Comparison of PET, MRI, and CT with pathology in a proven case of Alzheimer's disease

Abstract

Positron emission tomography (PET) with fluorodeoxyglucose (FDG), magnetic resonance imaging (MRI), and CT were carried out in a patient with Alzheimer's disease 16 months before he died. At autopsy, the gross appearance of the brain correlated with MRI and CT, which showed some regional atrophy. These were much less revealing than PET, which correlated with microscopic findings of neuronal loss and proliferation of glia. In areas of moderately impaired local cerebral metabolic rate of glucose, as revealed by reduced FDG uptake, there was some gliosis, primarily around the numerous senile plaques. In areas of severe metabolic impairment, there was a profound loss of neurons, extensive gliosis, and a diminished appearance of plaques. PET-FDG is a better measure of the severity of Alzheimer's disease than MRI or CT, because it reflects the degree of neuronal pathology.

Diminished Glucose Transport in Alzheimer's Disease: Dynamic PET Studies

“…We found a statistically significant reduction in KJ *, of �20%, in the frontal and temporal cortex of patients with AD relative to age-matched controls. Differences in K J * between AD patients and controls were minimal in occipital cortex and white matter, regions that are thought to be relatively spared by Alzheimer neuropathology (Brun and Englund, 1981;McGeer et al, 1986). These results can be interpreted as evidence for an abnormality of glucose transport in AD.…”

Regional cerebral blood flow correlates of visuospatial tasks in Alzheimer's disease

“…Positron Emission Tomography (PET) and Single Positron Emission Computed Tomography (SPECT) are functional imaging techniques that can produce three dimensional maps of resting state brain activity based on glucose metabolism or blood flow, which can be helpful in inferring the presence of AD pathology (Alexander et al, 2002;Buchert et al, 2005;Cutler, 1988;Ishii et al, 2006;McGeer et al, 1986;Silverman et al, 2001;Silverman, 2004;von Broczyskowski et al, 2006) Psychophysical research has demonstrated that reductions in visuomotor ability attributed to parietal dysfunction may be useful in detecting not only the presence of AD, but also in tracking its progression (Elble & Leffler, 2000;Ghilardi et al, 1999;Kluger et al, 1997;Ott et al, 1995;Tippett & Sergio, 2006). Decline in perfusion rates within regions such as the parietal lobe, can occur in the early stages of AD.…”

Cortical Hypometabolism and its Recovery following Nucleus Basalis Lesions in Baboons: A PET Study

“…Key Words: Nucleus ba salis of Meynert-Deafferentation-Positron tomog raphy (PET)-[I8F]Fluorodeoxyglucose. McGeer et al, 1986), but in some instances cortical deafferentation due to subcortical lesions has been implicated (d' Antona et al, 1985). More over, lesions of the thalamus or basal ganglia sub sequent to stroke are known to induce both a cog nitive impairment and an ipsilateral cortical hypo metabolism (Baron et al, 1986;Feeney and Baron, 1986;Metter et al, 1986).…”