The cingulate island sign in a mixed memory clinical cohort: Prevalence and diagnostic accuracy
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The cingulate island sign in a mixed memory clinical cohort : Prevalence and diagnostic accuracy. / Feng, Linda Ruohua; Waldemar, Gunhild; Hasselbalch, Steen Gregers; Vogel, Asmus; Henriksen, Otto Mølby; Law, Ian; Frederiksen, Kristian Steen.
In: Parkinsonism and Related Disorders, Vol. 122, 106062, 2024.Research output: Contribution to journal › Journal article › Research › peer-review
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TY - JOUR
T1 - The cingulate island sign in a mixed memory clinical cohort
T2 - Prevalence and diagnostic accuracy
AU - Feng, Linda Ruohua
AU - Waldemar, Gunhild
AU - Hasselbalch, Steen Gregers
AU - Vogel, Asmus
AU - Henriksen, Otto Mølby
AU - Law, Ian
AU - Frederiksen, Kristian Steen
N1 - Publisher Copyright: © 2024 The Authors
PY - 2024
Y1 - 2024
N2 - Introduction: Visual rating of the cingulate island sign (CIS) on [18F]fluorodeoxyglucose ([18F]FDG) positron emission tomography (PET) has a high specificity for dementia with Lewy bodies (DLB) in selected cohorts such as DLB versus Alzheimer's disease (AD). In a mixed memory clinical population this study aimed to uncover the prevalence of CIS, the diagnostic accuracy for DLB, and the relationship between CIS and disease severity. Methods: CIS on [18F]FDG-PET was retrospectively assessed with the visual CIS rating scale (CISRs) in 1000 patients with a syndrome diagnosis of mild cognitive impairment (MCI) or dementia with no restrictions in etiological diagnosis. Results: In this cohort 24.3 % had a CISRs score ≥1 and 3.5 % had a CISRs score = 4. The prevalence of a CISRs score ≥1 was highest in DLB (74.0 %, n = 57). A CISRs score ≥1 was present in at least 9 % in other diagnostic groups. The prevalence of CIS across disease severities showed no statistically significant difference (p = 0.23). To differentiate DLB from non-DLB the optimal cut-off was a CISRs score ≥1 (balanced accuracy = 77.1 %) in MCI/mild dementia and a CISRs score ≥2 (balanced accuracy = 80.6 %) in moderate/severe dementia. The positive predictive value of a CISRs score = 4 for DLB was 57.7 % in MCI/mild dementia and 33.3 % in moderate/severe dementia. Conclusion: The CISRs is useful in differentiating DLB from other etiologies in a mixed memory clinical population. Balanced accuracy and positive predictive value may vary across disease severities in the population studied.
AB - Introduction: Visual rating of the cingulate island sign (CIS) on [18F]fluorodeoxyglucose ([18F]FDG) positron emission tomography (PET) has a high specificity for dementia with Lewy bodies (DLB) in selected cohorts such as DLB versus Alzheimer's disease (AD). In a mixed memory clinical population this study aimed to uncover the prevalence of CIS, the diagnostic accuracy for DLB, and the relationship between CIS and disease severity. Methods: CIS on [18F]FDG-PET was retrospectively assessed with the visual CIS rating scale (CISRs) in 1000 patients with a syndrome diagnosis of mild cognitive impairment (MCI) or dementia with no restrictions in etiological diagnosis. Results: In this cohort 24.3 % had a CISRs score ≥1 and 3.5 % had a CISRs score = 4. The prevalence of a CISRs score ≥1 was highest in DLB (74.0 %, n = 57). A CISRs score ≥1 was present in at least 9 % in other diagnostic groups. The prevalence of CIS across disease severities showed no statistically significant difference (p = 0.23). To differentiate DLB from non-DLB the optimal cut-off was a CISRs score ≥1 (balanced accuracy = 77.1 %) in MCI/mild dementia and a CISRs score ≥2 (balanced accuracy = 80.6 %) in moderate/severe dementia. The positive predictive value of a CISRs score = 4 for DLB was 57.7 % in MCI/mild dementia and 33.3 % in moderate/severe dementia. Conclusion: The CISRs is useful in differentiating DLB from other etiologies in a mixed memory clinical population. Balanced accuracy and positive predictive value may vary across disease severities in the population studied.
KW - Cingulate island sign
KW - Dementia with Lewy bodies
KW - Disease severity
KW - Mixed memory clinical cohort
KW - Prevalence
KW - [F]FDG-PET
U2 - 10.1016/j.parkreldis.2024.106062
DO - 10.1016/j.parkreldis.2024.106062
M3 - Journal article
C2 - 38452445
AN - SCOPUS:85186662816
VL - 122
JO - Parkinsonism & Related Disorders
JF - Parkinsonism & Related Disorders
SN - 1353-8020
M1 - 106062
ER -
ID: 385585305