = 0.93 vs. 0.72, P = 0.001) and AD vs. DLB (AUC = 0.80 vs. 0.58, P = 0.005) comparisons. The sensitivity and specificity for dementia/no-dementia was 85% and 90%, respectively, for F-18-FDG PET and 71% and 70%, respectively, for SPECT. Conclusion: (F-18-FDG) PET was significantly superior to blood flow SPECT. We recommend F-18-FDG PET be performed instead of perfusion SPECT for the differential diagnosis of degenerative dementia if functional imaging is indicated.

Publication metadata

Author(s): O'Brien JT, Firbank MJ, Davison C, Barnett N, Bamford C, Donaldson C, Olsen K, Herholz K, Williams D, Lloyd J

Publication type: Article

Publication status: Published

Journal: Journal of Nuclear Medicine

Year: 2014

Volume: 55

Issue: 12

Pages: 1959-1965

Print publication date: 01/12/2014

Online publication date: 05/11/2014

Date deposited: 04/06/2015

ISSN (print): 0161-5505

ISSN (electronic): 1535-5667

Publisher: Society of Nuclear Medicine


DOI: 10.2967/jnumed.114.143347


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