Classification of Alzheimer's and MCI Patients from Semantically Parcelled PET Images: A Comparison between AV45 and FDG-PET

Early identification of dementia in the early or late stages of mild cognitive impairment (MCI) is crucial for a timely diagnosis and slowing down the progression of Alzheimer's disease (AD). Positron emission tomography (PET) is considered a highly powerful diagnostic biomarker, but few approaches investigated the efficacy of focusing on localized PET-active areas for classification purposes. In this work, we propose a pipeline using learned features from semantically labelled PET images to perform group classification. A deformable multimodal PET-MRI registration method is employed to fuse an annotated MNI template to each patient-specific PET scan, generating a fully labelled volume from which 10 common regions of interest used for AD diagnosis are extracted. The method was evaluated on 660 subjects from the ADNI database, yielding a classification accuracy of 91.2% for AD versus NC when using random forests combining features from cross-sectional and follow-up exams. A considerable improvement in the early versus late MCI classification accuracy was achieved using FDG-PET compared to the AV-45 compound, yielding a 72.5% rate. The pipeline demonstrates the potential of exploiting longitudinal multiregion PET features to improve cognitive assessment.