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Regional cerebral blood flow assessed with 99mTc-ECD SPET as a marker of progression of mild cognitive impairment to Alzheimer's disease

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Abstract

Patients diagnosed with mild cognitive impairment (MCI) have a higher risk of developing Alzheimer's disease (AD). However, not all such patients develop this kind of dementia. The purpose of this prospective study was to assess whether regional cerebral blood flow (rCBF) patterns measured with technetium-99m ethyl cysteinate dimer single-photon emission tomography (99mTc-ECD SPET) in patients suffering from MCI are useful in predicting progression to AD. The study group comprised 42 patients who fulfilled MCI criteria according to the International Psychogeriatric Association and the Alzheimer's Disease Cooperative Study. rCBF was calculated in 16 regions of interest (ROIs). All patients were clinically assessed for 1–3 years. Twenty-one developed AD (group I) while the initial diagnosis of MCI was retained in the other 21 (group II). ROC curves were designed, and sensitivity, specificity, positive and negative predictive values, and positive and negative likelihood ratios were determined for each ROI. Compared with group II (MCI), group I (AD) showed a significant reduction of relative blood flow (RBF), ranging from 7% to 10%, in the following areas: right and left prefrontal, right and left frontal, right and left parietal, right and left temporal, right and left frontoparietotemporal and left posterior lateral temporal. Left prefrontal, left frontal and left parietal areas showed sensitivities and specificities higher than 75% and areas below the ROC curve close to 80%. This study shows that RBF patterns in the right and left prefrontal, right and left frontal and left parietal areas are sensitive early markers of progression towards AD. Reduction of rCBF in the medial temporal and anterior lateral temporal cortex has no value as a predictor since it also occurs in patients with MCI who remain stable.

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Acknowledgements

We would like to express our gratitude to the nursing and radiography staff within the Nuclear Medicine Department for their contribution and to Eva Martín, graphic designer, for her technical support.

This research project was partially financed by a Postgraduate Scholarship, Complutense University, Madrid, Spain and by the Comunidad de Madrid (08.5/0009/98).

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Authors and Affiliations

  1. Department of Nuclear Medicine, Hospital Clínico San Carlos, Martín Lagos s/n, 28040, Madrid, Spain

    Marta Encinas, Ramón de Juan & José Antonio Cabranes

  2. Department of Neurology, Hospital Clínico San Carlos, Madrid, Spain

    Alberto Marcos

  3. Department of Geriatrics, Hospital Clínico San Carlos, Madrid, Spain

    Pedro Gil

  4. Research Unit, Hospital Clínico San Carlos, Madrid, Spain

    Ana Barabash, Cristina Fernández & Carmen de Ugarte

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  1. Marta Encinas
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Correspondence to José Antonio Cabranes.

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Encinas, M., de Juan, R., Marcos, A. et al. Regional cerebral blood flow assessed with 99mTc-ECD SPET as a marker of progression of mild cognitive impairment to Alzheimer's disease. Eur J Nucl Med Mol Imaging 30, 1473–1480 (2003). https://doi.org/10.1007/s00259-003-1277-z

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  • DOI: https://doi.org/10.1007/s00259-003-1277-z

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