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

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

Research output: Contribution to journalArticlepeer-review

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 languageEnglish
Pages (from-to)1-17
Number of pages17
JournalEuropean Journal of Nuclear Medicine and Molecular Imaging
DOIs
Publication statusAccepted/In press - May 7 2018

Keywords

  • Alzheimer’s disease
  • Atypical Alzheimer
  • Delphi
  • Dementia with Lewy bodies
  • FDG-PET
  • Frontotemporal lobar degeneration
  • PICO
  • Pseudodementia
  • Vascular dementia

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

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