Comparison of CT, MR, and PET in Alzheimer's dementia and normal aging

We compared the findings of computed tomography (CT), magnetic resonance (MR), and positron emission tomography (PET) scans of glucose metabolism in 30 patients with clinically diagnosed Alzheimer's Disease (DAT) to those noted in 25 age-matched normal controls. Mean ratings of cortical and ventricular atrophy on CT and of metabolic abnormality on PET were significantly different (p less than 0.001 and p less than 0.0001, respectively) between two subject groups, however, there was a considerable overlap in reading of cortical atrophy. CT hypodensities were present in 17% of DAT patients and 12% of controls. MR revealed numerous additional periventricular and deep white matter signal changes. Neither hypodensities nor hyperintensities were correlated with PET abnormalities. Although, not infrequently, hypometabolic areas on PET scans corresponded to atrophic regions on anatomic images, they also occurred without such changes. Interestingly, cortical high signal intensity seen on MRI was frequently observed to be associated with areas of hypometabolism. Our results suggest that PET may be the most sensitive modality for detecting cortical involvement in DAT.