Comparison of Deuterium Metabolic Imaging with FDG PET in Alzheimer Disease

Nikolaj Bøgh; Malene Aastrup; Janne K Mortensen; Hanne Gottrup; Jakob U Blicher; Per Borghammer; Mattias H Kristensen; Esben S S Hansen; Michael Vaeggemose; Christoffer Laustsen

doi:10.1148/radiol.241808

Comparison of Deuterium Metabolic Imaging with FDG PET in Alzheimer Disease

Nikolaj Bøgh, Malene Aastrup, Janne K Mortensen, Hanne Gottrup, Jakob U Blicher, Per Borghammer, Mattias H Kristensen, Esben S S Hansen, Michael Vaeggemose, Christoffer Laustsen

Research output: Contribution to journal/Conference contribution in journal/Contribution to newspaper › Journal article › Research › peer-review

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Abstract

Background: The approval of amyloid-targeting therapies has made it increasingly important to differentiate Alzheimer disease (AD) from other causes of dementia. Dysfunctional glucose metabolism is a recognized pathophysiological element in AD that may be visualized with spectroscopic MRI of deuterated glucose and its metabolites, also known as deuterium metabolic imaging (DMI). Purpose: To explore the potential of DMI as a diagnostic tool for AD. Materials and Methods: In this prospective cross-sectional study, participants with newly diagnosed AD and age-matched controls were recruited from April to October 2023. DMI was performed with a 3-T system equipped with a proton/deuterium head coil following oral consumption of 75 g of deuterated glucose. Clinical fluorodeoxyglucose (FDG) PET data were acquired from patient records for comparison. The predefined primary outcome, the ratio between lactate and glutamine plus glutamate (Glx) at DMI, was analyzed using age-corrected linear mixed-effect models. Results: Ten participants with AD (mean age, 72 years ± 6 [SD]; six women) and five age-matched healthy controls (mean age, 68 years ± 7; four men) were included. The primary analysis revealed no evidence of a difference in the ratio of lactate to Glx between participants with AD and controls (P = .24 across all regions of interest). Exploratory analyses revealed that participants with AD had reduced signals for medial temporal lactate (0.7 ± 0.2 vs 0.5 ± 0.1, P = .04) and Glx (0.5 ± 0.03 vs 0.48 ± 0.05, P = .03) compared with controls. Finally, a strong correlation (r = 0.73) was observed between DMI and FDG PET. Conclusion: This study did not find evidence to support a shift from oxidative to anaerobic metabolism in AD. Exploratory analyses revealed a decrease in glucose metabolism in the medial temporal lobe. In extension hereof, a similar distribution of low DMI metabolism and decreased FDG PET glucose uptake was observed.

Original language	English
Article number	e241808
Journal	Radiology
Volume	315
Issue	1
Pages (from-to)	e241808
ISSN	0033-8419
DOIs	https://doi.org/10.1148/radiol.241808
Publication status	Published - Apr 2025

Keywords

Humans
Alzheimer Disease/diagnostic imaging
Female
Male
Aged
Cross-Sectional Studies
Fluorodeoxyglucose F18
Prospective Studies
Positron-Emission Tomography/methods
Deuterium/metabolism
Radiopharmaceuticals
Brain/diagnostic imaging
Middle Aged
Aged, 80 and over

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title = "Comparison of Deuterium Metabolic Imaging with FDG PET in Alzheimer Disease",

abstract = "Background: The approval of amyloid-targeting therapies has made it increasingly important to differentiate Alzheimer disease (AD) from other causes of dementia. Dysfunctional glucose metabolism is a recognized pathophysiological element in AD that may be visualized with spectroscopic MRI of deuterated glucose and its metabolites, also known as deuterium metabolic imaging (DMI). Purpose: To explore the potential of DMI as a diagnostic tool for AD. Materials and Methods: In this prospective cross-sectional study, participants with newly diagnosed AD and age-matched controls were recruited from April to October 2023. DMI was performed with a 3-T system equipped with a proton/deuterium head coil following oral consumption of 75 g of deuterated glucose. Clinical fluorodeoxyglucose (FDG) PET data were acquired from patient records for comparison. The predefined primary outcome, the ratio between lactate and glutamine plus glutamate (Glx) at DMI, was analyzed using age-corrected linear mixed-effect models. Results: Ten participants with AD (mean age, 72 years ± 6 [SD]; six women) and five age-matched healthy controls (mean age, 68 years ± 7; four men) were included. The primary analysis revealed no evidence of a difference in the ratio of lactate to Glx between participants with AD and controls (P = .24 across all regions of interest). Exploratory analyses revealed that participants with AD had reduced signals for medial temporal lactate (0.7 ± 0.2 vs 0.5 ± 0.1, P = .04) and Glx (0.5 ± 0.03 vs 0.48 ± 0.05, P = .03) compared with controls. Finally, a strong correlation (r = 0.73) was observed between DMI and FDG PET. Conclusion: This study did not find evidence to support a shift from oxidative to anaerobic metabolism in AD. Exploratory analyses revealed a decrease in glucose metabolism in the medial temporal lobe. In extension hereof, a similar distribution of low DMI metabolism and decreased FDG PET glucose uptake was observed.",

keywords = "Humans, Alzheimer Disease/diagnostic imaging, Female, Male, Aged, Cross-Sectional Studies, Fluorodeoxyglucose F18, Prospective Studies, Positron-Emission Tomography/methods, Deuterium/metabolism, Radiopharmaceuticals, Brain/diagnostic imaging, Middle Aged, Aged, 80 and over",

author = "Nikolaj B{\o}gh and Malene Aastrup and Mortensen, {Janne K} and Hanne Gottrup and Blicher, {Jakob U} and Per Borghammer and Kristensen, {Mattias H} and Hansen, {Esben S S} and Michael Vaeggemose and Christoffer Laustsen",

year = "2025",

month = apr,

doi = "10.1148/radiol.241808",

language = "English",

volume = "315",

pages = "e241808",

journal = "Radiology",

issn = "0033-8419",

publisher = "Radiological Society of North America Inc.",

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T1 - Comparison of Deuterium Metabolic Imaging with FDG PET in Alzheimer Disease

AU - Bøgh, Nikolaj

AU - Aastrup, Malene

AU - Mortensen, Janne K

AU - Gottrup, Hanne

AU - Blicher, Jakob U

AU - Borghammer, Per

AU - Kristensen, Mattias H

AU - Hansen, Esben S S

AU - Vaeggemose, Michael

AU - Laustsen, Christoffer

PY - 2025/4

Y1 - 2025/4

N2 - Background: The approval of amyloid-targeting therapies has made it increasingly important to differentiate Alzheimer disease (AD) from other causes of dementia. Dysfunctional glucose metabolism is a recognized pathophysiological element in AD that may be visualized with spectroscopic MRI of deuterated glucose and its metabolites, also known as deuterium metabolic imaging (DMI). Purpose: To explore the potential of DMI as a diagnostic tool for AD. Materials and Methods: In this prospective cross-sectional study, participants with newly diagnosed AD and age-matched controls were recruited from April to October 2023. DMI was performed with a 3-T system equipped with a proton/deuterium head coil following oral consumption of 75 g of deuterated glucose. Clinical fluorodeoxyglucose (FDG) PET data were acquired from patient records for comparison. The predefined primary outcome, the ratio between lactate and glutamine plus glutamate (Glx) at DMI, was analyzed using age-corrected linear mixed-effect models. Results: Ten participants with AD (mean age, 72 years ± 6 [SD]; six women) and five age-matched healthy controls (mean age, 68 years ± 7; four men) were included. The primary analysis revealed no evidence of a difference in the ratio of lactate to Glx between participants with AD and controls (P = .24 across all regions of interest). Exploratory analyses revealed that participants with AD had reduced signals for medial temporal lactate (0.7 ± 0.2 vs 0.5 ± 0.1, P = .04) and Glx (0.5 ± 0.03 vs 0.48 ± 0.05, P = .03) compared with controls. Finally, a strong correlation (r = 0.73) was observed between DMI and FDG PET. Conclusion: This study did not find evidence to support a shift from oxidative to anaerobic metabolism in AD. Exploratory analyses revealed a decrease in glucose metabolism in the medial temporal lobe. In extension hereof, a similar distribution of low DMI metabolism and decreased FDG PET glucose uptake was observed.

AB - Background: The approval of amyloid-targeting therapies has made it increasingly important to differentiate Alzheimer disease (AD) from other causes of dementia. Dysfunctional glucose metabolism is a recognized pathophysiological element in AD that may be visualized with spectroscopic MRI of deuterated glucose and its metabolites, also known as deuterium metabolic imaging (DMI). Purpose: To explore the potential of DMI as a diagnostic tool for AD. Materials and Methods: In this prospective cross-sectional study, participants with newly diagnosed AD and age-matched controls were recruited from April to October 2023. DMI was performed with a 3-T system equipped with a proton/deuterium head coil following oral consumption of 75 g of deuterated glucose. Clinical fluorodeoxyglucose (FDG) PET data were acquired from patient records for comparison. The predefined primary outcome, the ratio between lactate and glutamine plus glutamate (Glx) at DMI, was analyzed using age-corrected linear mixed-effect models. Results: Ten participants with AD (mean age, 72 years ± 6 [SD]; six women) and five age-matched healthy controls (mean age, 68 years ± 7; four men) were included. The primary analysis revealed no evidence of a difference in the ratio of lactate to Glx between participants with AD and controls (P = .24 across all regions of interest). Exploratory analyses revealed that participants with AD had reduced signals for medial temporal lactate (0.7 ± 0.2 vs 0.5 ± 0.1, P = .04) and Glx (0.5 ± 0.03 vs 0.48 ± 0.05, P = .03) compared with controls. Finally, a strong correlation (r = 0.73) was observed between DMI and FDG PET. Conclusion: This study did not find evidence to support a shift from oxidative to anaerobic metabolism in AD. Exploratory analyses revealed a decrease in glucose metabolism in the medial temporal lobe. In extension hereof, a similar distribution of low DMI metabolism and decreased FDG PET glucose uptake was observed.

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KW - Alzheimer Disease/diagnostic imaging

KW - Female

KW - Male

KW - Aged

KW - Cross-Sectional Studies

KW - Fluorodeoxyglucose F18

KW - Prospective Studies

KW - Positron-Emission Tomography/methods

KW - Deuterium/metabolism

KW - Radiopharmaceuticals

KW - Brain/diagnostic imaging

KW - Middle Aged

KW - Aged, 80 and over

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U2 - 10.1148/radiol.241808

DO - 10.1148/radiol.241808

M3 - Journal article

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SN - 0033-8419

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SP - e241808

JO - Radiology

JF - Radiology

IS - 1

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ER -

Comparison of Deuterium Metabolic Imaging with FDG PET in Alzheimer Disease

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Keywords

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