Abstract Details

Title Multimodal Magnetic Resonance Imaging versus 18F-FDG-PET to Identify Mild Cognitive Impairment

Topic Aging, Dementia, and Behavioral Neurology

Presentation(s) P5 - Poster Session 5 (5:30 PM-6:30 PM)

Poster/Presentation
Number 9-022

Objective To compare arterial spin labeled (ASL) perfusion MRI and ¹⁸F-Fluorodeoxyglucose Positron Emission Tomography (¹⁸F-FDG-PET) in discriminating patients with amnestic mild cognitive impairment (MCI) from elderly controls and determine if structural MRI provides complementary discriminatory value to ASL perfusion.

Background ¹⁸F-FDG-PET is one of the most commonly used neurodegenerative biomarkers sensitive to the Alzheimer’s disease (AD) continuum. Because cerebral perfusion and metabolism are closely coupled, ASL-MRI can potentially substitute for FDG-PET. ASL-MRI can be readily acquired as part of routine MRI, to provide multimodal data in a single scanning session.

Design/Methods ASL perfusion and high-resolution structural MRI and ¹⁸F-FDG-PET were acquired in close proximity, usually on the same day, from 50 MCI patients (age=73.0±7.0 years, 16 female) and 35 elderly controls (age=70.2±6.9 years, 20 female). Regional relative cerebral blood flow (CBF, putamen reference), cortical thickness, hippocampal volume and standardized uptake value ratio (SUVR, cerebellar reference) were obtained for analysis.

Results The MCI group showed significant (p<0.05 FWE corrected) ASL-hypoperfusion in medial parietal cortex, posterior cingulate cortex (PCC) and hippocampus closely matching the observed ¹⁸F-FDG-PET hypometabolism pattern. Cortical thickness maps revealed significant thinning of bilateral medial temporal, lateral temporal, and parietal regions in MCI patients while midline parietal structures did not differ. Relative CBF and ¹⁸F-FDG SUVR in PCC demonstrated moderate discriminatory power in predicting MCI status (both AUC=0.74), while hippocampal volume demonstrated excellent discriminative power (AUC=0.87±0.09). The combination of PCC relative CBF and hippocampal volume produced the strongest group discrimination (AUC, 0.89 ± 0.09). A step-wise logistic regression model showed that the strongest prediction (χ²=43.5, p<0.001) included both hippocampal volume (β=-2615.6, p<0.001) and relative CBF (β=-2.9, p<0.05) indicating MRI measures of CBF and hippocampal volume provide complementary predictive power.

Conclusions Multimodal MRI may substitute for ¹⁸F-FDG-PET in clinical and research setting for detecting Alzheimer’s neurodegeneration.

Authors/Disclosures
Sudipto Dolui, PhD (University of Pennsylvania) PRESENTER	Dr. Dolui has nothing to disclose.
	No disclosure on file
Ilya Nasrallah, MD, PhD	Dr. Nasrallah has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Eisai. Dr. Nasrallah has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for Biogen. Dr. Nasrallah has received personal compensation in the range of $0-$499 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Springer. Dr. Nasrallah has received personal compensation in the range of $10,000-$49,999 for serving as an Expert Witness for Cassiday Schade LLP. The institution of Dr. Nasrallah has received research support from NIH. The institution of Dr. Nasrallah has received research support from ASNR.
John A. Detre, MD (Hosp of the Univ of Penn)	Dr. Detre has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Hura Imaging. The institution of Dr. Detre has received research support from NIH. Dr. Detre has received personal compensation in the range of $500-$4,999 for serving as a grant proposal reviewer with NIH, VA, European Science Foundation,Deutsche Forschungsgemeinschaft.
David A. Wolk, MD, FAAN (University of Pennsylvania)	Dr. Wolk has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Eli Lilly. Dr. Wolk has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Functional Neuromodulation. Dr. Wolk has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for GSK. The institution of Dr. Wolk has received research support from Biogen. Dr. Wolk has received publishing royalties from a publication relating to health care. Dr. Wolk has received personal compensation in the range of $5,000-$9,999 for serving as a CME speaker with Eli Lilly.

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