TY - JOUR
T1 - Clinical utility of FDG-PET for the differential diagnosis among the main forms of dementia
AU - Nestor, Peter J
AU - Altomare, Daniele
AU - Festari, Cristina
AU - Drzezga, Alexander
AU - Rivolta, Jasmine
AU - Walker, Zuzana
AU - Bouwman, Femke
AU - Orini, Stefania
AU - Law, Ian
AU - Agosta, Federica
AU - Arbizu, Javier
AU - Boccardi, Marina
AU - Nobili, Flavio
AU - Frisoni, Giovanni Battista
AU - EANM-EAN Task Force for the Prescription of FDG-PET for Dementing Neurodegenerative Disorders
PY - 2018/7
Y1 - 2018/7
N2 - AIM: To assess the clinical utility of FDG-PET as a diagnostic aid for differentiating Alzheimer's disease (AD; both typical and atypical forms), dementia with Lewy bodies (DLB), frontotemporal lobar degeneration (FTLD), vascular dementia (VaD) and non-degenerative pseudodementia.METHODS: A comprehensive literature search was conducted using the PICO model to extract evidence from relevant studies. An expert panel then voted on six different diagnostic scenarios using the Delphi method.RESULTS: The level of empirical study evidence for the use of FDG-PET was considered good for the discrimination of DLB and AD; fair for discriminating FTLD from AD; poor for atypical AD; and lacking for discriminating DLB from FTLD, AD from VaD, and for pseudodementia. Delphi voting led to consensus in all scenarios within two iterations. Panellists supported the use of FDG-PET for all PICOs-including those where study evidence was poor or lacking-based on its negative predictive value and on the assistance it provides when typical patterns of hypometabolism for a given diagnosis are observed.CONCLUSION: Although there is an overall lack of evidence on which to base strong recommendations, it was generally concluded that FDG-PET has a diagnostic role in all scenarios. Prospective studies targeting diagnostically uncertain patients for assessing the added value of FDG-PET would be highly desirable.
AB - AIM: To assess the clinical utility of FDG-PET as a diagnostic aid for differentiating Alzheimer's disease (AD; both typical and atypical forms), dementia with Lewy bodies (DLB), frontotemporal lobar degeneration (FTLD), vascular dementia (VaD) and non-degenerative pseudodementia.METHODS: A comprehensive literature search was conducted using the PICO model to extract evidence from relevant studies. An expert panel then voted on six different diagnostic scenarios using the Delphi method.RESULTS: The level of empirical study evidence for the use of FDG-PET was considered good for the discrimination of DLB and AD; fair for discriminating FTLD from AD; poor for atypical AD; and lacking for discriminating DLB from FTLD, AD from VaD, and for pseudodementia. Delphi voting led to consensus in all scenarios within two iterations. Panellists supported the use of FDG-PET for all PICOs-including those where study evidence was poor or lacking-based on its negative predictive value and on the assistance it provides when typical patterns of hypometabolism for a given diagnosis are observed.CONCLUSION: Although there is an overall lack of evidence on which to base strong recommendations, it was generally concluded that FDG-PET has a diagnostic role in all scenarios. Prospective studies targeting diagnostically uncertain patients for assessing the added value of FDG-PET would be highly desirable.
KW - Alzheimer Disease
KW - Dementia/diagnostic imaging
KW - Diagnosis, Differential
KW - Fluorodeoxyglucose F18
KW - Humans
KW - Lewy Body Disease
KW - Positron-Emission Tomography
KW - Prospective Studies
U2 - 10.1007/s00259-018-4035-y
DO - 10.1007/s00259-018-4035-y
M3 - Review
C2 - 29736698
VL - 45
SP - 1509
EP - 1525
JO - European Journal Of Nuclear Medicine
JF - European Journal Of Nuclear Medicine
SN - 1619-7070
IS - 9
ER -