Comparing PET Imaging Options to Predict Cognitive Decline (Transcript)

BALTIMORE — For patients in the very early stages of mild cognitive impairment, prognosis can be gauged with PET imaging using two different tracers — fluorodeoxyglucose (FDG) and florbetapir, which measures beta-amyloid pathology — according to new research reported here at the Society of Nuclear Medicine and Molecular Imaging 2015 Annual Meeting.

"If you're looking across the broad range of levels of impairment, FDG may better predict how fast one will decline, but if you're looking specifically at a very minimally impaired group, amyloid may be a better way to separate out who is going to decline faster," said Jooyeon Lee, from the David Geffen School of Medicine at the University of California, Los Angeles.

If you're looking across the broad range of levels of impairment, FDG may better predict how fast one will decline.

The study involved 131 patients with mild cognitive impairment — all with a Clinical Dementia Rating of 0.5 — who underwent both FDG-PET and florbetapir-PET scans at baseline.

After 2 years, investigators used scores on the Mini-Mental State Exam to rate cognitive decline, and compared them with baseline FDG-PET and florbetapir-PET scans.

But if you're looking specifically at a very minimally impaired group, amyloid may be a better way to separate out who is going to decline faster.

In the overall population, the association was significant for both FDG-PET and florbetapir-PET. When the population was stratified by level of impairment, the association was significant for FDG in patients with either minimal or mild cognitive impairment, but was significant for florbetapir only in patients with minimal cognitive impairment.

Although FDG-PET can be used to predict cognitive trajectories across the spectrum of severity in patients with amnestic mild cognitive impairment, florbetapir-based imaging is a better estimate of cognitive impairment in patients with minimal impairment, Dr Lee concluded.

Dr Lee has disclosed no relevant financial relationships.

Society of Nuclear Medicine and Molecular Imaging (SNMMI) 2015 Annual Meeting: Abstract 190. Presented June 8, 2015.

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