TY - JOUR
T1 - Clinical utility of FDG-PET for the differential diagnosis among the main forms of dementia
AU - for the EANM-EAN Task Force for the Prescription of FDG-PET for Dementing Neurodegenerative Disorders
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
PY - 2018/5/7
Y1 - 2018/5/7
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
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U2 - 10.1007/s00259-018-4035-y
DO - 10.1007/s00259-018-4035-y
M3 - Article
AN - SCOPUS:85046553687
SP - 1
EP - 17
JO - European Journal of Pediatrics
JF - European Journal of Pediatrics
SN - 0340-6199
ER -