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Lack of association between cortical amyloid deposition and glucose metabolism in early stage Alzheimer´s disease patients

Daniela Ehrlich
Daniela Ehrlich
, 
Andreas Dunzinger
Andreas Dunzinger
, 
Gertraud Malsiner-Walli
Gertraud Malsiner-Walli
, 
Bettina Grün
Bettina Grün
, 
Raffi Topakian
Raffi Topakian
, 
Marina Hodolic
Marina Hodolic
, 
Elmar Kainz
Elmar Kainz
 and 
Robert Pichler
Robert Pichler
   | Dec 22, 2021
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Article Category: Research Article
Published Online: Dec 22, 2021
Page range: 23 - 31
Received: Oct 12, 2021
Accepted: Nov 09, 2021
DOI: https://doi.org/10.2478/raon-2021-0051
© 2022 Daniela Ehrlich, Andreas Dunzinger, Gertraud Malsiner-Walli, Bettina Grün, Raffi Topakian, Marina Hodolic, Elmar Kainz, Robert Pichler, published by Sciendo
This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

Figure 1

2-[18F] fluoro-2-deoxy-d-glucose (FDG) and amyloid brain PET/CT of 59-year-old woman. (A) FDG brain PET/CT of a 59-year-old woman with a history of fluctuating cognitive impairment (mini mental state examination [MMSE] = 14/30). Glucose hypometabolism was demonstrated in the parietal dorsolateral and temporolateral, and occipatal cortical areas. The glucose metabolism in the left temporomesial area is weak. The other cortical structures show a slight attenuation of FDG metabolism. Basal ganglia show more intense uptake compared to the cortical areas. This FDG brain PET study shows the typical picture of abnormal glucose metabolism that occurs in Alzheimer´s disease (AD) and is additionally compatible with pronounced microvascular changes. (B) On the amyloid PET a non-specific tracer accumulation from the pons to the basal ganglia is evident. PET images of the white matter demonstrate individual non-specific enrichments. In the frontal and temporal cortices as well as sporadically in the parietal cortical areas, a pathological tracer accumulation occurs. This global cortical tracer uptake is consistent with the neuropathology of AD.
2-[18F] fluoro-2-deoxy-d-glucose (FDG) and amyloid brain PET/CT of 59-year-old woman. (A) FDG brain PET/CT of a 59-year-old woman with a history of fluctuating cognitive impairment (mini mental state examination [MMSE] = 14/30). Glucose hypometabolism was demonstrated in the parietal dorsolateral and temporolateral, and occipatal cortical areas. The glucose metabolism in the left temporomesial area is weak. The other cortical structures show a slight attenuation of FDG metabolism. Basal ganglia show more intense uptake compared to the cortical areas. This FDG brain PET study shows the typical picture of abnormal glucose metabolism that occurs in Alzheimer´s disease (AD) and is additionally compatible with pronounced microvascular changes. (B) On the amyloid PET a non-specific tracer accumulation from the pons to the basal ganglia is evident. PET images of the white matter demonstrate individual non-specific enrichments. In the frontal and temporal cortices as well as sporadically in the parietal cortical areas, a pathological tracer accumulation occurs. This global cortical tracer uptake is consistent with the neuropathology of AD.

Figure 2

FDG and amyloid brain PET/CT of a 70-year-old woman. (A) 2-[18F] fluoro2-deoxy-d-glucose (FDG) brain PET/CT of a 70-year-old woman, who presented with a history of cognitive decline (mini mental state examination [MMSE] = 15/30). The glucose metabolism in the cerebral cortex is inhomogenous and moderately attenuated. In the cerebellum, normal glucose metabolism was demonstrated. This FDG brain PET study does not show the typical picture of abnormal glucose metabolism that occurs in Alzheimer´s disease (AD), but temporomesial and temporolateral some decreased tracer uptake can be observed. Additionally the images are compatible with pronounced microvascular changes. (B) Amyloid PET images demonstrate pathologically increased tracer accumulation in the entire brain, more pronounced in the frontal and temporal cortical areas. This is compatible with the diagnosis of AD.
FDG and amyloid brain PET/CT of a 70-year-old woman. (A) 2-[18F] fluoro2-deoxy-d-glucose (FDG) brain PET/CT of a 70-year-old woman, who presented with a history of cognitive decline (mini mental state examination [MMSE] = 15/30). The glucose metabolism in the cerebral cortex is inhomogenous and moderately attenuated. In the cerebellum, normal glucose metabolism was demonstrated. This FDG brain PET study does not show the typical picture of abnormal glucose metabolism that occurs in Alzheimer´s disease (AD), but temporomesial and temporolateral some decreased tracer uptake can be observed. Additionally the images are compatible with pronounced microvascular changes. (B) Amyloid PET images demonstrate pathologically increased tracer accumulation in the entire brain, more pronounced in the frontal and temporal cortical areas. This is compatible with the diagnosis of AD.

Figure 3

Scatter plots of the amyloid standardized uptake value (SUV) (on the x- axis) and the 2-[18F] fluoro-2-deoxy-d-glucose (FDG) values represented by NeuroQ (on the y-axis) for the 30 amyloid positive patient for the left side. Each panel represents a brain regions with the name indicated in the strip. Least-squares regression lines with slope proportional to the Pearson correlation coefficient indicate the association. The Pearson correlation (r) and the associated p-value (P) are shown in the label on the top of each panel.
Scatter plots of the amyloid standardized uptake value (SUV) (on the x- axis) and the 2-[18F] fluoro-2-deoxy-d-glucose (FDG) values represented by NeuroQ (on the y-axis) for the 30 amyloid positive patient for the left side. Each panel represents a brain regions with the name indicated in the strip. Least-squares regression lines with slope proportional to the Pearson correlation coefficient indicate the association. The Pearson correlation (r) and the associated p-value (P) are shown in the label on the top of each panel.

Figure 4

Scatter plots of the amyloid standardized uptake value (SUV) (on the x-axis) and the 2-[18F] fluoro-2-deoxy-d-glucose (FDG) values represented by NeuroQ (on the y-axis) for the 30 amyloid positive patient for the right side. Each panel represents a brain regions with the name indicated in the strip. Least-squares regression lines with slope proportional to the Pearson correlation coefficient indicate the association. The Pearson correlation (r) and the associated p-value (P) are shown in the label on the top of each panel.
Scatter plots of the amyloid standardized uptake value (SUV) (on the x-axis) and the 2-[18F] fluoro-2-deoxy-d-glucose (FDG) values represented by NeuroQ (on the y-axis) for the 30 amyloid positive patient for the right side. Each panel represents a brain regions with the name indicated in the strip. Least-squares regression lines with slope proportional to the Pearson correlation coefficient indicate the association. The Pearson correlation (r) and the associated p-value (P) are shown in the label on the top of each panel.

Regions of interest

superior frontal cortex
middle frontal cortex
Inferior frontal cortex
anterior cingulate cortex
posterior cingulate cortex
sensorimotoric cortex
superior lateral temporal cortex
medial anterior temporal cortex
medial posterior temporal cortex
inferior lateral anterior temporal cortex
inferior lateral posterior temporal cortex
superior parietal cortex
inferior parietal cortex
parietotemporal cortex
primary visual cortex
associative visual cortex
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