EVALUATION OF DEMENTIA-TYPE COGNITIVE DECLINE THROUGH 18F-FDG PET-CT QUANTIFICATION AND CORRELATIONS OF THE MMSE TEST WITH FUNCTIONAL IMAGING BIOMARKERS

Authors

  • Roxana IACOB Grigore T. Popa” University of Medicine and Pharmacy Iasi
  • O. GHERASIM “Gh. Zane” Institute of Economic and Social Researche
  • Irena GRIEROSU Grigore T. Popa” University of Medicine and Pharmacy Iasi
  • R. STAMATE “Sf. Spiridon” County Clinical Emergency Hospital Iasi, Romania
  • V. GHIZDOVAT Grigore T. Popa” University of Medicine and Pharmacy Iasi
  • A.G. NAUM Grigore T. Popa” University of Medicine and Pharmacy Iasi
  • Cipriana STEFANESCU Grigore T. Popa” University of Medicine and Pharmacy Iasi

Abstract

Recognition of the given moment when a mild cognitive impairment (MCI) converts to Alzheimer’s Disease (AD) represents a turning point in the assessment of the mental status rate of decline, but is still insufficiently systematically studied. Our aim was to contribute to the identification of the dementia irreversible starting point by cognitive assessment test Mini Mental State Examination (MMSE) and correlating it with the hybrid imaging technique positron emission tomography (PET) with fluor-18 fluorodeoxyglucose (18F-FDG) combined with localization computed tomography imaging (PET/CT), emphasizing that the method of quantification is crucial for patient evaluation and regression analysis can be helpful. Materials and methods: We studied 30 patients aged between 22 and 76 years presented during the assessment of their oncological pathologies. We evaluated their cognitive status by a MMSE test. All patients underwent a 18F-FDG PET/CT examination, the image acquisition including the brain region. After specific image processing, characteristic regions of interest (ROIs) were identified, maximum and mean standardized values (SUVmax and SUVmean) were extracted. We computed correlations between 17 variables including: age, MMSE score value, glycemia, Administered Radiopharmaceutical Dose, Uptake Period, SUVmax and SUVmean for numerous ROIs as cerebral (SUVmaxCC) and cerebellar cortex (SUVmaxCc), posterior cingulate gyrus (SUVmaxPCG) and precuneus (SUVmaxP), as well as two SUV ratios: SUVRPCG and SUVRP. Calculation of mean, minimum, maximum and standard deviation have been made for each variable, and calculation of 4 regression functions (linear, exponential, power and logarithmic) and unique correlation analysis have been made for each pair of variables. Results: MMSE tests identified values of over 24, with an average of 28.07 ± 1.5DS, all patients examined having a normal cognitive status. SUVmaxPCG had values between 5.1 and 21.3 g/mL, with an average of 13.36 ± 3.77DS, SUVmeanPCG between 4 and 13.2 g/mL, average 8.68±2.35DS, and SUVmaxP between 4.8 and 21 g/mL with an average of 13.06 ± 3.81DS, SUVmeanP between 4.1 and 14.1 g/mL with an average of 9.93±2.73DS. From the 34 strong and very strong linear and exponential correlations identified between SUVs of the studied ROIs, 7 correlations have “extremely strong” values (R>0.925) including SUVs of AD cerebral specific ROIs. Also, there is a mean linear correlation between Age and MMSE score (R=0.57). Conclusions: Quantitative evaluation of 18F-FDG PET-CT images for patients with neoplasia, found in a stage when an MCI can evolve simultaneously, could bring useful information for a possible early AD diagnostic and would be advisable in the precision medicine of the brain cognitive status evaluation.

Author Biographies

  • Roxana IACOB, Grigore T. Popa” University of Medicine and Pharmacy Iasi

    Faculty of Medicine / Biophysics and Medical Physics Division
    Regional Institute of Oncology, Iasi, Romania
    Nuclear Medicine Department

  • Irena GRIEROSU, Grigore T. Popa” University of Medicine and Pharmacy Iasi

    Faculty of Medicine / Biophysics and Medical Physics Division
    “Sf. Spiridon” County Clinical Emergency Hospital Iasi, Romania
    Nuclear Medicine Department

  • R. STAMATE, “Sf. Spiridon” County Clinical Emergency Hospital Iasi, Romania

    Nuclear Medicine Department

  • V. GHIZDOVAT, Grigore T. Popa” University of Medicine and Pharmacy Iasi

    Faculty of Medicine / Biophysics and Medical Physics Division

  • A.G. NAUM, Grigore T. Popa” University of Medicine and Pharmacy Iasi

    Faculty of Medicine / Biophysics and Medical Physics Division

  • Cipriana STEFANESCU, Grigore T. Popa” University of Medicine and Pharmacy Iasi

    Faculty of Medicine / Biophysics and Medical Physics Division
    “Sf. Spiridon” County Clinical Emergency Hospital Iasi, Romania
    Nuclear Medicine Department

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Additional Files

Published

2024-06-28

Issue

Vol. 128 No. 2 (2024): The Medical-Surgical Journal

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BASIC SCIENCES

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