Clinical utility of FDG-PET for the differential diagnosis among the main forms of dementia

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 - for the EANM-EAN Task Force for the Prescription of FDG-PET for Dementing Neurodegenerative Disorders

PY - 2018

Y1 - 2018

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’s disease

KW - Atypical Alzheimer

KW - Delphi

KW - Dementia with Lewy bodies

KW - FDG-PET

KW - Frontotemporal lobar degeneration

KW - PICO

KW - Pseudodementia

KW - Vascular dementia

U2 - 10.1007/s00259-018-4035-y

DO - 10.1007/s00259-018-4035-y

M3 - Journal article

C2 - 29736698

AN - SCOPUS:85046553687

SN - 1619-7070

VL - 45

SP - 1509

EP - 1525

JO - European Journal of Nuclear Medicine and Molecular Imaging

JF - European Journal of Nuclear Medicine and Molecular Imaging

IS - 9

ER -