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Using FDG-PET to Diagnose PSP, CBD, MSA, DLB, etc.
In this Chinese study, an (18)F-FDG PET was given to 18 Parkinson's Disease patients, 22 MSA patients, 13 PSP patients, 5 CBD patients, 7 DLB patients, and one normal pressure hydrocephalus patient. The researchers found that there was a reduction in glucose metabolism in different brain structures for each of the patient groups.
Certainly one limitation of this study is that all of these patients had clinical diagnoses. No one's diagnosis was autopsy-confirmed. Another limitation is that the number of patients studied was quite small.
Parkinsonism & Related Disorders. 2012 Jan;18 Supplement 1:S60-2.
(18)[F]-FDG PET study on the Idiopathic Parkinson's disease from several parkinsonian-plus syndromes.
Zhao P, Zhang B, Gao S.
Department of Neurology, Second Hospital of Tianjin Medical University, Tianjin, China; Department of Neurology, General Hospital of Tianjin Medical University, Tianjin, China.
To investigate the difference in glucose metabolism on (18)F-fluorodeoxyglucose positron emission tomography ((18)F-FDG PET) imaging for differential diagnosis of idiopathic Parkinson's disease (IPD) from several parkinsonian-plus syndromes using SPM2 approach.
(18)F-FDG PET was performed for 18 IPD patients, 22 multiple system atrophy (MSA) patients, 13 progressive supranuclear palsy (PSP) patients, 5 corticobasal degeneration (CBD) patients, 7 dementia with Lewy bodies (DLB) patients and 1 normal pressure hydrocephalus (NPH) patient. Imaging-based diagnosis was obtained by statistical parametric mapping (SPM2) software to analyze the differences and overlaps among these groups.
The (18)F-FDG PET images analyzed with SPM2 demonstrated that a reduction in glucose metabolism occurred in bilateral parietal area for IPD, in bilateral putamen for MSA-P, in bilateral cerebellum for MSA-C, in midbrain and the middle frontal cortex for PSP, in asymmetrical metabolism of the cortex and the basal ganglia for CBD, in bilateral occipital and parieto-occipital areas for DLB. The metabolic reductions in a patient of NPH group were observed in the ventricular system.
This study identifies different patterns of glucose metabolism in parkinsonism. (18)F-FDG PET imaging may contribute to early differential diagnosis in clinically ambiguous cases of parkinsonism.
PMID: #22166456 (see pubmed.gov for this abstract only)