Rapid assessment of regional cerebral metabolic abnormalities in single subjects with quantitative and nonquantitative [F-18]FDG PET: A clinical validation of statistical parametric mapping

The [F-18]fluorodeoxyglucose ([F-18]FDG) method for measuring brain metabol ism has not the wide clinical application that one might expect, partly bec ause of its high cost and the complexity of the quantification procedure, b ut also because of reporting techniques based on region of interest (ROI) a nalysis, which are time-consuming and not fully objective. In this paper we report a clinical validation of statistical parametric mapping (SPM) using rCMRglc (quantitative) and radioactivity distribution (nonquantitative) [F -18]FDG PET data. We show that a 10-min noninteractive voxel-based SPM anal ysis on a standard workstation enables objective assessment, including loca lization in stereotactic space, of regional glucose consumption abnormaliti es, whose reliability can be assessed on statistical and clinical grounds, Clinical validity was established using a small series of patients with deg enerative or developmental disorders, including probable Alzheimer's diseas e, progressive aphasia, multiple sclerosis, developmental specific language impairment, and epilepsy. Analysis of quantitative and nonquantitative dat a showed the same pattern of results, suggesting that, for clinical purpose s, quantitation and invasive arterial cannulation can be avoided. This shou ld facilitate a wider application of the technique and the extension of SPM clinical analysis to (H2O)-O-15 PET or high resolution SPECT perfusion stu dies. (C) 1999 Academic Press.