Clinical utility of FDG-PET for the clinical diagnosis in MCI

J Arbizu, C Festari, D Altomare, Z Walker, F Bouwman, J Rivolta, S Orini, H Barthel, F Agosta, A Drzezga, P Nestor, M Boccardi, GB Frisoni, F Nobili, for the EANM-EAN Task Force for the Prescription of FDG-PET for Dementing Neurodegenerative Disorders

Research output: Contribution to journalArticle

Abstract

Purpose: We aim to report the quality of accuracy studies investigating the utility of [ 18 F]fluorodeoxyglucose (FDG)-PET in supporting the diagnosis of prodromal Alzheimer’s Disease (AD), frontotemporal lobar degeneration (FTLD) and prodromal dementia with Lewy bodies (DLB) in mild cognitive impairment (MCI) subjects, and the corresponding recommendations made by a panel of experts. Methods: Seven panellist, four from the European Association of Nuclear Medicine, and three from the European Academy of Neurology, produced recommendations taking into consideration the incremental value of FDG-PET, as added on clinical-neuropsychological examination, to ascertain the aetiology of MCI (AD, FTLD or DLB). A literature search using harmonized population, intervention, comparison, and outcome (PICO) strings was performed, and an evidence assessment consistent with the European Federation of Neurological Societies guidance was provided. The consensual recommendation was achieved based on Delphi rounds. Results: Fifty-four papers reported the comparison of interest. The selected papers allowed the identification of FDG patterns that characterized MCI due to AD, FTLD and DLB. While clinical outcome studies supporting the diagnosis of MCI due to AD showed varying accuracies (ranging from 58 to 100%) and varying areas under the receiver-operator characteristic curves (0.66 to 0.97), no respective data were identified for MCI due to FTLD or for MCI due to DLB. However, the high negative predictive value of FDG-PET and the existence of different disease-specific patterns of hypometabolism support the consensus recommendations for the clinical use of this imaging technique in MCI subjects. Conclusions: FDG-PET has clinical utility on a fair level of evidence in detecting MCI due to AD. Although promising also in detecting MCI due to FTLD and MCI due to DLB, more research is needed to ultimately judge the clinical utility of FDG-PET in these entities. © 2018 Springer-Verlag GmbH Germany, part of Springer Nature
Original languageEnglish
Pages (from-to)1497-1508
Number of pages12
JournalEuropean Journal of Nuclear Medicine and Molecular Imaging
Volume45
Issue number9
DOIs
Publication statusPublished - 2018

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Frontotemporal Lobar Degeneration
Lewy Body Disease
Alzheimer Disease
Cognitive Dysfunction
Fluorodeoxyglucose F18
Neurology
Germany
Consensus
Outcome Assessment (Health Care)
Research
Population

Cite this

Arbizu, J., Festari, C., Altomare, D., Walker, Z., Bouwman, F., Rivolta, J., ... Disorders, F. T. EANM-EAN. T. F. F. T. P. O. FDG-PET. F. D. N. (2018). Clinical utility of FDG-PET for the clinical diagnosis in MCI. European Journal of Nuclear Medicine and Molecular Imaging, 45(9), 1497-1508. https://doi.org/10.1007/s00259-018-4039-7

Clinical utility of FDG-PET for the clinical diagnosis in MCI. / Arbizu, J; Festari, C; Altomare, D; Walker, Z; Bouwman, F; Rivolta, J; Orini, S; Barthel, H; Agosta, F; Drzezga, A; Nestor, P; Boccardi, M; Frisoni, GB; Nobili, F; Disorders, for the EANM-EAN Task Force for the Prescription of FDG-PET for Dementing Neurodegenerative.

In: European Journal of Nuclear Medicine and Molecular Imaging, Vol. 45, No. 9, 2018, p. 1497-1508.

Research output: Contribution to journalArticle

Arbizu, J, Festari, C, Altomare, D, Walker, Z, Bouwman, F, Rivolta, J, Orini, S, Barthel, H, Agosta, F, Drzezga, A, Nestor, P, Boccardi, M, Frisoni, GB, Nobili, F & Disorders, FTEANM-EANTFFTPOFDG-PETFDN 2018, 'Clinical utility of FDG-PET for the clinical diagnosis in MCI', European Journal of Nuclear Medicine and Molecular Imaging, vol. 45, no. 9, pp. 1497-1508. https://doi.org/10.1007/s00259-018-4039-7
Arbizu, J ; Festari, C ; Altomare, D ; Walker, Z ; Bouwman, F ; Rivolta, J ; Orini, S ; Barthel, H ; Agosta, F ; Drzezga, A ; Nestor, P ; Boccardi, M ; Frisoni, GB ; Nobili, F ; Disorders, for the EANM-EAN Task Force for the Prescription of FDG-PET for Dementing Neurodegenerative. / Clinical utility of FDG-PET for the clinical diagnosis in MCI. In: European Journal of Nuclear Medicine and Molecular Imaging. 2018 ; Vol. 45, No. 9. pp. 1497-1508.
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abstract = "Purpose: We aim to report the quality of accuracy studies investigating the utility of [ 18 F]fluorodeoxyglucose (FDG)-PET in supporting the diagnosis of prodromal Alzheimer’s Disease (AD), frontotemporal lobar degeneration (FTLD) and prodromal dementia with Lewy bodies (DLB) in mild cognitive impairment (MCI) subjects, and the corresponding recommendations made by a panel of experts. Methods: Seven panellist, four from the European Association of Nuclear Medicine, and three from the European Academy of Neurology, produced recommendations taking into consideration the incremental value of FDG-PET, as added on clinical-neuropsychological examination, to ascertain the aetiology of MCI (AD, FTLD or DLB). A literature search using harmonized population, intervention, comparison, and outcome (PICO) strings was performed, and an evidence assessment consistent with the European Federation of Neurological Societies guidance was provided. The consensual recommendation was achieved based on Delphi rounds. Results: Fifty-four papers reported the comparison of interest. The selected papers allowed the identification of FDG patterns that characterized MCI due to AD, FTLD and DLB. While clinical outcome studies supporting the diagnosis of MCI due to AD showed varying accuracies (ranging from 58 to 100{\%}) and varying areas under the receiver-operator characteristic curves (0.66 to 0.97), no respective data were identified for MCI due to FTLD or for MCI due to DLB. However, the high negative predictive value of FDG-PET and the existence of different disease-specific patterns of hypometabolism support the consensus recommendations for the clinical use of this imaging technique in MCI subjects. Conclusions: FDG-PET has clinical utility on a fair level of evidence in detecting MCI due to AD. Although promising also in detecting MCI due to FTLD and MCI due to DLB, more research is needed to ultimately judge the clinical utility of FDG-PET in these entities. {\circledC} 2018 Springer-Verlag GmbH Germany, part of Springer Nature",
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AU - Arbizu, J

AU - Festari, C

AU - Altomare, D

AU - Walker, Z

AU - Bouwman, F

AU - Rivolta, J

AU - Orini, S

AU - Barthel, H

AU - Agosta, F

AU - Drzezga, A

AU - Nestor, P

AU - Boccardi, M

AU - Frisoni, GB

AU - Nobili, F

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

PY - 2018

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N2 - Purpose: We aim to report the quality of accuracy studies investigating the utility of [ 18 F]fluorodeoxyglucose (FDG)-PET in supporting the diagnosis of prodromal Alzheimer’s Disease (AD), frontotemporal lobar degeneration (FTLD) and prodromal dementia with Lewy bodies (DLB) in mild cognitive impairment (MCI) subjects, and the corresponding recommendations made by a panel of experts. Methods: Seven panellist, four from the European Association of Nuclear Medicine, and three from the European Academy of Neurology, produced recommendations taking into consideration the incremental value of FDG-PET, as added on clinical-neuropsychological examination, to ascertain the aetiology of MCI (AD, FTLD or DLB). A literature search using harmonized population, intervention, comparison, and outcome (PICO) strings was performed, and an evidence assessment consistent with the European Federation of Neurological Societies guidance was provided. The consensual recommendation was achieved based on Delphi rounds. Results: Fifty-four papers reported the comparison of interest. The selected papers allowed the identification of FDG patterns that characterized MCI due to AD, FTLD and DLB. While clinical outcome studies supporting the diagnosis of MCI due to AD showed varying accuracies (ranging from 58 to 100%) and varying areas under the receiver-operator characteristic curves (0.66 to 0.97), no respective data were identified for MCI due to FTLD or for MCI due to DLB. However, the high negative predictive value of FDG-PET and the existence of different disease-specific patterns of hypometabolism support the consensus recommendations for the clinical use of this imaging technique in MCI subjects. Conclusions: FDG-PET has clinical utility on a fair level of evidence in detecting MCI due to AD. Although promising also in detecting MCI due to FTLD and MCI due to DLB, more research is needed to ultimately judge the clinical utility of FDG-PET in these entities. © 2018 Springer-Verlag GmbH Germany, part of Springer Nature

AB - Purpose: We aim to report the quality of accuracy studies investigating the utility of [ 18 F]fluorodeoxyglucose (FDG)-PET in supporting the diagnosis of prodromal Alzheimer’s Disease (AD), frontotemporal lobar degeneration (FTLD) and prodromal dementia with Lewy bodies (DLB) in mild cognitive impairment (MCI) subjects, and the corresponding recommendations made by a panel of experts. Methods: Seven panellist, four from the European Association of Nuclear Medicine, and three from the European Academy of Neurology, produced recommendations taking into consideration the incremental value of FDG-PET, as added on clinical-neuropsychological examination, to ascertain the aetiology of MCI (AD, FTLD or DLB). A literature search using harmonized population, intervention, comparison, and outcome (PICO) strings was performed, and an evidence assessment consistent with the European Federation of Neurological Societies guidance was provided. The consensual recommendation was achieved based on Delphi rounds. Results: Fifty-four papers reported the comparison of interest. The selected papers allowed the identification of FDG patterns that characterized MCI due to AD, FTLD and DLB. While clinical outcome studies supporting the diagnosis of MCI due to AD showed varying accuracies (ranging from 58 to 100%) and varying areas under the receiver-operator characteristic curves (0.66 to 0.97), no respective data were identified for MCI due to FTLD or for MCI due to DLB. However, the high negative predictive value of FDG-PET and the existence of different disease-specific patterns of hypometabolism support the consensus recommendations for the clinical use of this imaging technique in MCI subjects. Conclusions: FDG-PET has clinical utility on a fair level of evidence in detecting MCI due to AD. Although promising also in detecting MCI due to FTLD and MCI due to DLB, more research is needed to ultimately judge the clinical utility of FDG-PET in these entities. © 2018 Springer-Verlag GmbH Germany, part of Springer Nature

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