Abstract
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.
| Original language | English |
|---|---|
| Journal | European Journal of Nuclear Medicine and Molecular Imaging |
| Volume | 45 |
| Issue number | 9 |
| Pages (from-to) | 1509-1525 |
| Number of pages | 17 |
| ISSN | 1619-7070 |
| DOIs | |
| Publication status | Published - 2018 |
Keywords
- Alzheimer’s disease
- Atypical Alzheimer
- Delphi
- Dementia with Lewy bodies
- FDG-PET
- Frontotemporal lobar degeneration
- PICO
- Pseudodementia
- Vascular dementia