Amyloid-PET and 18F-FDG-PET in the diagnostic investigation of Alzheimer's disease and other dementias: The Lancet Neurology

G. Chételat, J. Arbizu, H. Barthel, V. Garibotto, I. Law, S. Morbelli, E. van de Giessen, F. Agosta, F. Barkhof, D.J. Brooks, M.C. Carrillo, B. Dubois, A.M. Fjell, G.B. Frisoni, O. Hansson, K. Herholz, B.F. Hutton, Jr Jack C.R., A.A. Lammertsma, S.M. LandauS. Minoshima, F. Nobili, A. Nordberg, R. Ossenkoppele, W.J.G. Oyen, D. Perani, G.D. Rabinovici, P. Scheltens, V.L. Villemagne, H. Zetterberg, A. Drzezga

Research output: Contribution to journalArticlepeer-review


Various biomarkers are available to support the diagnosis of neurodegenerative diseases in clinical and research settings. Among the molecular imaging biomarkers, amyloid-PET, which assesses brain amyloid deposition, and 18F-fluorodeoxyglucose (18F-FDG) PET, which assesses glucose metabolism, provide valuable and complementary information. However, uncertainty remains regarding the optimal timepoint, combination, and an order in which these PET biomarkers should be used in diagnostic evaluations because conclusive evidence is missing. Following an expert panel discussion, we reached an agreement on the specific use of the individual biomarkers, based on available evidence and clinical expertise. We propose a diagnostic algorithm with optimal timepoints for these PET biomarkers, also taking into account evidence from other biomarkers, for early and differential diagnosis of neurodegenerative diseases that can lead to dementia. We propose three main diagnostic pathways with distinct biomarker sequences, in which amyloid-PET and 18F-FDG-PET are placed at different positions in the order of diagnostic evaluations, depending on clinical presentation. We hope that this algorithm can support diagnostic decision making in specialist clinical settings with access to these biomarkers and might stimulate further research towards optimal diagnostic strategies. © 2020 Elsevier Ltd
Original languageEnglish
Pages (from-to)951-962
Number of pages12
JournalLancet Neurol.
Issue number11
Publication statusPublished - 2020


  • amyloid
  • biological marker
  • fluorodeoxyglucose f 18
  • tracer
  • amyloid precursor protein
  • algorithm
  • Alzheimer disease
  • cerebrospinal fluid
  • clinical decision making
  • clinical outcome
  • cognitive defect
  • comorbidity
  • controlled study
  • degenerative disease
  • dementia
  • diagnostic value
  • differential diagnosis
  • diffuse Lewy body disease
  • early diagnosis
  • ethics
  • follow up
  • frontotemporal dementia
  • genotype
  • human
  • human tissue
  • mild cognitive impairment
  • molecular imaging
  • nerve degeneration
  • neuroimaging
  • nuclear magnetic resonance imaging
  • parkinsonism
  • positron emission tomography
  • posterior cingulate
  • priority journal
  • reimbursement
  • Review
  • aged
  • brain
  • case report
  • diagnostic imaging
  • male
  • metabolism
  • multiinfarct dementia
  • procedures
  • psychology
  • Aged
  • Alzheimer Disease
  • Amyloid beta-Protein Precursor
  • Brain
  • Dementia, Vascular
  • Diagnosis, Differential
  • Fluorodeoxyglucose F18
  • Humans
  • Male
  • Positron-Emission Tomography


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