Comparative Assessments of PET and ASL MR Perfusion in the Evaluation of Early Dementia

Background: Overtly morbid dementing diseases have a prodromal MCI (mild cognitive impairment) phase which is crucial to recognize. Clinical scores provide an easy bedside assessment tool for holistic cognitive evaluation but fail to provide lead time. While routine biomarkers of brain atrophy are...

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Main Authors: Savyasachi Jain, Shailesh B Gaikwad, Bheru Dan Charan, Anu Gupta, Madhvi Tripathy
Format: Article
Language:English
Published: Vilnius University Press 2025-02-01
Series:Acta Medica Lituanica
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Online Access:https://www.journals.vu.lt/AML/article/view/35906
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author Savyasachi Jain
Shailesh B Gaikwad
Bheru Dan Charan
Anu Gupta
Madhvi Tripathy
author_facet Savyasachi Jain
Shailesh B Gaikwad
Bheru Dan Charan
Anu Gupta
Madhvi Tripathy
author_sort Savyasachi Jain
collection DOAJ
description Background: Overtly morbid dementing diseases have a prodromal MCI (mild cognitive impairment) phase which is crucial to recognize. Clinical scores provide an easy bedside assessment tool for holistic cognitive evaluation but fail to provide lead time. While routine biomarkers of brain atrophy are late to appear, non-contrast MRI perfusion studies like ASL may serve as a valuable alternative to 18F-FDG-PET for the recognition and classification of the degree of neurodegeneration in individuals with MCI, especially when FDG-PET is not available. Our study adds confidence as we noted brain regions where PET-ASL concordance was most robust and devised concordance with ACE-3 scores. Material and methods: We conducted a prospective study from Jan 2021 to Jan 2024. Cases were selected based on the inclusion and exclusion criteria, which have objective cognitive impairment. Healthy controls were selected. MRI and PET scans were performed in all cases. Perfusion values of arterial spine labeling, PET, and clinical examination were recorded. Results: We included 33 patients and 15 healthy controls in the study. We compared ASL and PET for all selected individuals. Our study showed that ASL can detect a hypo-perfusion region with a 91% sensitivity, 85.98% specificity, 89.8% PPV, and 87.62% NPV, with a diagnostic accuracy of 88.9%. Conclusion: ASL was a dependable replacement for the gold-standard FDG-PET. ASL may serve as a valuable alternative to 18F-FDG-PET for classifying the degree of neurodegeneration in individuals with prodromal AD, especially when FDG-PET is unavailable.
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spelling doaj-art-21a4ff73baa04be19f78c0bc5322fcb72025-08-20T02:00:33ZengVilnius University PressActa Medica Lituanica1392-01382029-41742025-02-0132110.15388/Amed.2025.32.1.10Comparative Assessments of PET and ASL MR Perfusion in the Evaluation of Early DementiaSavyasachi Jain0Shailesh B Gaikwad1Bheru Dan Charan2https://orcid.org/0009-0002-8711-2023Anu Gupta3Madhvi Tripathy4https://orcid.org/0000-0003-1033-1690All India Institute of Medical Sciences, New DelhiAll India Institute of Medical Sciences, New DelhiAll India Institute of Medical Sciences RishikeshAll India Institute of Medical Sciences, New DelhiAll India Institute of Medical Sciences, New Delhi Background: Overtly morbid dementing diseases have a prodromal MCI (mild cognitive impairment) phase which is crucial to recognize. Clinical scores provide an easy bedside assessment tool for holistic cognitive evaluation but fail to provide lead time. While routine biomarkers of brain atrophy are late to appear, non-contrast MRI perfusion studies like ASL may serve as a valuable alternative to 18F-FDG-PET for the recognition and classification of the degree of neurodegeneration in individuals with MCI, especially when FDG-PET is not available. Our study adds confidence as we noted brain regions where PET-ASL concordance was most robust and devised concordance with ACE-3 scores. Material and methods: We conducted a prospective study from Jan 2021 to Jan 2024. Cases were selected based on the inclusion and exclusion criteria, which have objective cognitive impairment. Healthy controls were selected. MRI and PET scans were performed in all cases. Perfusion values of arterial spine labeling, PET, and clinical examination were recorded. Results: We included 33 patients and 15 healthy controls in the study. We compared ASL and PET for all selected individuals. Our study showed that ASL can detect a hypo-perfusion region with a 91% sensitivity, 85.98% specificity, 89.8% PPV, and 87.62% NPV, with a diagnostic accuracy of 88.9%. Conclusion: ASL was a dependable replacement for the gold-standard FDG-PET. ASL may serve as a valuable alternative to 18F-FDG-PET for classifying the degree of neurodegeneration in individuals with prodromal AD, especially when FDG-PET is unavailable. https://www.journals.vu.lt/AML/article/view/35906dementianeurodegenerationMRI
spellingShingle Savyasachi Jain
Shailesh B Gaikwad
Bheru Dan Charan
Anu Gupta
Madhvi Tripathy
Comparative Assessments of PET and ASL MR Perfusion in the Evaluation of Early Dementia
Acta Medica Lituanica
dementia
neurodegeneration
MRI
title Comparative Assessments of PET and ASL MR Perfusion in the Evaluation of Early Dementia
title_full Comparative Assessments of PET and ASL MR Perfusion in the Evaluation of Early Dementia
title_fullStr Comparative Assessments of PET and ASL MR Perfusion in the Evaluation of Early Dementia
title_full_unstemmed Comparative Assessments of PET and ASL MR Perfusion in the Evaluation of Early Dementia
title_short Comparative Assessments of PET and ASL MR Perfusion in the Evaluation of Early Dementia
title_sort comparative assessments of pet and asl mr perfusion in the evaluation of early dementia
topic dementia
neurodegeneration
MRI
url https://www.journals.vu.lt/AML/article/view/35906
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